[Modern problems of stroke at different hospitalization stages based on the data of the Regional Vascular Center of Tyumen].

AIM: To analyze clinical and organizational aspects of stroke patients care and factors affecting the outcomes of the disease at the prehospital and inpatient stages.

MATERIAL AND

METHODS

The medical documentation of patients with acute vascular lesions of the brain who were admitted and were subsequently treated at the Regional Vascular Center in Tyumen in 2016-2018 was studied retrospectively. At the first stage, factors affecting the delay in admission of patients (n=173) to the hospital were identified. At the second stage, the frequency and nature of discrepancies in diagnoses were determined, as well as the main factors affecting mortality at each stage of hospitalization of patients. For this purpose, 1330 accompanying documents and 508 case histories of patients with transient ischemic attacks and cerebral infarction were studied.

RESULTS AND

CONCLUSION

The main factor affecting the transfer of patients to the hospital outside the 'therapeutic window' was living alone (58.8%, p=0.01). There was a significant number of discrepancies in the diagnoses of the referring institution (73.7% in out-patient clinics and 61.9% in other referring hospitals (p<0.001)), the emergency department and the specialized vascular department of the inpatient department which were significantly correlated with the mortality rate. In cases when all three diagnoses differed, the probability of a fatal outcome increased from 18.9 to 80.0% (p<0.001).