Intracerebral haemorrhage management practices and adherence to the INTERACT3 care bundle in Latin America: Results from an international survey

IF 1.8 4区医学 Q3 NEUROSCIENCES

Journal of Stroke & Cerebrovascular Diseases Pub Date : 2025-08-11 DOI:10.1016/j.jstrokecerebrovasdis.2025.108419

Julieta Rosales MD , Leonardo Augusto Carbonera MD, MSc , Ana Cláudia De Souza MD, PhD , Eva Rocha MD, PhD , Vanessa Cano-Nigenda MD, MSc , Karen D. Orjuela MD, MSc, MBA , Rodrigo Guerrero MD , Carlos Delfino MD, PhD(c) , Marilaura Nuñez MD, PhD(c) , Paula Muñoz Venturelli MD, PhD , Alejandro Gonzalez-Aquines MD, MPH

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引用次数: 0

Abstract

Objective

To assess intracerebral hemorrhage (ICH) management practices and adherence to the INTERACT3 care bundle across Latin American countries.

Methods

We conducted a multi-national survey among neurologists, neurosurgeons, intensive care specialists, and emergency physicians. From August to December 2024, the survey was distributed across 19 Latin American countries. It assessed hospital characteristics, availability of an ICH code, adherence to INTERACT3 measures, and resource availability. Stroke leaders from the surveyed countries were involved in developing and disseminating the survey.

Results

Out of 580 respondents (mean age 40.25 years; 61.6% male), most worked in teaching (86%) and public hospitals (53.6%). Only 27.9% reported an ICH code at their institution. Adherence to INTERACT3 measures ranged from 57.2% (anticoagulation reversal) to 84.7% (blood pressure control), with just 44.5% reporting adherence to all four measures. Time-to-target was not measured by 65%, and only 53.9% maintained interventions for one week. Neuroimaging, neurosurgery, and hematology services were higher in private compared to public and mixed hospitals (p<0.001). ICH code availability was associated with private hospitals and emergency care specialists, while full adherence was more likely among intensive care specialists.

Conclusions

ICH management in Latin America is evolving, with increasing adoption of evidence-based practices. However, variability in adherence underscores the need for regional initiatives to standardize ICH care and ensure equitable implementation of best practices.

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拉丁美洲脑出血管理实践和对INTERACT3护理包的遵守：一项国际调查的结果

目的：评估拉丁美洲国家脑出血（ICH）的管理实践和对INTERACT3护理包的依从性。方法：我们对神经科医生、神经外科医生、重症监护专家和急诊医生进行了多国调查。从2024年8月到12月，这项调查分布在19个拉丁美洲国家。它评估了医院的特点、ICH规范的可用性、对INTERACT3措施的依从性和资源的可用性。来自被调查国家的中风领导人参与了调查的制定和传播。结果：580名受访者(平均年龄40.25岁；男性占61.6%)，大多数在教学（86%）和公立医院（53.6%）工作。只有27.9%的人在他们的机构报告了ICH代码。INTERACT3措施的依从性从57.2%（抗凝逆转）到84.7%（血压控制）不等，只有44.5%的人报告遵守了所有四项措施。65%的人没有测量达到目标的时间，只有53.9%的人维持干预措施一周。与公立和混合医院相比，私立医院的神经影像学、神经外科和血液学服务更高(结论：拉丁美洲的脑出血管理正在发展，越来越多地采用循证实践。然而，依从性的差异突出表明需要采取区域行动，使非ICH医疗标准化，并确保公平实施最佳做法。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Stroke & Cerebrovascular Diseases Medicine-Surgery

CiteScore

5.00

自引率

4.00%

发文量

583

审稿时长

62 days

期刊介绍： The Journal of Stroke & Cerebrovascular Diseases publishes original papers on basic and clinical science related to the fields of stroke and cerebrovascular diseases. The Journal also features review articles, controversies, methods and technical notes, selected case reports and other original articles of special nature. Its editorial mission is to focus on prevention and repair of cerebrovascular disease. Clinical papers emphasize medical and surgical aspects of stroke, clinical trials and design, epidemiology, stroke care delivery systems and outcomes, imaging sciences and rehabilitation of stroke. The Journal will be of special interest to specialists involved in caring for patients with cerebrovascular disease, including neurologists, neurosurgeons and cardiologists.