Topical issues on in-hospital ischemic stroke clinical diagnostics

S. V. Kolomentsev; I. A. Voznyuk; M. M. Odinak; I. V. Litvinenko; A. V. Savello; S. N. Yanishevsky; N. V. Tsygan; Yu. V. Khlystov

doi:10.17816/brmma623009

Bulletin of the Russian Military Medical Academy ›› 2017, Vol. 19 ›› Issue (3) : 98 -104. DOI: 10.17816/brmma623009

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Topical issues on in-hospital ischemic stroke clinical diagnostics

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Abstract

The use of systemic thrombolytic therapy and endovascular surgery in the treatment of acute ischemic stroke is limited by strict time limits. Patients with in-hospital stroke have none logistical problems associated with the transportation to the hospital, they are already examined, and represent a unique cohort of high-priority candidates to receive reperfusion treatment within the «therapeutic» and «surgical» frameworks, compared with the patients with the out-of-hospital stroke. Despite the current requirements to medical care protocols, literature shows the delays in in-hospital stroke diagnostics, the lower rate of systemic thrombolytic therapy, a lower quality of medical care and less favorable outcomes. The most common causes of delays in providing care to in-patients with stroke are difficulties in clinical diagnosis, which are of impersonal nature. The latter include: disturbance of consciousness level, degree of initial neurological deficit, the severity of the hospital-acquired stroke, the severity of comorbidity. The role of the human factor is very significant and affects the efficiency of diagnostic and treatment activities carried out in patients with stroke. Improving the early diagnostics of in-hospital stroke will improve the quality of medical care, reduce the mortality and disablement rates, and promote the achievement of the target values for use of emergency reperfusion treatment in acute ischemic stroke.

Keywords

in-hospital ischemic stroke / diagnostic difficulties / systemic thrombolytic therapy / intravascular recanalization / endovascular intervention / quality medical care

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S. V. Kolomentsev, I. A. Voznyuk, M. M. Odinak, I. V. Litvinenko, A. V. Savello, S. N. Yanishevsky, N. V. Tsygan, Yu. V. Khlystov. Topical issues on in-hospital ischemic stroke clinical diagnostics. Bulletin of the Russian Military Medical Academy, 2017, 19(3): 98-104 DOI:10.17816/brmma623009

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