Authors

Ylenia Vigil González1, Lorena Benavente Fernández2, Sergio Calleja Puerta3

Position

1Máster en Enfermería de Urgencias y Cuidados Críticos. Enfermera. Hospital Universitario Central de Asturias. Oviedo (Asturias)2Doctora en Medicina. Neuróloga adjunta. Servicio de Neurología. Hospital Universitario Central de Asturias. Profesora asociada. Departamento de Medicina. Universidad de Oviedo (Asturias)3Doctor en Medicina. Neurólogo adjunto. Servicio de Neurología. Hospital Universitario Central de Asturias. Oviedo (Asturias)

Contact address

Ylenia Vigil González. Hospital Universitario Central de Asturias. Avda. de Roma, s/n. 33011 Oviedo (Asturias).

Contact email: yleniavigil@gmail.com

Abstract

Objective: to learn about the evolution of patients hospitalized and treated at the Stroke Unit of a third-level hospital following the current model of treatment, compared with those patients previously hospitalized and treated in a conventional Neurology ward.
Method: an observational retrospective study, on patients managed at the Hospital Universitario Central de Asturias after suffering a stroke, conducted in two stages: before the Stroke Unit was set up (January, 1st to 31st, 2009), and after implementing the unit (January, 1st to 31st, 2014). A notebook for data collection was designed. The TOAST classification system was used, as well as the NIHSS scale (for stroke severity) and the modified Rankin scale (level of physical disability after a stroke). A review of electronic clinical records was conducted through Cerner Millenium. Analysis was conducted with the SPPS statistical package, version 22.
Results: the study included 152 patients in 2009 and 132 patients in 2014; their mean age was 73.92 years, and the majority were male (62.9%). There was a reduction in hospitalization days and mortality during admission between 2009 and 2014. There was a twofold increase in the number of activations of the Stroke Code protocol. The application of recanalization treatments increased from 16.1% to 20.4%. The early initiation in physical therapy increased from 7% to 33% since the creation of the Stroke Unit; those patients who did not require physical therapy increased from 42% to 80%.
Conclusions: the implementation of the Stroke Unit and the activation of the Stroke Code have contributed to improve the results in identification, classification, treatment, follow-up and results at discharge, in patients hospitalized for stroke.

Keywords:

stroke; evaluation of disability; patient severity; physical therapy; nursing care

Versión en Español

Título:

Evolución de la atención al ictus en un hospital de tercer nivel