Evaluación de la eficacia de la implementación del Código Stroke en pacientes con ECV isquémico a partir de su evolución clínica posterior al tratamiento con rtPA en el Hospital General del Norte IESS Los Ceibos en el período comprendido entre 1 abril del 2018 y 31 de diciembre del 2019.

Abstract

Introduction: Cerebrovascular disease is a clinical syndrome characterized by the acute onset of neurological deficit due to loss of focal function of the CNS as a result of compromised cerebral circulation. There are two types of cerebrovascular disease: ischemic stroke 80-85% and hemorrhagic stroke 15-20%. The gold standard treatment of acute ischemic stroke (AIS) is intravenous rt-PA and it has been developed a protocol, called Stroke Code, in order to improve the patient approach, the thrombolized patient rate and to decrease functional disability and mortality. Objective: The main objective of this research work is to evaluate the effectiveness of the implementation of the Stroke Code in patients with AIS based on their clinical evolution after treatment with intravenous rt-PA. Methods: A prospective longitudinal observational study was performed. Among the 101 patients diagnosed with AIS, 13 were treated with rt-PA under the NIHSS inclusion and exclusion criteria. The clinical evolution were analyzed using the NIHSS Scale at the admission in the emergency room, after treatment with rt-PA, at the moment of hospital discharge and at the 3-months-control. Results:The male gender was the most affected with 53.8% and then female with 46.2%. The age group most affected was the patientes between 61 and 75 years old. It was reported that 53.8% of AIS patients had a severe stroke messured by NIHSS scale at the admission. After the administration of rt-PA, 69.2% of the patients obtained a moderate NIHSS. At the 3-months-control, a mild NIHSS was observed in 69.2% of the patients and a moderate NIHSS in a 30.8%. Conclusion: The efficacy of the Stroke Code in AIS patients was proved based on the good clinical evolution messured by NIHSS and Rankin Scale through the established timeline. A therapeutic success of 75% was found.