Use of the National Institute of Health Stroke Scale as a diagnostic method within the window period in patients with ischaemic stroke

Introduction: Stroke is the third leading cause of death and the leading cause of disability in Argentina. Eighty per cent of strokes are ischaemic. Stroke requires the use of a standardised scale, such as the National Institute of Health Stroke Scale (NIHSS), in order to document possible deficits and their severity, as well as to make decisions regarding the treatment to be administered. Objective: To calculate the frequency with which the NIHSS scale is used within the window period as a method of diagnosing ischemic stroke in patients attending the Eva Perón Hospital (Granadero Baigorria, Santa Fe) in 2023. Materials and methods: A quantitative, observational study was conducted with a descriptive, cross-sectional, retrospective design. The population consisted of all patients of both sexes diagnosed with ischaemic stroke who attended a post-hospitalisation check-up at the outpatient clinic of the neurology department of Eva Perón Hospital. Patients over 18 years of age diagnosed with ischaemic stroke during the study period were included. The medical records of patients diagnosed with ischaemic stroke were used as a secondary data source. Results: A sample of 20 patients diagnosed with ischaemic stroke was analysed. Of these, only 30% were diagnosed within the therapeutic window, but only 20% of the total number of patients were classified based on the NIHss scale at admission. Seventy per cent of patients had an NIHss score between 4 and 24 points, which allowed them to be classified as possible candidates for fibrinolytic treatment, but only 10% of patients were able to access this treatment and 85% were left with serious sequelae. Conclusions: The NIHss scale is rarely used as a diagnostic method for ischaemic stroke within a window period. The lack of this data at the appropriate time hinders decision-making and makes it less likely that fibrinolytic treatment will be administered at the right time and that patients will have a better outcome.