[Clinical and care implications of the 10-year application of a cerebrovascular diseases register. Descriptive analysis of the last 1000 patients and comparative with the first 1000 patients]. / Implicaciones clínicas y asistenciales de la aplicación durante 10 años de un registro de enfermedades cerebrovasculares. Análisis descriptivo de los últimos 1.000 pacientes y comparativo con los 1.000 primeros pacientes.

ABSTRACT

BACKGROUND: There are few studies which analyze clinical and patients' care implications of the continuous application of acute stroke registry. PATIENTS AND METHODS: A prospective study was carried out on 2,000 consecutive patients with acute stroke who were admitted in the neurology department over a period of 10 years (1986-1995). A descriptive clinical analysis of the last 1,000 patients (1986-1991) and a comparative clinical analysis between the last 1,000 patients and the first 1,000 patients (1991-1995) were performed. CT scan and/or MRI were performed in all patients. We used a previously validated registry and we studied clinical and assistance implications of its systematic use. RESULTS: Between the last 1,000 patients and the first 1,000 patients there were significant differences in the frequency of transient ischaemic attacks (TIA) (15% vs 9%; p < 0.0001), lacunar infarcts (20.5% vs 17%; p < 0.04), cardioembolic infarcts (22.3% vs 12.4%; p < 0.0001), infarcts of undetermined cause (7.5% vs 15%; p < 0.0005), intraparenchymatous hemorrhage (9% vs 14%; p < 0.0005), in-hospital mortality (13.8% vs 16.7%; p = 0.07, NS) and mean length of hospital stay (16.5 vs 19.5 days; p < 0.005). CONCLUSIONS: The continuous application of stroke registry brought major interest to the care of stroke patients, resulting in a higher admission rate of TIA patients, a better diagnosis of cardioembolic and lacunar stroke and fewer infarcts of undetermined cause. A decrease in the mean length of hospital stay was observed as well as a lower in-hospital mortality rate.