Tiempo transcurrido entre el inicio de síntomas y la aplicación de la escala de nihss al ingreso al servicio de urgencias en pacientes con accidente cerebrovascular en hgzmf 1

Background: Ischemic stroke (IS) is a neurological emergency characterized by sudden-onset focal deficits due to partial or complete occlusion of a cerebral artery. Timely diagnosis and treatment significantly reduce morbidity and mortality. Non-contrast cranial CT is the initial imaging modality in the acute phase, while the NIH Stroke Scale (NIHSS) helps assess neurological deficit severity and guides therapeutic decisions, particularly for thrombolysis with tissue plasminogen activator (tPA). Despite advances, only a small percentage of patients receive reperfusion therapy. Objective: To determine the time elapsed between symptom onset and application of the NIHSS upon admission to the emergency department, and to describe the demographic characteristics and use of thrombolytic treatment in patients with IS at HGZ‑MF No. 1 in Pachuca. Methods: A descriptive, retrospective, and observational study was conducted, analyzing 56 clinical records of patients diagnosed with ischemic stroke between January 2023 and December 2024. Descriptive statistics were used to evaluate demographic variables, time to arrival, NIHSS scores, and administration of thrombolytic therapy. Results: Women accounted for 55.4% of cases; 50% were aged 71–80 years. Over 53% had only primary education, which may correlate with reduced awareness of stroke warning signs. Although 64.3% of patients were identified as candidates for fibrinolysis based on NIHSS, 69.6% did not receive tPA. Notably, 41% arrived within 3–4 hours of symptom onset. Only 38% received fibrinolytic treatment despite arriving within the therapeutic window, indicating potential systemic, clinical, or social barriers. Conclusions: Most patients arrived within the optimal 4-hour window; however, thrombolysis rates remained low. The actual time from symptom onset to NIHSS application was 3–4 hours, not 7–8 hours as initially suspected. These findings highlight the need to strengthen protocols, improve staff training, and enhance public awareness to increase reperfusion rates and improve outcomes in IS patients.