Napon Christian, Dabilgou Anselme, Kyelem Julie, Bonkoungou Papougnézambo, Kaboré Jean
Neurology Department, Hospital Yalgado OUEDRAOGO, Ouagadougou, Burkina Faso.
Neurology Department, Hospital Yalgado OUEDRAOGO, Ouagadougou, Burkina Faso.
J Neurol Sci. 2017 Jan 15;372:75-77. doi: 10.1016/j.jns.2016.11.017. Epub 2016 Nov 14.
The advent of the neurovascular units and thrombolysis has improved support for stroke in developed countries. Our objective was to study the therapeutic route of stroke patients in Burkina Faso, a country with limited resources.
It was a prospective cohort study over a period of 4months, from February 02, 2014 to June 05, 2014, in medical emergencies and Neurology department of the teaching hospital Yalgado Ouedraogo. The study focused on patients diagnosed with stroke through brain imaging when they first entered hospital or during hospitalization. Variables of the study included socio-demographic data of the patients, route of the patients, nature of the stroke, treatment and clinical course.
The time between the onset of clinical signs and the first contact with a peripheral public health unit extended from 30min to 24h with an average of 6h and 56min. The minimum time between the first contact with a peripheral public health unit and medical emergencies of the Teaching Hospital Yalgado Ouédraogo was 15min, and the maximum, two weeks. After their arrival in medical emergencies, patients spent on average 21h and 18min to achieve the cerebral CT scan. Concerning the treatment, the thrombolysis, which was not available yet, had never been prescribed, while 19% of patients were eligible according to the 4h30mn period criteria.
Our study shows that the long delay in the access of neurological expertise is, in most cases, related to the therapeutic route of patients. Thus, the setting-up of a stroke sector would improve the management and the prognosis of cases in Burkina Faso.
神经血管单元和溶栓治疗的出现改善了发达国家对中风患者的支持。我们的目标是研究资源有限的布基纳法索中风患者的治疗途径。
这是一项前瞻性队列研究,为期4个月,从2014年2月2日至2014年6月5日,在亚尔加杜·韦德拉奥果教学医院的医疗急救科和神经科进行。该研究聚焦于首次入院或住院期间通过脑部成像被诊断为中风的患者。研究变量包括患者的社会人口统计学数据、患者的就诊途径、中风的性质、治疗情况和临床病程。
临床症状出现与首次接触基层公共卫生单位之间的时间从30分钟延长至24小时,平均为6小时56分钟。首次接触基层公共卫生单位与亚尔加杜·韦德拉奥果教学医院医疗急救科之间的最短时间为15分钟,最长为两周。患者到达医疗急救科后,平均花费21小时18分钟才进行脑部CT扫描。关于治疗,当时尚无溶栓治疗,也从未被处方过,而根据4小时30分钟的标准,19%的患者符合条件。
我们的研究表明,在大多数情况下,获得神经专科治疗的长时间延迟与患者的治疗途径有关。因此,在布基纳法索设立一个中风专科将改善病例的管理和预后。