El tiempo es cerebro: una revisión de alcance sobre las barreras para la trombólisis oportuna en el ictus isquémico
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https://doi.org/10.5294/aqui.2026.26.3.5Palabras clave:
Accidente cerebrovascular isquémico, terapia trombolítica, diagnóstico tardío, barreras al acceso a la atención sanitaria, salud pública, salud poblacionalResumen
Introducción: El ictus isquémico es una emergencia clínica que requiere que la persona afectada inicie el tratamiento dentro de las primeras 4,5 horas, ventana terapéutica de la alteplasa, para minimizar la aparición de secuelas graves e irreversibles. Aunque existen estudios sobre su manejo, todavía persisten brechas en la sistematización de los factores que explican los retrasos en el tratamiento. Por ello, esta revisión se diferencia por mapear de forma exhaustiva los obstáculos que comprometen la trombólisis oportuna. Objetivo: verificar en la literatura los factores asociados con el retraso en la terapia trombolítica en el ictus isquémico. Materiales y método: Este es un estudio cualitativo y exploratorio, del tipo de revisión de alcance, realizado en las bases de datos Web of Science, Scopus, MEDLINE, Embase y PubMed en 2025. La búsqueda y el cribado fueron realizados por dos revisores, en un proceso doble ciego, utilizando el software Rayyan.ai. El proceso siguió las recomendaciones del Preferred Reporting Items for Systematic Review and Meta-Analyses extension for Scoping Reviews, con la inclusión de 30 artículos. Resultados: Se identificaron obstáculos categorizados en condiciones socioeconómicas, aspectos geográficos, falta de conocimiento, hábitos culturales, logística de los servicios de salud, variación en los patrones de manifestación de la enfermedad y antecedentes de patológicos, configurándose como barreras que dificultan el tratamiento en el momento adecuado y como factores asociados con una mayor morbilidad y mortalidad por la enfermedad. Conclusión: Los hallazgos refuerzan la importancia de estrategias integradas de educación sanitaria para la población, la formación profesional, el fortalecimiento de la logística y la infraestructura de los servicios de salud. La identificación y el debate acerca de estas carencias contribuyen a la promoción de políticas públicas que reducen la morbilidad y mortalidad y mejoran la calidad de vida de la población.
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Derechos de autor 2026 Manoel Mateus Xavier do Nascimento, Maria Luiza Peixoto Brito, Kenya Waléria de Siqueira Coelho Lisboa, Emmily Petícia do Nascimento Sales, Valterlúcio dos Santos Sales, Francisco Nascimento Pereira Junior
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