New paradigms: 12 years of systemic thrombolysis. Stroke Unit, Clinicas Hospital

Introduction: Strokes are a health problem and sys-temic thrombolysis constitutes a reperfusion strategy backed up by significant evidence on its positive the-rapeutic impact. National reports on its use are scarce. Objectives: To report and analyze results obtained with this therapeutic approach at the Clinicas Hospital. To establish predictive factors for a good evolution, in-tracranial hemorrhage and mortality. Method: Observational, analytical study of throm-bolysed patients at Clinicas Hospital (2010-2021). Re -sults: Systemic thrombolysis was performed in 268 patients. Average NIHSS score was 12 points when admitted to hospital.42 % of cases were total anterior circulation infarct (TACI). Cardioembolic ischaemmic stroke was the most frequent etiopahogenesis. 59.3% of patients were discharged with functional independence and 55.2% had minimal neurologic deficit. Symptomatic intracranial hemorrhage and mortality rates were 7.1% and 18.7% respectively. 57% of patients were assisted within <60 minutes they showed up at the ER. Throm-bolysis percentage in total number of strokes was 18.9%. Age, NIHSS score upon arrival to hospital and admission to the stroke unit were significant variables to predict a good evolution, intracranial hemorrhage and death. Discussion and conclusions: The large number of cases in the country was reported. Effectiveness and sa-fety parameters for this treatment were comparable to those reported internationally. The good door-to -need-le time and thrombolysis rate versus total number of strokes stood out as satisfactory indicators of health-care quality. Admission to the stroke unit behaved as a predictive factor of functional independence and it protected patients from hospital mortality.