Fibrinólisis Farmacológica en el Ictus Isquémico Agudo. Experiencia en un Hospital Terciario del Ecuador

Introduction. Pharmacological thrombolysis in ischemic stroke is associated with a better recovery. Objective. Describe the thrombolysis results after using r-Tpa applying an intrahospital stroke code, during one year. Methods. A prospective, longitudinal study was performed in patients with cerebral infarction admitted to the stroke unit, with clinical follow-up up to 3 months after hospital discharge. The variables evaluated were compared in two groups of patients (only one group received the treatment). Results. 107 patients were studied: 16 (14.9%) were thrombolyzed, 29 (27.1%) arrived in the therapeutic window period and 76 (71%) arrived after 4.5 hours. The average age was 68, 8 years and women predominated. The greatest impact of thrombolysis was on the difference in score between the initial assessment and the discharge on the NIHSS scale. At three months of evolution, the percentage of patients with mild disability (Rankin 0-2) was almost equal in the two groups. Mortality increased in patients with more severe disability (Rankin 3-5). Conclusions. Treatment with r-Tpa shows benefits at hospital discharge. Further analysis is required with a greater number of cases.