The Joan XXIII, third Catalan hospital of reference in Codi Ictus

The Joan XXIII Hospital in Tarragona is currently the third reference hospital in Catalonia for stroke treatment. So far this year, 492 Ictus Codes have been activated in the Tarragona health center. Ahead of him, only the Hospital Clínic, with 696 activations, and the Vall d'Hebron, with 564, go. The average age of the people treated in Tarragona is 69 years, according to data from the Dades Obertes portal of the Generalitat of Catalonia. But what is Codi Ictus? What are the warning symptoms? And the possible treatments? These and other doubts have been resolved by the team of neurologists at Hospital Joan XXIII, within the framework of World Stroke Day, which will take place this Saturday, October 29.

The Codi Ictus is an action protocol that is activated when there is any suspicion of suffering a stroke. The objective is to centralize these patients in a facility that can respond. In the case of the demarcation of Tarragona, the reference hospital is the Joan XXIII.

“A stroke affects a part of the brain and the brain is our computer. Therefore, we will notice that we suffer from this pathology when the orders that are sent are not executed, ”explains Dr. Xavier Ustrell, a neurologist at the Joan XXIII and one of the coordinators of the area. Stroke is a "time-dependent" disease, which means that arriving at the hospital on time is essential for its treatment and recovery.

The acronym RAPID will help us identify this pathology. If the person diverts the mouth to the Laugh, if you can't liftGet up– your arm or leg, and if you have trouble speaking –Speak–, we have to think about a stroke and we have to notify –hurry– to 112.

“Stroke care in the last 30 years has made an abysmal medical change. Before, it seemed that it was an untreatable disease, with a poor prognosis. We now know that the brain improves faster than we thought, "explains Ustrell.

There are two types of stroke, ischemic – which is the most common – and hemorrhagic. The first occurs when a clot or thrombus obstructs a part of the cerebral circulation and, therefore, neither blood nor oxygen reaches it, and the neurons die. It is what is known as a cerebral infarction. Instead, hemorrhagic occurs when the artery ruptures. It is what we popularly call a stroke.

One of the treatments is intravenous thrombolysis, a drug that tries to dissolve the thrombus and considerably improves the patient's prognosis, that is, fewer sequelae. It is important that this treatment is applied in a time frame of less than 4.5 hours from the stroke. Otherwise, the drug is not as effective, and it can also pose a risk to the patient. "Hence the importance of quickly identifying pathology," says Ustrell.

Continuing with the treatments, in 2015 it was possible to demonstrate that by inserting a catheter through the arteries, the thrombus could be eliminated, "like a kind of corkscrew," the doctor details. It is a very powerful treatment aimed, above all, at severe strokes. The problem, in this case, is personnel and technology. Not all hospitals have access to this resource. "Work is being done to establish it throughout the Catalan territory and so that no one is left out," says the doctor. Joan XXIII has been working with this technique for years.

Stroke is a serious pathology that affects both elderly and young people, and represents the second cause of death and the first cause of disability in our environment. Currently, it is a treatable disease thanks to advances in recent years in its management at specialized Stroke Units and urgent reperfusion treatments.

The neurology team at the Tarragona hospital – made up of 11 doctors, in addition to other professionals, such as nurses or rehabilitation personnel – works together with specialists from Sant Joan de Reus, Pius de Valls and Hospital del Vendrell. «In the case of Vendrell, which is the center furthest from ours, when a stroke patient arrives, we make an initial joint assessment via videoconference. Then it is transferred to the Joan XXIII, "explains Ustrell.

The team of professionals who run this unit is one hundred percent involved in the cause. They collaborate in international clinical trials, to find new drugs and work on their own lines of research. A dedicated staff that manages to bring patients who have suffered a stroke back to life.

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