title: In-hospital stroke: a multi-centre prospective registry.
abstract: BACKGROUND
  in-hospital strokes (IHS) are relatively frequent. Avoidable delays in neurological assessment have been demonstrated. We study the clinical characteristics, neurological care and mortality of IHS.
  
  
  METHODS
  multi-centre 1-year prospective study of IHS in 13 hospitals. Demographic and clinical characteristics, admission diagnosis, quality of care, thrombolytic therapy and mortality were recorded.
  
  
  RESULTS
  we included 273 IHS patients [156 men; 210 ischaemic strokes (IS), 37 transient ischaemic attacks (TIA) and 26 cerebral haemorrhages]. Mean age was 72 ± 12 years. Cardiac sources of embolism were present in 138 (50.5%), withdrawal of antithrombotic drugs in 77 (28%) and active cancers in 35 (12.8%). Cardioembolic stroke was the most common subtype of IS (50%). Reasons for admission were programmed or urgent surgery in 70 (25%), cardiac diseases in 50 (18%), TIA or stroke in 30 (11%) and other medical illnesses in 71 (26%). Fifty-two per cent of patients were evaluated by a neurologist within 3 h of stroke onset. Thirty-three patients received treatment with tPA (15.7%). Thirty-one patients (14.7%) could not be treated because of a delay in contacting the neurologist. During hospitalization, 50 patients (18.4%) died, 41 of them because of the stroke or its complications.
  
  
  CONCLUSIONS
  cardioembolic IS was the most frequent subtype of stroke. Cardiac sources of embolism, active cancers and withdrawal of antithrombotic drugs constituted special risk factors for IHS. A significant proportion of patients were treated with thrombolysis. However, delays in contacting the neurologist excluded a similar proportion of patients from treatment. IHS mortality was high, mostly because of stroke.
authors.affiliation: Hospital Ramón y Cajal, Madrid Hospital La Fe, Valencia Hospital La Paz, Madrid, Spain.
authors.forename: R
authors.initials: R
authors.lastname: Vera
authors.forename: A
authors.initials: A
authors.lastname: Lago
authors.forename: B
authors.initials: B
authors.lastname: Fuentes
authors.forename: J
authors.initials: J
authors.lastname: Gállego
authors.forename: J
authors.initials: J
authors.lastname: Tejada
authors.forename: I
authors.initials: I
authors.lastname: Casado
authors.forename: F
authors.initials: F
authors.lastname: Purroy
authors.forename: P
authors.initials: P
authors.lastname: Delgado
authors.forename: P
authors.initials: P
authors.lastname: Simal
authors.forename: J
authors.initials: J
authors.lastname: Martí-Fábregas
authors.forename: J
authors.initials: J
authors.lastname: Vivancos
authors.forename: F
authors.initials: F
authors.lastname: Díaz-Otero
authors.forename: M
authors.initials: M
authors.lastname: Freijo
authors.forename: J
authors.initials: J
authors.lastname: Masjuan
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002545:Brain Ischemia / Q000209:etiology* / Q000628:therapy; D005260:Female; D006760:Hospitalization; D006761:Hospitals; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012042:Registries; D012307:Risk Factors; D012907:Smoking; D020521:Stroke / Q000209:etiology* / Q000628:therapy; D015912:Thrombolytic Therapy