Planning of stroke care and urgent prehospital care across Europe: Results of the ESO/ESMINT/EAN/SAFE Survey

on Behalf of The ESO/ESMINT/EAN/SAFE Survey on Stroke Care Collaborators†

Research output: Contribution to journalArticle

Abstract

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.

Original languageEnglish
JournalEuropean Stroke Journal
DOIs
Publication statusPublished - Jan 1 2019

Fingerprint

Ambulatory Care
Neurology
Stroke
Organizations
Therapeutics
Reperfusion
Surveys and Questionnaires
Ambulances
Ships
Quality of Health Care

Keywords

  • intravenous thrombolysis
  • mechanical thrombectomy
  • prehospital care
  • quality of care
  • Stroke
  • systems of care

ASJC Scopus subject areas

  • Clinical Neurology
  • Cardiology and Cardiovascular Medicine

Cite this

Planning of stroke care and urgent prehospital care across Europe : Results of the ESO/ESMINT/EAN/SAFE Survey. / on Behalf of The ESO/ESMINT/EAN/SAFE Survey on Stroke Care Collaborators†.

In: European Stroke Journal, 01.01.2019.

Research output: Contribution to journalArticle

on Behalf of The ESO/ESMINT/EAN/SAFE Survey on Stroke Care Collaborators†. / Planning of stroke care and urgent prehospital care across Europe : Results of the ESO/ESMINT/EAN/SAFE Survey. In: European Stroke Journal. 2019.
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abstract = "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.",
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AU - Abilleira, Sònia

AU - de Sousa, Diana Aguiar

AU - Gattringer, Thomas

AU - Kobayashi, Adam

AU - Fazekas, Franz

AU - Szikora, I.

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AU - Caso, Valeria

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KW - quality of care

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