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Stroke Care and Application of Thrombolysis in Ibero-America

2019; Lippincott Williams & Wilkins; Volume: 50; Issue: 9 Linguagem: Inglês

10.1161/strokeaha.119.025668

1524-4628

María Alonso de Leciñana, Michael V. Mazya, Nikolaos Kostulas, Óscar H. Del Brutto, Carlos Abanto, Ayrton Roberto Massaro, Mario de Bastos, Sheila Cristina Ouriques Martins, Sebastián Ameriso, Fernando Góngora‐Rivera, Claudio Sacks, Arnold Hoppe, Patricio Abad, Gloria Meza, Antonio Araúz, Nils Wahlgren, Exuperio Díez–Tejedor, William Arias Sifontes, Margarita Cerda, Franz Chávez-Sell, Juan Carlos Durán, Gabriel De Freitas, Jorge Martinez Cerrato, Marco T. Medina, Nelson Novarro, Jamary Oliveira‐Filho, Octávio Marques Pontes‐Neto, G Pérez, Luis Salguero, Marina Romano, Claudia Gandolfo, Gustavo Herrera, Lorena Jure, María Elena Masih, R. Rey, Facundo Enrique Tomas, Magda Carla Ouriques Martins, Carlos Aguilera, P. Araya, Ludwig Codjambasis, J. Gigoux, R. Rivas, Mário Fernando Cerón-Muñoz, Juan Camilo Vargas, Tomás Alarcón, Braulio Martínez-Burbano, Jorge Moncayo, José Luis Ruíz‐Sandoval, Jorge Villarreal, Rosalía Vázquez, Juan A. Nader, Luis Manuel Murillo-Bonilla, Carolina Ponce de León, Aron Benzadón, Ernesto Triana, A. Guzman Olmedo, Donoband Melgarejo, Margarita Paredes, Rosa Ecos, Frank Solis, Vı́ctor Gómez, Greasse Muñoz, Juliana Aparcana, Luis Miguel Uchuya, Taly Paredes, A. Peralta, Enrique Salcedo, Luis Huaroto, Luis Vera, Martín Gavidia, Alejandro Calvo, Evelyn Mariños, Luís Eduardo Sandoval, Marcos Vilca, René Valderrama, I. Lafuente Villanueva, Daniel Diez-Canseco, Juan Barreto, Guillermo Molero–Castillo, Juan Carlos Lazo, José Cruz, Aglaé Duplat, Juan Carlos Guedes,

Venous Thromboembolism Diagnosis and Management

Standardized registries may provide valuable data to further improve stroke care. Our aim was to obtain updated information about characteristics of stroke patients and management of stroke across the Ibero-American countries, using a common in-hospital registry (Safe Implementation of Treatments in Stroke–Sociedad Iberoamericana de Enfermedades Cerebrovasculares) as a basis for further quality improvement.Data for this study were entered into the Safe Implementation of Treatments in Stroke registry from September 2009 to December 2013 by 58 centers in 14 countries. Data included demographics, risk factors, onset-to-door time, National Institutes of Health Stroke Scale score, stroke subtype, ischemic stroke etiology, treatments, 3-month mortality, and modified Rankin Scale score. Time to treatment was also recorded for patients treated with thrombolysis.Five thousand four hundred one patients were registered; median age, 65 years; 46% women; 3915 (72.5%) ischemic strokes; 686 (13.7%) hemorrhagic strokes; 213 (4.3%) subarachnoid hemorrhages; 414 (8.3%) transient ischemic attacks; and 31 (0.6%) cerebral vein thrombosis. The most prevalent risk factors were hypertension (71.3%), dyslipidemia (35.2%), and diabetes mellitus (23.6%). Atrial fibrillation was present in 15.1%. Three hundred one ischemic strokes were treated with intravenous thrombolysis (IVT; 7.7%). Patients undergoing IVT were more severely affected (median baseline National Institutes of Health Stroke Scale score, 11 versus 6). The rate of symptomatic intracerebral hemorrhages after IVT was 5.7%. At 3 months, 60.3% of IVT-treated patients and 59.1% of untreated patients were independent (modified Rankin Scale score, 0–2). Mortality was 11.4% in treated and 12.8% in untreated patients.Safe Implementation of Treatments in Stroke–Sociedad Iberoamericana de Enfermedades Cerebrovasculares is the largest registry of a general stroke population and the first study to evaluate the level of IVT use in Ibero-America. It provides valuable information that may help to improve the quality of stroke care in the Ibero-American region.