Determinantes del tiempo puerta-aguja en trombolisis endovenosa en el infarto cerebral, experiencia de un centro
Date
2020
Type:
Article
item.page.extent
item.page.accessRights
item.contributor.advisor
ORCID:
Journal Title
Journal ISSN
Volume Title
Publisher
item.page.isbn
item.page.issn
item.page.issne
item.page.doiurl
item.page.other
item.page.references
Abstract
Background: Intravenous thrombolysis (IT) in acute ischemic stroke (AIS)
is time dependent. The time elapsed from hospital admission to the thrombolytic
bolus is named door to needle time (DNT) and is recommend to be of less than
60 min. Aim: To describe the DNT in our center and determine those factors
associated with a DNT longer than 60 min. Material and Methods: Prospective analysis of patients treated with IT at a private hospital between June 2016
and June 2019. The percentage of patients with DNT exceeding 60 min, and
the causes for this delay were evaluated. Results: IT was used in 205 patients.
DNT was 43.6 ± 23.8 min. Forty patients (19.5% (95% CI, 14.4-25.7), had
a DNT longer than 60 min. Uni-varied analysis demonstrated that AIS with
infratentorial symptomatology (ITS), was significantly associated with DNTs
exceeding 60 min. A history of hypertension, a higher NIH Stroke Scale score, the
presence of an hyperdense sign in brain tomography (p = 0.001) and the need
for endovascular therapy (p = 0.019), were associated with DNT shorter than
60 min. Multivariate analysis ratified the relationship between ITS and DNT
longer than 60 min (Odds ratio: 3.19, 95% confidence intervals 1.26-8). Conclusions: The individual elements that correlated with a DNT longer than 60 min
were the failure to detect the AIS during triage and doubts about its diagnosis
Description
item.page.coverage.spatial
item.page.sponsorship
Citation
Revista Médica de Chile, 2020, vol.148(8): 1090-1095
Keywords
Stroke, Triage, Thrombolytic Therapy