Actualización en diagnóstico y tratamiento del ataque cerebrovascular isquémico agudo

Alfonso, Carolina García; Reyes, Andrea Martínez; García, Valentina Herrera; Ricaurte-Fajardo, Andrés; Torres, Isabel Cristina Salazar; Coral, Juliana

doi:10.11144/javeriana.umed60-3.actu

Cited by 21 publications

(19 citation statements)

References 39 publications

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“…This study examined how indicators of social position were associated with cardiovascular risk factors, early emergency department consultation, access to reperfusion therapy, and mortality in the context of acute stroke treated at a referral hospital in Bogotá. The results can be summarised as follows [1]: between men and women, there was no difference in consultation time or management received; however, mortality was higher in women [2]; patients from rural areas more frequently had HT and dyslipidaemia, although there was no difference in arrival time or access to reperfusion therapy, mortality was higher in patients from rural areas [3]; lower schooling was associated with higher frequency of HT and dyslipidaemia, as well as delayed ED consultation [4]; patients with formal employment and those living in a household with a stratum ≥3 had earlier ED consultation and, like patients with a partner, had greater access to reperfusion therapy.…”

Section: Discussionmentioning

confidence: 99%

“…Once the hypoxic-ischaemic cascade is initiated, reperfusion therapy must be started within 4.5 h (in the case of intravenous thrombolysis) or within 6 h (in the case of mechanical thrombectomy) [3]. Once this time has elapsed, neuronal death and suffering are irreversible, resulting in a permanent clinical deficit [3]. Therefore, access to reperfusion therapy can also be considered as a marker of inequality.…”

Section: Introductionmentioning

confidence: 99%

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Risk Factors, Presentation, and Outcome in Acute Stroke according to Social Position Indicators in Patients Hospitalised in a Referral Centre in Bogotá 2011–2019

et al. 2023

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Introduction: Treatment of stroke is time-dependent and it challenges patients’ social and demographic context for timely consultation and effective access to reperfusion therapies. Objective: The objective of this study was to relate indicators of social position to cardiovascular risk factors, time of arrival, access to reperfusion therapy, and mortality in the setting of acute stroke. Methods: A retrospective analysis of patients with a diagnosis of ischaemic stroke in a referral hospital in Bogotá was performed. A simple random sample with a 5% margin of error and 95% confidence interval was selected. Patients were characterised according to educational level, place of origin, marital status, occupation, duration of symptoms before consultation, cardiovascular risk factors, access to reperfusion therapy, and mortality during hospitalisation. Results: 558 patients were included with a slight predominance of women. Diagnosis of diabetes was more common in women and smoking in men (n = 68, 28.4% vs. n = 51, 15.9%; p = 0.0004). Rural origin was associated with higher prevalence of hypertension, diabetes, and dyslipidaemia (hypertension n = 45, 73.8% vs. n = 282, 57.4%; p = 0.007; diabetes n = 20, 33.3% vs. 109, 19.5%; p = 0.02; dyslipidaemia n = 19, 32.7% vs. n = 93, 18.9%; p = 0.02). Mortality was higher in rural patients (n = 8, 14.2% vs. n = 30, 6.1%; p = 0.03). Lower schooling was associated with higher frequency of hypertension and dyslipidaemia (hypertension n = 152, 76.0% vs. n = 94, 46.3%; p ≤ 0.0001; dyslipidaemia n = 56, 28% vs. n = 35, 17.0%; p = 0.009) as well as with late consultation (n = 30, 15% vs. n = 59, 28.7%; p = 0.0011) and lower probability of accessing reperfusion therapy (n = 12, 6% vs. n = 45, 22%; p ≤ 0.0001). Formal employment was associated with a visit to the emergency department in less than 3 h (n = 50, 25.2% vs. n = 58, 18%, p = 0.04 and a higher probability of accessing reperfusion therapy (n = 35, 17.6% vs. n = 33, 10.2%; p = 0.01). Finally, living in a household with a stratum higher than 3 was associated with a consultation before 3 h (n = 77, 25.5% vs. n = 39, 15.6%; p = 0.004) and a higher probability of reperfusion therapy (n = 57, 18.9% vs. n = 13, 5.2%; p ≤ 0.0001). Conclusion: Indicators of socio-economic status are related to mortality, consultation time, and access to reperfusion therapy. Mortality and reperfusion therapy are inequitably distributed and, therefore, more attention needs to be directed to the cause of these disparities in order to reduce the access gap in the context of acute stroke in Bogotá.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Risk Factors, Presentation, and Outcome in Acute Stroke according to Social Position Indicators in Patients Hospitalised in a Referral Centre in Bogotá 2011–2019

et al. 2023

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“…The demographic and epidemiological transition has allowed an increase in life expectancy worldwide (1); therefore, living with more than one Chronic Non-Communicable Disease (CNCD) (2) such as arterial hypertension, Type II diabetes, dyslipidemias, and heart diseases, which are risk factors to develop a stroke, requires greater demand of constant health care measures in older adults (OAs) (3).…”

