[Asymmetries in the hospital treatment of acute ischemic stroke]

J Healthc Qual Res. 2018 Jan-Feb;33(1):18-22. doi: 10.1016/j.cali.2017.12.003. Epub 2018 Feb 17.
[Article in Spanish]

Abstract

Objective: To analyze the degree of implementation of the protocolized care for acute stroke in the Spanish emergency departments and to discuss the territorial differences in the treatment of stroke.

Material and methods: Multicenter national survey conducted to evaluate the current treatment of ischemic stroke in emergency departments. The main variables analyzed were focused at evaluating the participation of ERs in the performance of thrombolysis, interventional treatment and destination of patients with stroke.

Results: 42 emergency services participated. 90.5% have stroke protocol. In 52.4% is identified an emergency physician referent in cerebrovascular pathology. In 2016 2090 thrombolysis were performed, we observe a great variability in the number of treatments per hospital [0-222]. 11.9% were admitted in the Observation area. Only one-third of the hospitals currently treat stroke with thrombectomy. 31% have a telemedicine service available.

Conclusions: Urgencies plays a fundamental role in the chain of care of stroke treatment. There is a worrying variability between centers in the management of the stroke.

Keywords: Emergency; Health organization; Ictus; Organización sanitaria; Stroke; Urgencias.

Publication types

  • Multicenter Study

MeSH terms

  • Acute Disease
  • Brain Ischemia / therapy*
  • Disease Management
  • Emergency Service, Hospital* / statistics & numerical data
  • Fibrinolysis
  • Fibrinolytic Agents / therapeutic use
  • Health Care Surveys
  • Healthcare Disparities*
  • Hospital Bed Capacity
  • Hospitals
  • Humans
  • Procedures and Techniques Utilization
  • Telemedicine / statistics & numerical data
  • Thrombectomy / statistics & numerical data
  • Thrombolytic Therapy / statistics & numerical data

Substances

  • Fibrinolytic Agents