Stroke Care and Application of Thrombolysis in Ibero-America Report From the SITS-SIECV Ibero-American Stroke Register
Journal
Stroke
ISSN
0039-2499
1524-4628
Date Issued
2019
Author(s)
María Alonso de Leciñana
Michael V. Mazya
Nikolaos Kostulas
Oscar H. Del Brutto
Carlos Abanto
Ayrton R. Massaro
Mario de Bastos
Sheila Martins
Sebastian F. Ameriso
Fernando Gongora-Rivera
Claudio Sacks
Patricio Abad
Gloria Meza
Antonio Arauz-Gongora
Nils Wahlgren
Exuperio Díez-Tejedor
William Arias Sifontes
Margarita Cerda
Franz Chávez-Sell
Juan Carlos Duran
Gabriel de Freitas
Jorge Martinez Cerrato
Marco Tulio Medina
Nelson Novarro
Jamary Oliveira-Filho
Octavio Pontes Neto
German Enrique Perez
Luis Salguero
Marina Romano
Claudia Gandolfo
Gustavo Herrera
Lorena Jure
María Elena Masih
Raul Rey
Facundo Enrique Tomas
Magda Carla Martins
Carlos Aguilera
Pablo Araya
Ludwig Codjambasis
Juan Gigoux
Rodrigo Rivas
Mario Muñoz
Juan Camilo Vargas
Tomás Alarcón
Braulio Martínez
Jorge Moncayo
José Luis Ruiz-Sandoval
Jorge Villarreal
Rosalía Vázquez
Juan Nader
Luis Murillo-Bonilla
Carolina León
Arón Benzadón
Ernesto Triana
Aurora Olmedo
Donoband Melgarejo
Margarita Paredes
Rosa Ecos
Frank Solis
Víctor Gómez
Greasse Muñoz
Juliana Aparcana
Luis Miguel Uchuya
Taly Paredes
Antero Peralta
Enrique Salcedo
Luis Huaroto
Luis Vera
Martín Gavidia
Alejandro Calvo
Evelyn Mariños
Luis Sandoval
Marcos Vilca
René Valderrama
Isolina Villanueva
Daniel Diez-Canseco
Juan Barreto
Guillermo Castillo
Juan Carlos Lazo
José Cruz
Aglaé Duplat
Juan Carlos Guedes
Type
Resource Types::text::journal::journal article
DOI
URL
Abstract
<jats:sec> <jats:title>Background and Purpose—</jats:title> <jats:p>Standardized registries may provide valuable data to further improve stroke care. Our aim was to obtain updated information about characteristics of stroke patients and management of stroke across the Ibero-American countries, using a common in-hospital registry (Safe Implementation of Treatments in Stroke–Sociedad Iberoamericana de Enfermedades Cerebrovasculares) as a basis for further quality improvement.</jats:p> </jats:sec> <jats:sec> <jats:title>Methods—</jats:title> <jats:p>Data for this study were entered into the Safe Implementation of Treatments in Stroke registry from September 2009 to December 2013 by 58 centers in 14 countries. Data included demographics, risk factors, onset-to-door time, National Institutes of Health Stroke Scale score, stroke subtype, ischemic stroke etiology, treatments, 3-month mortality, and modified Rankin Scale score. Time to treatment was also recorded for patients treated with thrombolysis.</jats:p> </jats:sec> <jats:sec> <jats:title>Results—</jats:title> <jats:p>Five thousand four hundred one patients were registered; median age, 65 years; 46% women; 3915 (72.5%) ischemic strokes; 686 (13.7%) hemorrhagic strokes; 213 (4.3%) subarachnoid hemorrhages; 414 (8.3%) transient ischemic attacks; and 31 (0.6%) cerebral vein thrombosis. The most prevalent risk factors were hypertension (71.3%), dyslipidemia (35.2%), and diabetes mellitus (23.6%). Atrial fibrillation was present in 15.1%. Three hundred one ischemic strokes were treated with intravenous thrombolysis (IVT; 7.7%). Patients undergoing IVT were more severely affected (median baseline National Institutes of Health Stroke Scale score, 11 versus 6). The rate of symptomatic intracerebral hemorrhages after IVT was 5.7%. At 3 months, 60.3% of IVT-treated patients and 59.1% of untreated patients were independent (modified Rankin Scale score, 0–2). Mortality was 11.4% in treated and 12.8% in untreated patients.</jats:p> </jats:sec> <jats:sec> <jats:title>Conclusions—</jats:title> <jats:p>Safe Implementation of Treatments in Stroke–Sociedad Iberoamericana de Enfermedades Cerebrovasculares is the largest registry of a general stroke population and the first study to evaluate the level of IVT use in Ibero-America. It provides valuable information that may help to improve the quality of stroke care in the Ibero-American region.</jats:p> </jats:sec>