Section: Introductionmentioning

confidence: 99%

Transition to the Role of Family Caregiver of Older Adults After a Stroke: A Specific Theory

Saucedo-Pahua,

López-González,

Gómez-García

et al. 2023

Aquichan

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Introduction: Nursing professionals develop situation-specific theories to describe, explain, and provide comprehensive care during a family member’s transition to the caregiver role. Objective: To develop a situation-specific theory about the transition to the role of family caregiver of older adults after a stroke. Methodology: The integrating approach by Meleis and Im was applied, which consists of five stages: 1) Description of the context and target population, 2) Verification of assumptions regarding the philosophical stance, 3) Exploration of multiple sources, 4) Theorization of concepts, and 5) Proposal of empirical indicators for validation and verification. Results: The prescriptive theory was developed in the light of Afaf Meleis’ Theory of Transitions and was supported by an exhaustive literature review, with four underlying concepts: Situational transition to the family caregiver role, Care-related knowledge and skills, Self-confidence and coping in adopting the caregiver role, and Nursing therapeutic education. The following assumption emerges from these concepts: a healthy transition to the family caregiver role is directly dependent on the care-related knowledge and skills provided by Nursing therapeutic education to develop self-confidence and coping in adopting the caregiver role. Conclusions: The proposal provides a conceptual framework that identifies the transition challenges and needs faced by family caregivers to adopt the role of caregivers of older adults after a stroke.

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“…La enfermedad cerebrovascular (ECV) es aquella anormalidad en la funcionalidad del sistema nervioso central, causada por una interferencia entre el aporte de sangre al cerebro, provocando una pérdida temporal o permanente de movilidad, actividad mental, memoria, lenguaje y/o sensación 1 .…”

Section: Introductionunclassified

Serie de casos sobre el cuidado al adulto con enfermedad cerebrovascular en el hogar

Andrade

2022

CuidArte

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Introducción: La enfermedad cerebrovascular es una de las primeras causas de mortalidad y discapacidad en el mundo, las personas con esta afección presentan diversas limitaciones físicas que le impiden ejecutar actividades de la vida diaria. Por ello, el objetivo de este proyecto fue implementar un programa de cuidado al adulto con enfermedad cerebrovascular en el hogar, el cual buscó conseguir el máximo nivel posible de funcionalidad, reduciendo la incapacidad y aumentando la independencia, en colaboración con la familia. Presentación de los casos: Pacientes que habían presentado un evento cerebrovascular en los seis meses previos al ingreso al programa de cuidado, se desarrolló en la ciudad de Guanajuato, donde los participantes permitieron el acceso a sus hogares, para brindar cuidados personales, rehabilitación, terapia ocupacional y prevención de úlceras por presión, lo anterior apegado al código de ética que rige al profesional de salud. El programa tuvo una duración de 10 semanas, donde participaron ocho personas y sus familias, logrando que 4 participantes disminuyeran su déficit neurológico, 2 mejoraron su puntuación en la escala NIHSS; la funcionalidad de las personas mejoró y no hubo presencia de úlceras. Conclusión: La rehabilitación es prioritaria para la recuperación de las personas por lo que debe comenzar desde el período de hospitalización, así mismo la intervención en el hogar permitió que los cuidados fueran personalizados a las necesidades de cada persona y familia, permitiendo coadyuvar con la recuperación, rehabilitación y re-incorporación del enfermo a su cotidianidad.

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Actualización en diagnóstico y tratamiento del ataque cerebrovascular isquémico agudo

Cited by 21 publications

References 39 publications

Risk Factors, Presentation, and Outcome in Acute Stroke according to Social Position Indicators in Patients Hospitalised in a Referral Centre in Bogotá 2011–2019

Risk Factors, Presentation, and Outcome in Acute Stroke according to Social Position Indicators in Patients Hospitalised in a Referral Centre in Bogotá 2011–2019

Transition to the Role of Family Caregiver of Older Adults After a Stroke: A Specific Theory

Serie de casos sobre el cuidado al adulto con enfermedad cerebrovascular en el hogar

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