Resumen:
Background and Purpose—Standardized registries may provide valuable data to further improve stroke care. Our aim was to
obtain updated information about characteristics of stroke patients and management of stroke across the Ibero-American
countries, using a common in-hospital registry (Safe Implementation of Treatments in Stroke–Sociedad Iberoamericana
de Enfermedades Cerebrovasculares) as a basis for further quality improvement.
Methods—Data for this study were entered into the Safe Implementation of Treatments in Stroke registry from September
2009 to December 2013 by 58 centers in 14 countries. Data included demographics, risk factors, onset-to-door time,
National Institutes of Health Stroke Scale score, stroke subtype, ischemic stroke etiology, treatments, 3-month mortality,
and modified Rankin Scale score. Time to treatment was also recorded for patients treated with thrombolysis.
Results—Five thousand four hundred one patients were registered; median age, 65 years; 46% women; 3915 (72.5%)
ischemic strokes; 686 (13.7%) hemorrhagic strokes; 213 (4.3%) subarachnoid hemorrhages; 414 (8.3%) transient
ischemic attacks; and 31 (0.6%) cerebral vein thrombosis. The most prevalent risk factors were hypertension (71.3%),
dyslipidemia (35.2%), and diabetes mellitus (23.6%). Atrial fibrillation was present in 15.1%. Three hundred one ischemic
strokes were treated with intravenous thrombolysis (IVT; 7.7%). Patients undergoing IVT were more severely affected
(median baseline National Institutes of Health Stroke Scale score, 11 versus 6). The rate of symptomatic intracerebral
hemorrhages after IVT was 5.7%. At 3 months, 60.3% of IVT-treated patients and 59.1% of untreated patients were
independent (modified Rankin Scale score, 0–2). Mortality was 11.4% in treated and 12.8% in untreated patients.
Conclusions—Safe Implementation of Treatments in Stroke–Sociedad Iberoamericana de Enfermedades Cerebrovasculares
is the largest registry of a general stroke population and the first study to evaluate the level of IVT use in Ibero-America. It
provides valuable information that may help to improve the quality of stroke care in the Ibero-American region.