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"resumen" => "<span class="elsevierStyleSectionTitle">Objetivo</span><p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Evaluar el impacto de la introducción de una trayectoria clínica sobre la atención a los pacientes con un ictus isquémico.</p> <span class="elsevierStyleSectionTitle">Métodos</span><p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Se diseñó un estudio de intervención, controlado, sin asignación aleatoria, de seguimiento de 2 cohortes de pacientes, no coincidentes en el tiempo, correspondiente a los períodos inmediatamente anterior (grupo PRE o control) y posterior (grupo POST o intervención) a la introducción de la trayectoria clínica. Las principales medidas del resultado fueron: <span class="elsevierStyleItalic">a)</span> indicadores de calidad asistencial; <span class="elsevierStyleItalic">b)</span> mejora en la capacidad funcional (índice de Barthel) y la función neurológica (escala Canadiense); <span class="elsevierStyleItalic">c)</span> complicaciones intrahospitalarias; <span class="elsevierStyleItalic">d)</span> satisfacción, y <span class="elsevierStyleItalic">e)</span> estancia media.</p> <span class="elsevierStyleSectionTitle">Resultados</span><p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Se reclutó a 139 pacientes, 69 correspondientes al período PRE y 70 al período POST, sin que se observaran diferencias significativas al ingreso entre ambos grupos. Se constató una reducción del 36,5% en el tiempo transcurrido desde el ingreso hasta el inicio de la movilización, aunque no se observaron diferencias significativas en los otros indicadores de calidad ni en el incremento de la función neurológica o la capacidad funcional. El porcentaje de individuos con alguna complicación durante el ingreso fue del 44,6% en el período PRE y del 28,6% en el período POST (p = 0,039). No se observaron diferencias significativas en la valoración global del cuestionario de satisfacción, pero los pacientes del período POST presentaron una mayor satisfacción en las dimensiones «información recibida» y «profesionalidad y confianza ». La estancia media se redujo de 11 a 10 días.</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">La introducción de la trayectoria clínica del ictus isquémico puede contribuir a reducir el número de complicaciones y los días de estancia, así como mejorar la calidad de la atención y la satisfacción de los pacientes.</p>"
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"resumen" => "<span class="elsevierStyleSectionTitle">Objective</span><p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">To assess the impact of the implementation of a clinical pathway for stroke patients.</p> <span class="elsevierStyleSectionTitle">Methods</span><p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">We performed a controlled intervention study without random allocation that compared two non-concomitant cohorts of stroke patients corresponding to the periods immediately before (control group) and after (intervention group) the implementation of a clinical pathway. The main outcome measures were: <span class="elsevierStyleItalic">a)</span> quality of care indicators; <span class="elsevierStyleItalic">b)</span> improvements in functional capacity (Barthel score) and neurological function (Canadian scale); <span class="elsevierStyleItalic">c)</span> nosocomial complications; <span class="elsevierStyleItalic">d)</span> satisfaction, and <span class="elsevierStyleItalic">e)</span> mean length of hospital stay.</p> <span class="elsevierStyleSectionTitle">Results</span><p id="spar0075" class="elsevierStyleSimplePara elsevierViewall">One hundred and thirty-nine patients were recruited. Sixty-nine corresponded to the period before implementation of the pathway and 70 corresponded to the period after implementation. There were no significant differences between the two groups on admission. A 36.5% reduction in the time from admission to mobilization was observed. No significant differences were observed between the groups for the other quality of care indicators, or in improvements in functional and neurological capacity. Nosocomial complications occurred in 44.5% of patients in the control group compared with 28.6% in the intervention group (p = .039). No significant differences were observed in the overall satisfaction assessment, but patients in the intervention group showed greater satisfaction in the dimensions of «information» and «trust and professionalism ». The mean length of hospital stay was reduced from 11 to 10 days.</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p id="spar0080" class="elsevierStyleSimplePara elsevierViewall">The implementation of the stroke clinical pathway contributed to reducing the length of hospital stay and the number of inpatient complications, as well as to improving some quality of care indicators.</p>"
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