Evaluación de una unidad de tratamiento del ataque cerebral en un hospital universitario

Abstract

Background: Stroke is the second specific cause of death in Chile, with a mortality rate of 48.6 per 100.000 inhabitans. It accounts for 6% of all hospitalizations among adults. Aim: To study the type of patients hospitalized at a Stroke Unit in a general hospital and the costs and benefits of such unit. Material and methods: A descriptive and retrospective study using a patient registry, developed in Access® that included separate sections for ischemic and hemorrhagic stroke. Established diagnostic criteria were used. The mean costs per patient and complications were also calculated. Results: During 2003, 425 stroke patients were admitted to our hospital and 105 (age range 30-89 years, 58% female) were hospitalized at the Stroke Unit. Eighty three percent had ischemic and 16% had hemorrhagic stroke. The most common etiologies were thrombosis in 41%, embolism in 36%, lacunar in 13%, arterial dissection in 5% and transient ischemic attack in 3%. Fifty eight percent of patients had partial anterior ischemic stroke (PACI), 73% had hypertension and 29.5% diabetes. Only 18% arrived to the Stroke Unit with less of 6 hours of evolution, 7% of patients were admitted within the 3 hours after the onset of symptoms and 18%, from 3 to 6 hours. The mean lenght of stay in the Stroke Unit was 6.6 days and at the hospital 9.9 days (p <0.01). The mean costs per patient at the Stroke Unit and at the hospital were US$ 5.550 and US$ 4.815, respectively (p =ns). Conclusions: The Stroke Unit decreases hospital stay days without raising costs importantly. The inclusion criteria for stroke patients admitted to the Unit were adequate and the stroke registry allowed a good assessment of the Unit operation.