Introduction
Adequate
planning and implementation of stroke systems of
care is key to
guarantee a rapid healthcare response and delivery of specific
reperfusion therapies among candidates. We assessed the availability of
stroke
care plans in Europe, and evaluated their impact on rates of
reperfusion therapies for stroke.
Patients
Based
on the European Stroke Organisation (ESO), the European Society of
Minimally Invasive Neurological Therapy (ESMINT), the European Academy
of Neurology (EAN), and the Stroke Alliance for Europe (SAFE) survey, we
analysed specific prespecified items in the questionnaire regarding
availability and adequacy of stroke
care plans, organised prehospital
care and their potential impact on rates of delivery of reperfusion
therapies for stroke at the country level.
Results
Of
44 participating European countries, 37 have stroke
care plans that
operate at national and/or regional levels. Most stroke
care plans take
responsibility for the organisation/implementation of stroke systems of
care (86%), quality of
care assessment (77%), and act as a liaison
between emergency medical systems and stroke physicians (79%). As for
stroke systems of
care, the focus is mainly on prehospital and
in-hospital acute stroke
care (Code Stroke systems available in 37/44
countries). Preferred urgent transport is via non-medicalised ambulances
(70%). Presence of stroke
care plans, stroke registry data, transport
of urgent stroke patients via non-medicalised ambulances, and
drip-and-ship routing of acute patients showed higher reperfusion
treatment rates.
Discussion
Availability
of stroke
care plans, still absent in some European countries, as well
as some features of the stroke systems of
care are associated with
higher reperfusion treatment rates.
Conclusion
Stroke is not yet a priority everywhere in Europe, which is a barrier to the spread of reperfusion therapies for stroke.
(You have explicitly proven that by focusing on care rather than results.)
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