Patients who present neurological symptoms compatible with an ischemic cerebrovascular event benefit from the use of alteplase (intravenous thrombolysis) as long as it is administered within 4.5 hours after the onset of symptoms.
Objective: Establish the time in hours that it takes our patients to arrive at the Emergency Department of the General Hospital Del Norte in Guayaquil Los Ceibos, Ecuador.
Methods: It is an observational, descriptive cross-sectional study that included 157 patients with a diagnosis of acute ischemic cerebrovascular event by computed tomography and/or magnetic resonance imaging and who attended the emergency room of our hospital between January and June, 2022 and from February to April 2023. Other variables such as percentage of thrombolyzed patients, sex, average age, age groups, blood pressure at admission and localization of the cerebral infarct were also studied.
Results: The average time in arrival hours was 34.7 hours, of which 18 (11.5 %) arrived up to 3.0 hours, 14 (8.9%) between > 3.0 to 4.5 hours and 125 subjects (79.6%) arrived after 4.5 hours from the onset of symptoms. Only 3.2 % of patients were thrombolyzed. Men were affected in 64.3% and women in 35.7%. The average age was 69 years old; by age groups, the vast majority ocurres after age 50 and only 8.3 % before that age. 72.6% were hypertensive and of these, 62.3% were male and 37.7% were female; by age groups, we see that 81.6% of hypertensive patients are between 60 and 89 years old. Regarding the location of the infarction, of all patients, the anterior territory is affected in 64.5% of cases and the posterior territory in 35.5%. Conclusions: Our patients arrive very late to the emergency room, well beyond the 4.5 hours that is the time during which they would benefit from thrombolytic treatment, the highest percentage of events ocurres after the age of 50, the majority are men, most arrive with hypertension and the anterior brain territory is more affected than the posterior.
