Introduction: Acute cerebrovascular disease, or stroke, is one of the most prevalent pathologies in Europe and is a very common reason for visits to the emergency services of a tertiary care hospital. AIM. To explore the types of emergency neurovascular pathology that are treated at the hospital and their development and impact over an eight-year period.
Patients and methods: The prospective study included 11,254 consecutive patients with acute stroke. The following variables were reported: demographic data, type of stroke, first stroke, need for hospital admission, fibrinolysis, mean stay and mortality rate.
Results: Between January 2001 and December 2008, an average of four patients were treated per day, with a predominance of males (53.6%) and a mean age of 71.8 ± 13.8 years, which was five years higher in females (p < 0.001). Ischaemic stroke represented 84.6% of the total number and haemorrhagic stroke accounted for the remaining 15.4%. Throughout the eight years of the study, there was seen to be an increase in the number of non-lacunar strokes (44-49%; p < 0.05), intracerebral haemorrhage (13.7-16.4%; not significant), first stroke (63.5-74.6%; p < 0.05) and fibrinolysis (6.2-13.5%; p < 0.001). The number of strokes in young patients increased (47.5%), at the expense of ischaemic stroke (p = 0.002) and males (p = 0.023). In contrast, there was a decrease in the number of transient ischaemic attacks (18.9-11.9%; p < 0.05), the need to be admitted to hospital (56-49.3%; p < 0.05), mean length of stay and mortality.
Conclusions: Advances in the management of stroke in recent years are associated to a decrease in the need for admission to hospital, mortality, and mean length of stay in hospital, together with a change in the clinical profile of the patients treated in emergency departments. The increase in the number of cases of strokes among young people is something that health care systems should take note of.