Medicina Intensiva Medicina Intensiva
Med Intensiva 2000;24:257-63 - Vol. 24 Núm.6 DOI: 10.1016/S0210-5691(00)79599-4
La patología cerebrovascular aguda en las Áreas de Cuidados Críticos y Urgencias de Andalucía. Análisis clínicos-epidemiológicos y de práctica médica. Proyecto EVASCAN
Acute Cerebrovascular Disease in Andalousian Critical Care and Emergency Areas. An Analysis on Clinical, Epidemiological and Medical Practice Aspects. Evascan Project
P. Navarrete Navarro1, A. Garcíw Alcántara, F. Murillo Cabezas, G. Vázquez Mata, S. Fernández Fern´ndez, J.M. Jiménez Moragas, I. Galindo Ángel, R. Rivera Fernández, J.M. Domínguez Roldán, E. Pino de Moya, B. Nacle López, M.a A. Muñoz Sánchez
Grupo Evascan
* Relación de componentes del grupo: ANEXO 1.
Aceptado 23 marzo 2000

To study the epidemiology, the healthcare chain and the resource management of stroke patients in Andalousia, identifying areas of improvement.


A prospective observational study in 27 hospitals. Patients: they were included in the study via consecutive sampling in three crosssectional 24 h-studies (days 5,15 and 25). Period: from 5/3/98 to 25/8/98. Inclusion criteria: acute compatible clinical profile plus CT diagnosis.


Emergency Area population : n = 347, 81% hemorrhagic etiology, age 71% > 65 years, risk factors : hypertension in 55.8% and atrial fibrilation in 16.5%. Transport means: 48.7% own means. Hospital delay from stroke onset (T1) < 3 h, CT screening delay from emergency admission (T2): 56.8% < 3 h. ICU population: sample ICU: n = 133, (16/27 ICU and 5.9% of total patients) 83.9% hemorrhagic stroke, age < 65 years in 67.3%. Transport means to hospital : 43.8% Mobile ICU, T1 : 64.4% < 3h and T2 : 79.8% < 3 h. Severity score : APACHE III 63.2 (29.2), ICU length of stay: 12 (9.5) d, mechanical ventilation: 74.2%. Hospital mortality: 33.3% and 53 % at 1 year.


Hospital arrival delays and CT screening must be reduced, above all in ischemic patients. Transport means are related to initial clinical severity. ACVD currently admitted to Andalusian ICU, third level hospital above all, are hemorrhagic strokes and are characterized by high severity, resource consumption, and hospital and 12 month after mortality.

Palabras Clave
enfermedad cerebrovascular aguda, epidemiología, tratamiento
Key Words
Acute stroke, cerebrovascular disease, epidemiology, management
El Texto completo solo está disponible en PDF
R. Regidor,J. Iñigo,J.M. Sendra,J.L. Gutiérrez-Fisac
Evolución de la mortalidad por las principales enfermedades crónicas en España, 1975-1988
Med Clin (Barc), 99 (1992), pp. 725-728
Grupo Evascan. La enfermedad cerebrovascular aguda y su relación con los Servicios de Cuidados Críticos y Urgencias en Andalucía. Proyecto Evascan. Rev Calidad Asistenc 2000 (en prensa
T.G. Kwiatkowski,R.B. Libman,M. Frankel,B.C. Tilley,L.B. Morgeristern,M. Lu
Effects of Tissue. Plasminogen activator for acute Ischemic. Stroke at one year
N Engl J Med, 340 (1999), pp. 1.781-1.787
J. Bamford,P. Sandercock,M. Dennis,J. Burn,C.h. Warlow
Classification and natural history of clinically identifiable subtypes of cerebral infarction
Lancet, 337 (1991), pp. 1.521-1.526
B. Dobkin
The economic impact of stroke
Neurology, 45 (1995), pp. S6-S9
T.N. Taylor,P.H. Davis,J.C. Torner,J. Holmes,J.W. Meyer,M.F. Jacobson
Lifetime Cost of Stroke in the United States
Stroke, 27 (1996), pp. 1.459-1.466
H.P. Adams,T.G. Brott,A.J. Furlan,C.R. Gómez,J. Grotta,C.M. Helgason
Guidelines for Thrombolytic Therapy for Acute. Stroke: A Supplement to the Guidelines for the Management of Patients With Acute Ischemic Stroke
Circulation, 94 (1996), pp. 1.167-1.174
H.P. Jr Adams,T.G. Brott,R.M. Crowell,A.J. Furlan,C.R. Gómez,J. Grotta
Guidelines for the Management of Patients With Acute Ischemic Stroke
Stroke, 25 (1994), pp. 1.901-1.914
R. Rivera,G. Vázquez,M. Bravo,J.E. Zimmerman,D. Wagner,W. Knaus
The Apache III pronostic system : customized mortality predictions for spanish ICU patientes
Intensive Care Med, 24 (1998), pp. 574-581
T. León-Colombo,J. Vivancos-Mora,T. del Ser-Quijano,C. Fernández-Segura,T. Segura-Martin,C. Monforte-Dupret
¿Cómo es el ictus del paciente que ingresamos? Factores de decisión en la hospitalización
Rev Neurologia, 27 (1998), pp. 662-666
A. Guber,A. Rienprecht,L. Illevich,R. Fitzgerald,W. Dietrich,T. Czech,B. Richling
Extracerebral organ dysfunction and neurologic outcome after aneurysmal subarachnoid hemorrage
Crit Care Med, 27 (1999), pp. 505-514
R.B. Becker,J.E. Zimmerman
ICU scoring systems allow prediction of patients outcome and comparison of ICU performance
Crit Care Clin, 12 (1996), pp. 503-514
R. Cote,R.N. Baltista,C. Wolfson,J. Boucher,J. Adams,V.C. Hachinski
The Canadian Neuroiogical Scale; validation and reliability assessment
Neurology, 39 (1989), pp. 638-643
G. Teasdale,D. Jennett
Assessment of impalred coma and consciousness. A practical scale
Lancet, 2 (1974), pp. 81-84
F.I. Mahoney,D.W. Barthel
Functional evaluation; the Barthel index
Med State Med J, 14 (1965), pp. 61-65
A.M. Ostfeld,E. Wilk
Epidemiology of Stroke, 1980-1990: A progress report
Stroke, 12 (1990), pp. 253-256
The European atrial Fibrillation Trial Study Group. Optimal oral antícoagulant therapy in patients witht nonrheumatic atrial fibrillation and recent cerebral ischemia
N Engl J Med, 332 (1995), pp. 54-55
A. Dávalos,J. Castillo,E. Martínez-Vila
Delay in Neurological Attention ang Stroke Outcome
Stroke, 26 (1995), pp. 2.233-2.237
D. Goldhill,A. Summer
Outcome of Intensive Care patients in a group of British intensive care units
Crit Care Med, 26 (1998), pp. 1.337-1.345

( ! ) Warning: Invalid argument supplied for foreach() in /var/www/html/includes_ws/librerias/html/item.php on line 1196
Call Stack
10.0008246904{main}( ).../index.php:0
20.51943588640include( '/var/www/html/includes_ws/plantilla/template.php' ).../index.php:62
30.52353623200include( '/var/www/html/includes_ws/contenidos/item.php' ).../template.php:20
40.61733662288getAutorCorrespondenciaHTML( ).../item.php:160
Copyright © 2000. Sociedad Española de Medicina Intensiva, Critica y Unidades Coronarias (SEMICYUC) and Elsevier España, S.L.
Med Intensiva 2000;24:257-63 - Vol. 24 Núm.6 DOI: 10.1016/S0210-5691(00)79599-4