Zevallos Juan Carlos, Gonzalez Juan, Santiago Fernando, Rodríguez Rafael, Rivera Ada, García Ana Michelle, Flecha Felixa, Colón Marielys, Yarzebski Jorge
Office of Clinical Research, Endowed Health Services Research Center, San Juan, PR 00936-5067.
Bol Asoc Med P R. 2009 Jul-Sep;101(3):11-3.
Stroke is the third leading cause of death in Puerto Rico. We examined the pre-hospital phase, management and case-fatality-rates (CFR) of patients discharged with acute stroke from the Carolina University of Puerto Rico Hospital during 2007.
Trained personnel collected information on demographics, delay-time, mode-of-transportation, management, and mortality from all medical records. STATAâ was utilized to conduct univariate comparison of demographics, mode-of-transportation, therapeutics and diagnostic characteristics. Logistic regression analysis assessed cohort effect and controlled for confounders.
The average age was 69.1 years, and 53% were males. The average delay between onset of symptoms suggestive of stroke and arrival at the emergency department was 4.5 hours. Only 62% of patients utilized Emergency Medical Services (EMS). Intravenous thrombolysis was not administered. Stroke mortality increased with age. Ischemic vs. hemorrhagic CFR was significantly higher (63.9% vs. 36.10%; p = 0.034).
These findings highlight the potential benefit of evidence-based therapeutics and EMS use among stroke patients.