Evolución del accidente cerebrovascular en la ciudad de Rivera, Uruguay

Abstract

Improving the health care dispensed to patients who have suffered a cerebrovascular accident (CVA) requires a thorough knowledge of its evolution. To examine the evolution of CVA and its subgroups by looking at the rates of mortality, recurrences and extra-neurological complications. We also sought to determine the value of different clinical scales and urinary incontinence at the beginning of CVA as factors that could potentially predict its severity. A third objective was to find out the time elapsed between the onset of CVA and the patient's contacting the medical team. The study, which spanned the period between 1st March 2000 and 28th February 2002, was conducted in the town of Rivera, which has a population of 62 859 and is located in the north of the Eastern Republic of Uruguay. During the first year of the study, 79 patients with CVA were registered, each of whom was clinically monitored for a year. The mortality rate at one month was 24% and at one year rose to 38%. The validity of certain factors predicting mortality due to CVA was confirmed as a lower score on the Glasgow scale, a higher score on the NIH impairment scale, and the presence of urinary incontinence, haemorrhagic CVA and total anterior circulation syndrome. In 87.3% of cases the patient was attended within the first 24 hours. The findings of this study will make it possible to adopt health care strategies to improve the quality of medical attention, lower the mortality rate and prevent sequelae in CVA patients.