Functional Outcome Improvement In Patients With Stroke: Experience Of A Neovascular Care Unit

Fernando Gongora-Rivera,Alan Baltazar Trevino-Herrera,Alejandro Gonzalez-Aquines, Adolfo Cesar Cordero-Perez,Carlos Rodrigo Camara-Lemarroy,Adrian Infante-Valenzuela,Erick Garcia-Valadez, Hector Jorge Villarreal-Velazquez,Alejandro Marfil-Rivera, Hector Ramon-Martinez, Romulo Ramirez, Ricardo Rangel-Guerra, Hector J. Villarreal-Montemayor, Alfonso Gil-Valadez,Xochitl Ortiz, Oscar Cavazos, Victoria Montes, Donato Cantu, Antonio Anaya, Hazael Flores, Hector Julian-Calderon,Anally Soto-Garcia, Mildred Gutierrez, Ana Lucia-Herrera,Walter Muruet, Sergio Saldivar-Davila, Daniela Trevino-Herrera, Jonathan Rocha, Humberto Leal-Bailey, Mezli Espinosa-Ortega,Nicolas Escobedo-Zuniga,Denisse Martinez-Roque,Mario Cristobal-Nino

GACETA MEDICA DE MEXICO(2018)

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摘要
Background and objective : Neurovascular care units (NCU) have a positive impact on the functional prognosis of stroke patients. The effectiveness of NCUs in Mexico has not been evaluated. Our objective was to determine the impact of an NCU in a third-level academic hospital in northeastern of Mexico. Method: We performed a prospective observational, analytic cohort study. The population was divided into two periods: the first one consisted of those patients admitted before the implementation of the NCU (2008-2010), and the second period consisted of patients admitted after the implementation of the UCN (2010-2014). Functional status was assessed with the modified Rankin scale at discharge and 3 months. Results and conclusions: 598 patients were included (period 1: 246; period 2: 352). Patients in period 2 had a higher deep venous thrombosis prophylaxis (odds ratio [OR]: 3.235; 95 % confidence interval [95 % CI]: 2.18-4.80; p = 0.01), a shorter hospital stay (OR: 0.42; 95 % CI: 0.29-0.62: p = 0.01) and less severe disability (Rankin >= 3) at 3 months of follow-up (OR: 0.42; 95 % CI: 0.29-0.62; p = 0.01). The implementation of an NCU in a third-level academic hospital improved the functional outcome at 3 months and decreased the days of in-hospital stay of patients with stroke.
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关键词
Stroke, Stroke care unit, Functional outcome
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