European Stroke Organisation Recommendations to Establish a Stroke Unit and Stroke Center

Ringelstein, E. Bernd; Chamorro, Ángel; Kaste, Markku; Langhorne, Peter; Leys, Didier; Lyrer, Philippe; Thijs, Vincent; Thomassen, Lars; Toni, Danilo

doi:10.1161/strokeaha.112.670430

Cited by 141 publications

(129 citation statements)

References 67 publications

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“…5 Along this pathway, thrombolysis should be initiated immediately after radiological exclusion of intracranial bleeds. Once thrombolysis is running, arterial imaging is rapidly added to identify and transfer suitable endovascular patients (drip-and-ship, pathway B2).…”

mentioning

confidence: 99%

Prehospital Scales for Large Vessel Occlusion

Michel

2017

Stroke

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mentioning

confidence: 99%

Prehospital Scales for Large Vessel Occlusion

Michel

2017

Stroke

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“…Only two (10%) of the ROI units and none of the NI units met the ESO recommended 1:2 total nursing ratio for low dependency stroke beds and none met the 1.5:1 ratio suggested for high acuity beds in ESO guidelines. 3 Ratio of allied health professionals per 10 stroke unit beds is outlined in Table 2. It appears that there are a significantly higher proportion of Dieticians and Speech and Language Therapists in ROI than either NI or the UK.…”

Section: Resultsmentioning

confidence: 99%

“…Whilst the evidence for stroke units is also strong and the components that represent stroke unit care are agreed, 2,6 it is sometimes difficult to make an arbitrary call as to whether a hospital meets criteria or not. Both ESO and American Stroke Association guidelines 3,15 have tried to address this by establishing The other issue is in resource allocation. At first glance there is little difference between Irish and UK facilities.…”

Section: Discussionmentioning

confidence: 99%

A comparison of service organisation and guideline compliance between two adjacent European health services

McElwaine

McCormack

McCormick³

et al. 2017

European Stroke Journal

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Introduction: Outcomes in stroke patients are improved by a co-ordinated organisation of stroke services and provision of evidence-based care. We studied the organisation of care and application of guidelines in two neighbouring health care systems with similar characteristics. Methods: Organisational elements of the 2015 National Stroke Audit (NSA) from the Republic of Ireland (ROI) were compared with the Sentinel Stroke National Audit Programme (SSNAP) in Northern Ireland (NI) and the United Kingdom (UK). Compliance was compared with UK and European guidelines. Results: Twenty-one of 28 ROI hospitals (78%) reported having a stroke unit (SU) compared with all 10 in NI. Average SU size was smaller in ROI (6 beds vs. 15 beds) and bed availability per head of population was lower (1:30,633 vs. 1:12,037 p < 0.0001 Chi Sq). Fifty-four percent of ROI patients were admitted to SU care compared with 96% of UK patients (p < 0.0001). Twenty-four-hour physiological monitoring was available in 54% of ROI SUs compared to 91% of UK units (p < 0.0001). There was no significant difference between ROI and NI in access to senior specialist physicians or nurses or in SU nurse staffing (3.9/10 beds weekday mornings) but there was a higher proportion of trained nurses in ROI units (2.9/10 beds vs. 2.3/10 beds (p ¼ 0.02 Chi Sq). Conclusion: Whilst the majority of hospitals in both jurisdictions met key criteria for organised stroke care the small size and underdevelopment of the ROI units meant a substantial proportion of patients were unable to access this specialised care.

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“…In other countries, despite differences in the directions and ideas for organizing nationwide infrastructure for stroke care system, PSCs are key units of organizations to provide nationwide quality care for stroke. [5][6][7] PSCs, which aim to provide acute management of patients with stroke, could start intravenous thrombolysis after inclusion criteria evaluation. If a patient requires intra-arterial thrombolysis as bridging or primary therapy after initial therapy in a PSC, the patient will be transferred to a Regional CSC.…”

Section: Discussionmentioning

confidence: 99%

“…5 The United States and Europe have been trying to improve nationwide care quality of stroke through the systematic organization of stroke centers. 6,7 In 2008, the Ministry of Health and Welfare (MHW) of South Korea initiated the Regional Comprehensive Stroke Center (CSC) program to decrease the incidence and mortality of stroke. 4 Thus, CSCs were established in 9 local provincial regions nationwide, excluding the Seoul metropolitan area.…”

mentioning

confidence: 99%

Establishment of Government-Initiated Comprehensive Stroke Centers for Acute Ischemic Stroke Management in South Korea

Kim¹,

Hwang²,

Kim³

et al. 2014

Stroke

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Background and Purpose-In 2008, the Ministry of Health and Welfare of South Korea initiated the Regional ComprehensiveStroke Center (CSC) program to decrease the incidence and mortality of stroke nationwide. We evaluated the performance of acute ischemic stroke management after the Regional CSC program was introduced. Methods-The Ministry of Health and Welfare established 9 Regional CSCs in different provinces from 2008 to 2010. All Regional CSCs have been able to execute the critical processes independently for stroke management since 2011. The Ministry of Health and Welfare was responsible for program development and financial support, the Regional CSC for program execution, and the Korea Centers for Disease Control and Prevention for auditing the execution. We analyzed prospectively collected data on the required indices from 2011 and repeated the analysis the following year for comparison. Results-After the Regional CSCs were established, the first brain image was taken within 1 hour from arrival at the emergency room for all patients with stroke; the length of hospital stay decreased from 14 to 12 days; for the rapid execution of thrombolysis, the first brain image was taken within 12 minutes; intravenous and intra-arterial thrombolysis were started within 40 and 110 minutes, respectively, after emergency room arrival; and the hospital stay of thrombolytic patients decreased from 19 to 15 days. Conclusions-The

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European Stroke Organisation Recommendations to Establish a Stroke Unit and Stroke Center

Cited by 141 publications

References 67 publications

Prehospital Scales for Large Vessel Occlusion

Prehospital Scales for Large Vessel Occlusion

A comparison of service organisation and guideline compliance between two adjacent European health services

Establishment of Government-Initiated Comprehensive Stroke Centers for Acute Ischemic Stroke Management in South Korea

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