RUO Home

Repositorio Institucional de la Universidad de Oviedo

View Item 
  •   RUO Home
  • Producción Bibliográfica de UniOvi: RECOPILA
  • Tesis
  • View Item
  •   RUO Home
  • Producción Bibliográfica de UniOvi: RECOPILA
  • Tesis
  • View Item
    • español
    • English
JavaScript is disabled for your browser. Some features of this site may not work without it.

Browse

All of RUOCommunities and CollectionsBy Issue DateAuthorsTitlesSubjectsxmlui.ArtifactBrowser.Navigation.browse_issnAuthor profilesThis CollectionBy Issue DateAuthorsTitlesSubjectsxmlui.ArtifactBrowser.Navigation.browse_issn

My Account

LoginRegister

Statistics

View Usage Statistics

RECENTLY ADDED

Last submissions
Repository
How to publish
Resources
FAQs
Las tesis leídas en la Universidad de Oviedo se pueden consultar en el Campus de El Milán previa solicitud por correo electrónico: buotesis@uniovi.es

Evolución clínica tras el tratamiento trombolítico intravenoso con activador del plasminógeno tisular recombinante en el ictus isquémico. Factores pronósticos

Author:
González Delgado, MontserratUniovi authority
Director:
Hernández Lahoz, CarlosUniovi authority; López Muñiz, Alfonso JoaquínUniovi authority
Centro/Departamento/Otros:
Psicología, Departamento deUniovi authority
Publication date:
2008-05-09
Descripción física:
219 p.
Abstract:

Introduction: Intravenous(IV) thrombolysis with recombinant tisular plasminogen activator (rt-PA) is the only approved treatment for the acute ischemic stroke. The cinical evolution after this treatment could be variable. Patients(Method: Theaim of this study was to analyze the different clinical evolutions in patients 48 hours after IV thrombolysis trying to identify prognostic factors. We took four groups: patients remaining stable after treatment, without clinical changes or changes less than 4 points NIHSS (group I); patients with clinical improvement, or decrease >- 4 pints NIHSS (group 2); patients with clinical worsening, or increase >- 4 points in the NIHSS (group 3); and patients with worsening after initial improvement, or initial decrease >- 4 points NIHSS and posterior worsening>- 4 points NIHSS. We analyzed previous cerebrovascular risk factors (smoking, artrial hypertension, hyperlipemia cardiopathy…): admission parmeters (glycemia, blood pressure…); neuroimaging (basa CT, angio-CT and perfusion-CT) at admission and worsening: and clinical and functional status (NIHSS, Bl and mRS). Results/Conclusions: Beween January 2000- october 2005, 136 patients fulfilled crieria to IV thrombolysis (57 females, 79 males): 11,8% (group 1), 67% (group 2), 13% (group 3) and 8% (group 4). Of the patients with initial improvement, 10,8% had posterior worsening. The mechanism of stroke (TOAST criteria) was: 18% large vessel, 3% small vessel, 48% cardioembolic, 15% another actiology and 19% undetermined. Female sex, peripheral vascular disease and no hyperlipemia were associated at group 3. Tobacco and no valvulopathy were associated at group 2. No occlusion in the admission angio-TC and penumbra > core in the admission perfusion-CT were associated with better prognostic. Nevertheless 25% patients with penumbra> core had worsening after initial improvement. Persistent oclusion in angio-TC was associated with group 3. Causes of worsening were symptomatic intracranial haemorrhage (sICH) (mortality RR igual 30), intracranial oedema (mortality RR igual 29) and reoclusion/new (mortality RR igual 4). Patients with sICH had a mortality RR igual 9,6.In comparison to group 2, group 3 patients had a mortality RR igual 43,6, and group 4 had a mortality RR igual 14,7.

Introduction: Intravenous(IV) thrombolysis with recombinant tisular plasminogen activator (rt-PA) is the only approved treatment for the acute ischemic stroke. The cinical evolution after this treatment could be variable. Patients(Method: Theaim of this study was to analyze the different clinical evolutions in patients 48 hours after IV thrombolysis trying to identify prognostic factors. We took four groups: patients remaining stable after treatment, without clinical changes or changes less than 4 points NIHSS (group I); patients with clinical improvement, or decrease >- 4 pints NIHSS (group 2); patients with clinical worsening, or increase >- 4 points in the NIHSS (group 3); and patients with worsening after initial improvement, or initial decrease >- 4 points NIHSS and posterior worsening>- 4 points NIHSS. We analyzed previous cerebrovascular risk factors (smoking, artrial hypertension, hyperlipemia cardiopathy…): admission parmeters (glycemia, blood pressure…); neuroimaging (basa CT, angio-CT and perfusion-CT) at admission and worsening: and clinical and functional status (NIHSS, Bl and mRS). Results/Conclusions: Beween January 2000- october 2005, 136 patients fulfilled crieria to IV thrombolysis (57 females, 79 males): 11,8% (group 1), 67% (group 2), 13% (group 3) and 8% (group 4). Of the patients with initial improvement, 10,8% had posterior worsening. The mechanism of stroke (TOAST criteria) was: 18% large vessel, 3% small vessel, 48% cardioembolic, 15% another actiology and 19% undetermined. Female sex, peripheral vascular disease and no hyperlipemia were associated at group 3. Tobacco and no valvulopathy were associated at group 2. No occlusion in the admission angio-TC and penumbra > core in the admission perfusion-CT were associated with better prognostic. Nevertheless 25% patients with penumbra> core had worsening after initial improvement. Persistent oclusion in angio-TC was associated with group 3. Causes of worsening were symptomatic intracranial haemorrhage (sICH) (mortality RR igual 30), intracranial oedema (mortality RR igual 29) and reoclusion/new (mortality RR igual 4). Patients with sICH had a mortality RR igual 9,6.In comparison to group 2, group 3 patients had a mortality RR igual 43,6, and group 4 had a mortality RR igual 14,7.

URI:
http://hdl.handle.net/10651/14806
Other identifiers:
https://www.educacion.gob.es/teseo/mostrarRef.do?ref=798426
Local Notes:

Tesis 2008-083

Collections
  • Tesis [7677]
Files in this item
Compartir
Exportar a Mendeley
Estadísticas de uso
Estadísticas de uso
Metadata
Show full item record
Página principal Uniovi

Biblioteca

Contacto

Facebook Universidad de OviedoTwitter Universidad de Oviedo
The content of the Repository, unless otherwise specified, is protected with a Creative Commons license: Attribution-Non Commercial-No Derivatives 4.0 Internacional
Creative Commons Image