Jesmo li spremni za intravensku trombolizu u liječenju akutnog moždanog udara u našoj regiji?

Acute stroke is the leading cause of disability in modern society. Early treatment is crucial to maximize the benefit of stroke intervention. Effective thrombolytic therapy is dependent on timely intervention and guidelines for the recommended use of recombinant tissue plasminogen activator therapy within 3 hours after onset of stroke symptoms. The aim of the study was to assess whether we are ready for the introduction of thrombolysis in our region. We investigated retrospectively the time from symptom onset to hospital arrival (delay time) for patients with acute stroke in our region. Medical histories of all patients admitted to the Department in 2006 with acute stroke symptoms were studied. Statistical analysis was performed by use of the SigmaStat (version 2.0) software. Study results showed that a very high rate of patients presented after 24 hours of stroke onset (35%); 15% of all acute ischemic stroke (AIS) patients arrived within 3 hours of stroke onset. Due to other exclusion criteria established, only 4% of all AIS patients were eligible for intravenous thrombolysis. Most patients arrived in the hospital too late to get maximum benefit from the emerging stroke therapies. This may be due to the failure to recognize signs and symptoms or the lack of awareness of the potential treatment benefits. Our further efforts should be focused on increasing public awareness of the stroke signs and symptoms and on reducing delay time.Akutni moždani udar je vodeći uzrok invalidnosti u današnjem društvu. Rano liječenje je bitno za što veću učinkovitost akutnog liječenja. Učinkovita tromboliza rekombiniranim aktivatorom tkivnog plazminogena ovisi o vremenu i preporukama da se provede unutar 3 sata od nastanka simptoma moždanog udara. Cilj ove studije bio je utvrditi jesmo li spremni za uvođenje trombolize u našu regiju. Retrospektivno se promatralo vrijeme od nastanka simptoma do dolaska u bolnicu (vrijeme kašnjenja) bolesnika s akutnim moždanim udarom. Promatrale su se povijesti bolesti svih bolesnika primljenih u bolnicu u 2006. godini. U statističkoj obradi primijenjen je program SigmaStat (verzija 2.0). Utvrđen je vrlo visok postotak (35%) bolesnika koji su došli nakon 24 sata od nastanka moždanog udara; 15% svih bolesnika primljenih s akutnim ishemijskim moždanim udarom (AIMU) došlo je unutar 3 sata. Uzimajući u obzir i ostale kriterije isključivanja samo je 4% svih bolesnika primljenih s AIMU moglo primiti sistemsku trombolizu. Većina bolesnika je stigla prekasno da bi imala maksimalnu korist od hitne terapije moždanog udara. Uzrok je možda nepoznavanje znakova i simptoma ili nedovoljna saznanja o korisnosti ovog liječenja. Potrebno je i dalje se truditi i poboljšavati poznavanje znakova i simptoma moždanog udara, kao i smanjiti vrijeme kašnjenja