title: [In-hospital ischemic strokes in patients admitted to Cardiology and Cardiac Surgery departments. Multi-centre registry].
abstract: OBJECTIVE
  Patients admitted to Cardiology and Cardiac Surgery Departments have an increased risk of ischemic stroke (IS). We analyzed clinical characteristics, quality of neurological care and mortality of in-hospital strokes (IHS) in these departments.
  
  
  METHODS
  Prospective registry of in-hospital ISs in Cardiology and Cardiac Surgery in 13 Spanish hospitals during 2008. Demographic, clinical and therapeutic data as well as mortality and functional evolution were recorded.
  
  
  RESULTS
  73 patients were included. Mean age was 72±11.6 years. 75.4% of IS were cardioembolic. Special risk factors were presence of cardiac sources of embolism (86.3%), prior withdrawal of antithrombotic treatment (22%) and invasive procedures (65.7%). First neurological assessment was done in the first 3hours in 49.5% and beyond 24hours from IS onset in 20.5%. Ten patients were treated with intravenous thrombolysis, which was not possible in 8 patients because of the delay in calling the neurologist. Most frequent reasons for exclusion from thrombolytic therapy were recent major surgical procedures (33.3%) and anticoagulant therapy (38%). Three-month mortality was 15% and only 53.7% were functionally independent. Patients treated with thrombolysis had a better evolution (87.5% of independent patients, p=0.04).
  
  
  CONCLUSIONS
  IS in Cardiology and Cardiac Surgery are mostly cardioembolic strokes and produce a high proportion of dependent patients. Patients treated with thrombolysis had a better evolution. Delays in contacting the neurologist led to exclusion from treatment an important proportion of patients who met thrombolysis criteria.
authors.affiliation: Servicio de Neurología, Hospital Universitario Ramón y Cajal, IRYCIS, Madrid, Spain. rovera78@hotmail.com
authors.forename: Rocío
authors.initials: R
authors.lastname: Vera
authors.forename: Aída
authors.initials: A
authors.lastname: Lago
authors.forename: Blanca
authors.initials: B
authors.lastname: Fuentes
authors.forename: Jaime
authors.initials: J
authors.lastname: Gállego
authors.forename: Javier
authors.initials: J
authors.lastname: Tejada
authors.forename: Ignacio
authors.initials: I
authors.lastname: Casado
authors.forename: Francisco
authors.initials: F
authors.lastname: Purroy
authors.forename: Pilar
authors.initials: P
authors.lastname: Delgado
authors.forename: Patricia
authors.initials: P
authors.lastname: Simal
authors.forename: Joan
authors.initials: J
authors.lastname: Martí-Fábregas
authors.forename: José
authors.initials: J
authors.lastname: Vivancos
authors.forename: Fernando
authors.initials: F
authors.lastname: Díaz-Otero
authors.forename: Mar
authors.initials: M
authors.lastname: Freijo
authors.forename: Exuperio
authors.initials: E
authors.lastname: Díez-Tejedor
authors.forename: Antonio
authors.initials: A
authors.lastname: Gil-Núñez
authors.forename: Jose
authors.initials: J
authors.lastname: Egido
authors.forename: Gemma
authors.initials: G
authors.lastname: Reig
authors.forename: María Luisa
authors.initials: ML
authors.lastname: Calle
authors.forename: María
authors.initials: M
authors.lastname: Alonso de Leciñana
authors.forename: Jaime
authors.initials: J
authors.lastname: Masjuan
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D016507:Cardiology Service, Hospital / Q000706:statistics & numerical data*; D003331:Coronary Vessels; D057210:Delayed Diagnosis; D003943:Diagnostic Techniques, Neurological; D004617:Embolism / Q000150:complications; D005260:Female; D005343:Fibrinolytic Agents / Q000627:therapeutic use; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D011446:Prospective Studies; D012042:Registries; D012307:Risk Factors; D020521:Stroke / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology / Q000401:mortality; D015912:Thrombolytic Therapy; D016896:Treatment Outcome
chemical_list: D005343:Fibrinolytic Agents