ictus isquémico agudo

Prevalence of Dehydration at Acute Ischemic Stroke Onset and the Impact of Dehydration Subtypes on Severity: A Prospective Observational Study. Prevalencia de la Deshidratación al Inicio del Ictus Isquémico Agudo y el Impacto de los Subtipos de Deshidratación en la Gravedad: Un Estudio Observacional Prospectivo

Background: Dehydration has been suggested to influence stroke severity and recovery through mechanisms like increased blood viscosity and thromboembolism risk. This study aims to estimate the prevalence of dehydration at acute ischemic stroke (AIS) onset and assess the impact of different dehydration subtypes on stroke severity.

Methods: This prospective observational study was conducted at a tertiary care center over a period of one year. Dehydration was assessed using specific biomarkers to check for intracellular dehydration (Group A using urine osmolarity, plasma osmolarity, urine/plasma osmolarity ratio >1.5) and mixed dehydration (Group B using BUN/creatinine ratio >0.20 ) parameters. Stroke severity was evaluated using the National Institutes of Health Stroke Scale (NIHSS).

Results: Out of 177 AIS admissions, 71 patients met the inclusion criteria (49 males, 22 females; average age: 61.1 years for males, 62.8 years for females). Dehydration was present in 65% of patients at stroke onset. Among dehydrated patients, 33.3% had abnormal Group A parameters, 30% had abnormal Group B parameters, and 36% had abnormalities in both groups. A significant correlation was found between the presence of multiple dehydration markers and increased stroke severity (p < 0.005).

Discussion: The high prevalence of dehydration in AIS patients at onset suggests it may be a potential trigger for stroke and exacerbates stroke severity. Dehydration subtypes, categorized into intracellular, mixed, and extracellular dehydration, have distinct physiological implications requiring specific management strategies. Further research into standardized protocols and innovative biomarkers for dehydration assessment is recommended to enhance patient outcomes.

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Palabras clave: Deshidratación, deshidratación extracelular, Deshidratación intracelular, ictus isquémico agudo, Prevención primaria, Prevención secundaria,

Keywords: acute ischemic stroke, Dehydration, extracellular dehydration, Intracellular dehydration, Primary prevention, Secondary prevention,

Índice leucoglucémico alto como predictor de mortalidad intrahospitalaria en pacientes con ictus isquémico agudo. High leuko-glycemic index as an in-hospital mortality predictor in patients with acute ischemical ictus

Objective: To demonstrate that the high leuko-glycemic index was a predictor of in-hospital mortality in patients with acute ischemic stroke of the Neurology Department at Belen of Trujillo Hospital in the period from January 2014 to December 2018.

Material and method: Observational, analytical, cohort and retrospective research, conducted at Belen of Trujillo Hospital, with a census sample of patients hospitalized in the Neurology department with diagnosis of acute ischemic stroke in the period from January 2014 to December 2018 , who met the selection criteria.

Results: 281 medical records were analyzed, where 18 were of deceased patients, of which 56% died with a leuko-glycemic index greater than 1600, the association being statistically significant (RRa: 6.33, CI: 95% [1.35 – 29.64]; p = 0.019). In addition, in the multivariate analysis, age greater than or equal to 80 years, admission moderate awareness disorder and in-hospital pneumonia were also relevant.

Conclusion: The high leuko-glycemic index was a predictor of in-hospital mortality in patients with acute ischemic stroke of the Neurology Department at Belen of Trujillo Hospital in the period from January 2014 to December 2018.

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Palabras clave: ictus isquémico agudo, índice leucoglucémico, mortalidad intrahospitalaria,

Keywords: acute ischemic stroke, in-hospital mortality, leuko-glycemic index,

Trombectomía Mecánica: Técnica de Primera Elección en el Tratamiento del Ictus Isquémico Agudo. Análisis de Beneficios y Resultados

The main objective of this article is to portrait mechanical thrombectomy as the modality of choice for interventional stroke treatment.

Methods and materials: Nine patients with acute ischemic stroke were diagnosed. Mechanical thrombectomy was perfomed in all of them with a solitaire type device associated with intraarterial rTPA. Eight patients (89%) had anterior vascular occlusion and only one (11%) had posterior vascular compromise. Treatment efficacy was assesed using a modified Rankin scale (mRs).

Results: Five patients (55%) had complete recovery while three of them (33%) had partial recovery. Only one patient (11%) showed no recovery at all.

Discussion: Although more data is needed, mechanical thrombectomy prooved to be effective and shows promising outcomes in patients with acute ischemic stroke.