Development of the Madrid Stroke Programme: Milestones and Changes in Stroke Trends and Mortality from 1997 to 2017

Pastor, Silvia; Celis, Elena de; García, Itsaso Losantos; Leciñana, María Alonso de; Fuentes, Blanca; Díez‐Tejedor, Exuperio

doi:10.1159/000514077

Cited by 5 publications

(2 citation statements)

References 14 publications

(11 reference statements)

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“…Ten of them have a stroke Unit (SU) and can provide intravenous thrombolysis (IVT). Seven are MT‐ready on a weekly rotation basis, ensuring that three hospitals provide full‐time coverage every day [ 20 , 21 ]. Patients are evaluated by the on-duty neurologist, who administers urgent treatment and admits them to the stroke unit after performing the relevant imaging tests.…”

Section: Methodsmentioning

confidence: 99%

The COVID-19 pandemic effect on the prehospital Madrid stroke code metrics and diagnostic accuracy

Riera-López

Gaetano-Gil²,

Martínez-Gómez³

et al. 2022

PLoS ONE

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Background Only very few studies have investigated the effect of the COVID-19 pandemic on the pre-hospital stroke code protocol. During the first wave, Spain was one of the most affected countries by the SARS-CoV-2 coronavirus disease pandemic. This health catastrophe overshadowed other pathologies, such as acute stroke, the leading cause of death among women and the leading cause of disability among adults. Any interference in the stroke code protocol can delay the administration of reperfusion treatment for acute ischemic strokes, leading to a worse patient prognosis. We aimed to compare the performance of the stroke code during the first wave of the pandemic with the same period of the previous year. Methods This was a multicentre interrupted time-series observational study of the cohort of stroke codes of SUMMA 112 and of the ten hospitals with a stroke unit in the Community of Madrid. We established two groups according to the date on which they were attended: the first during the dates with the highest daily cumulative incidence of the first wave of the COVID-19 (from February 27 to June 15, 2020), and the second, the same period of the previous year (from February 27 to June 15, 2019). To assess the performance of the stroke code, we compared each of the pre-hospital emergency service time periods, the diagnostic accuracy (proportion of stroke codes with a final diagnosis of acute stroke out of the total), the proportion of patients treated with reperfusion therapies, and the in-hospital mortality. Results SUMMA 112 activated the stroke code in 966 patients (514 in the pre-pandemic group and 452 pandemic). The call management time increased by 9% (95% CI: -0.11; 0.91; p value = 0.02), and the time on scene increased by 12% (95% CI: 2.49; 5.93; p value = <0.01). Diagnostic accuracy, and the proportion of patients treated with reperfusion therapies remained stable. In-hospital mortality decreased by 4% (p = 0.05). Conclusions During the first wave, a prolongation of the time “on the scene” of the management of the 112 calls, and of the hospital admission was observed. Prehospital diagnostic accuracy and the proportion of patients treated at the hospital level with intravenous thrombolysis or mechanical thrombectomy were not altered with respect to the previous year, showing the resilience of the stroke network and the emergency medical service.

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Section: Methodsmentioning

confidence: 99%

The COVID-19 pandemic effect on the prehospital Madrid stroke code metrics and diagnostic accuracy

Riera-López

Gaetano-Gil²,

Martínez-Gómez³

et al. 2022

PLoS ONE

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“…troke is the second leading cause of death worldwide [1]. The complications of a stroke in the early days of hospitalized patients significantly increase the mortality rate [2][3][4].…”

Section: Introductionmentioning

confidence: 99%

New-onset Constipation After Stroke: Caspian Nursing Process Projects

Alijanpour

Alimohamadi

Khafri

et al. 2022

J Holist Nurs Midwifery

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Introduction: The impacts of new-onset constipation outcomes in stroke clients have remained unclear. It seems helpful to update the structure planning with nursing-led intervention. Objective: The current study aimed to present a protocol and methods of Caspian Nursing Process Projects in new-onset constipation by nursing-led intervention considering the experts’ point of view. Materials and Methods: The current multi-stage evolutionary study describes the protocol and methods of Caspian Nursing Process Projects, which were conducted on stroke constipation, such as new-onset constipation. The study was conducted in several phases, including searching for scientific sources, formal-content validity, RAND and Delphi methods, and changes made at the Delphi stage and the experts’ panel. We selected 21 studies published between January 2004 and December 2019 in the Cochran database, Medline, Science Direct, PubMed, Elsevier, and Scopus. The PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) and AGREE II (The Appraisal of Guidelines for Research & Evaluation) were used to evaluate the articles and guidelines. Results: After considering the inclusion and exclusion criteria, 14 articles and guidelines were entered. Most of the authorities were 16 men (72.7%), 11 cases had MD degrees (50%), and 4 (18.2%) were neurologists. Regarding the priority, the highest agreement was found on patient and companion education (98%) and the lowest on disability in daily activity (75.6%). In terms of benefits, patient education again achieved the highest agreement with 97.2%, and use of the Bartel index with 73.6% obtained the lowest agreement. Regarding the applicability, registration, and reporting, the water and electrolyte impairment and educational booklet obtained the highest agreement with 93.6%. Conclusion: All recommendations had reached over 70% agreement in all four areas of the initial draft, and some care should be taken only by stroke nurses or critical care nursing. The study results can be used for developing national guidelines or criteria.

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