Universidade Estadual de Santa Cruz, Departamento de Ciências da Saúde, Ilhéus, Brazil.
Universidade Federal da Bahia, Departamento de Neurologia, Salvador, Brazil.
Arq Neuropsiquiatr. 2022 Aug;80(8):770-778. doi: 10.1055/s-0042-1755228. Epub 2022 Oct 17.
Stroke is one of the most common causes of death and incapacity in the world. The benefits of reperfusion therapies and hospitalization in neurologic intensive care units (ICUs) are undeniable. However, these treatments are not widely available in a continental-sized country like Brazil.
To describe the treatment for ischemic stroke and the functional outcome 90 days after the hospitalization of patients in the Brazilian countryside.
Observational, prospective case series study design. The data collected refer to randomly selected patients hospitalized in 3 hospitals in the south region of the state of Bahia between December 2018 and December 2019.
The population consisted of 61 consecutive patients. They were elderly (median age: 62 years old); with a predominance of hypertension (82%); and were light to moderate stroke cases (National Institute of Health Stroke Scale [NIHSS] median: 7). A total of 37.7% of the cases arrived at the hospital in a < 4.5-hour window but received no reperfusion therapy. Of these, 94.3% were discharged from the hospital with a prescription for antiplatelets or anticoagulant. A total of 64.1% of the patients received a statin prescription. At the end of the follow-up period, the general mortality was 21%. Almost half of the population (47.9%) evolved to an unfavored outcome (modified Rankin scale [mRs]: 3 to 6).
Our population presented sociodemographic and comorbidities characteristics similar to those of other national samples. No reperfusion therapy was used and the treatment was basically secondary and prophylaxis-oriented, and almost half of the population evolved with incapacities and a high mortality rate, despite the initial low clinical gravity.
中风是世界上最常见的死亡和丧失能力原因之一。再灌注治疗和在神经重症监护病房（NICUs）住院的益处是不可否认的。然而，在像巴西这样的大陆国家，这些治疗方法并不广泛。
描述巴西农村地区缺血性中风患者的治疗方法和住院 90 天后的功能结局。
观察性、前瞻性病例系列研究设计。收集的数据涉及 2018 年 12 月至 2019 年 12 月期间在巴伊亚州南部的 3 家医院住院的随机选择的患者。
该人群由 61 例连续患者组成。他们年龄较大（中位数年龄：62 岁）；高血压（82%）为主；中风程度较轻到中度（国立卫生研究院中风量表 [NIHSS]中位数：7）。37.7%的病例在<4.5 小时的时间窗内到达医院，但未接受再灌注治疗。其中，94.3%的患者出院时开了抗血小板或抗凝药物。共有 64.1%的患者开了他汀类药物。在随访期末，总死亡率为 21%。近一半的患者（47.9%）出现不良结局（改良 Rankin 量表[mRs]：3 至 6）。
我们的人群具有与其他国家样本相似的社会人口学和合并症特征。未使用再灌注治疗，治疗主要是二级和预防为导向，尽管初始临床严重程度较低，但近一半的患者仍出现残疾和高死亡率。
