Department of Quantitative Health Sciences; Meyers Primary Care Institute
Medical Subject Headings
Acute Disease; Adult; Aged; Aged, 80 and over; Antilipemic Agents; Cardiovascular Agents; Counseling; Emergency Service, Hospital; Female; Hospital Mortality; Hospital Records; Hospitals, University; Humans; Male; Middle Aged; Patient Discharge; Pilot Projects; Puerto Rico; Stroke; Tomography, X-Ray Computed; Transportation of Patients; Young Adult
Biostatistics | Epidemiology | Health Services Research
BACKGROUND: Stroke is the third leading cause of death in Puerto Rico. We examined the pre-hospital phase, management and case-fatality-rates (CFR) of patients discharged with acute stroke from the Carolina University of Puerto Rico Hospital during 2007.
METHODS: Trained personnel collected information on demographics, delay-time, mode-of-transportation, management, and mortality from all medical records. STATAa was utilized to conduct univariate comparison of demographics, mode-of-transportation, therapeutics and diagnostic characteristics. Logistic regression analysis assessed cohort effect and controlled for confounders.
RESULTS: The average age was 69.1 years, and 53% were males. The average delay between onset of symptoms suggestive of stroke and arrival at the emergency department was 4.5 hours. Only 62% of patients utilized Emergency Medical Services (EMS). Intravenous thrombolysis was not administered. Stroke mortality increased with age. Ischemic vs. hemorrhagic CFR was significantly higher (63.9% vs. 36.10%; p = 0.034).
CONCLUSIONS: These findings highlight the potential benefit of evidence-based therapeutics and EMS use among stroke patients.
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Citation: Bol Asoc Med P R. 2009 Jul-Sep;101(3):11-3. Link to article on publisher's site