Aguilar-Salas Emmanuel, Rodríguez-Aquino Guadalupe, García-Domínguez Katya, Garfias-Guzmán Catalina, Hernández-Camarillo Erika, Oropeza-Bustos Nayeli, Arguelles-Castro Rubí, Mitre-Salazar Ameyalli, García-Torres Gloria, Reynoso-Marenco Marco, Morales-Andrade Eduardo, Gervacio-Blanco Luis, García-López Víctor, Valiente-Herves Gabriel, Martínez-Marino Manuel, Flores-Silva Fernando, Chiquete Erwin, Cantú-Brito Carlos
Department of Neurology and Psychiatry, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City 14080, Mexico.
Department of Neurology, Hospital de Especialidades "Dr. Belisario Domínguez", Mexico City 09930, Mexico.
Brain Sci. 2022 Jun 30;12(7):865. doi: 10.3390/brainsci12070865.
Background: Acute stroke care has greatly improved in recent decades. However, the increasing stroke mortality in low-to-middle income countries suggests that progress has not been reached completely by these populations. Here we present the analysis of the hospital phase of the first population-based stroke surveillance study. Methods: A daily hospital surveillance method was used to identify adult patients with acute stroke during 18 months in six hospitals. We abstracted data on demographics, vascular risk factors, neuroimaging-confirmed stroke types, and clinical data. Results: A total of 1361 adults with acute stroke were identified (mean age 69.2 years; 52% women) with transient ischemic attack (5.5%), acute ischemic stroke (68.6%), intracerebral hemorrhage (23.1%), cerebral venous thrombosis (0.2%), and undetermined stroke (2.6%). The main risk factors were hypertension (80.7%) and diabetes mellitus (47.6%). The usage rate of thrombolysis was 3.6%, in spite of the fact that 37.2% of acute ischemic stroke patients arrived in <4.5 h. The 30-day case fatality rate was 32.6%, higher in hemorrhagic than ischemic stroke. Conclusion: We identified limitations in acute stroke care in the Mexico City, including neuroimaging availability and thrombolysis usage. The door-to-door phase will help to depict the acute stroke burden in Mexico.
近几十年来，急性卒中护理有了很大改善。然而，低收入和中等收入国家卒中死亡率不断上升，这表明这些人群尚未完全取得进展。在此，我们展示了第一项基于人群的卒中监测研究的医院阶段分析。方法：采用每日医院监测方法，在6家医院对18个月内的成年急性卒中患者进行识别。我们提取了人口统计学、血管危险因素、神经影像学确诊的卒中类型及临床数据。结果：共识别出1361例成年急性卒中患者（平均年龄69.2岁；52%为女性），包括短暂性脑缺血发作（5.5%）、急性缺血性卒中（68.6%）、脑出血（23.1%）、脑静脉血栓形成（0.2%）和未定型卒中（2.6%）。主要危险因素为高血压（80.7%）和糖尿病（47.6%）。尽管37.2%的急性缺血性卒中患者在4.5小时内到达医院，但溶栓使用率仅为3.6%。30天病死率为32.6%，出血性卒中高于缺血性卒中。结论：我们发现墨西哥城急性卒中护理存在局限性，包括神经影像学检查的可及性和溶栓治疗的使用情况。入户阶段将有助于描绘墨西哥的急性卒中负担。
