Delivery of acute ischaemic stroke treatments in the European region in 2019 and 2020

被引:19
作者
de Sousa, Diana Aguiar [1 ,2 ]
Wilkie, Arlene [3 ]
Norrving, Bo [4 ]
Macey, Chris [5 ]
Bassetti, Claudio [6 ,7 ]
Tiu, Cristina [8 ,9 ]
Roth, Greg [10 ]
Lunde, Grethe [3 ]
Christensen, Hanne [11 ]
Fiehler, Jens [12 ]
Pezzella, Francesca Romana [13 ]
Dichgans, Martin [14 ,15 ]
Roaldsen, Melinda B. [16 ,17 ]
Kelly, Peter [18 ,19 ,20 ]
Mikulik, Robert [21 ,22 ]
Sacco, Simona [23 ]
Caso, Valeria [24 ]
Fischer, Urs [25 ]
机构
[1] Lisbon Cent Univ Hosp, Stroke Ctr, Lisbon, Portugal
[2] Univ Lisbon, Fac Med, Lisbon, Portugal
[3] Stroke Alliance Europe, Brussels, Belgium
[4] Lund Univ, Skane Univ Hosp, Dept Clin Sci, Sect Neurol, Lund, Sweden
[5] Irish Heart Fdn, Dublin, Ireland
[6] Inselspital Bern, Dept Neurol, Bern, Switzerland
[7] Univ Bern, Med Fac, Bern, Switzerland
[8] Univ Med & Pharm Carol Davila, Dept Clin Neurosci, Bucharest, Romania
[9] Univ Hosp Bucharest, Dept Neurol, Bucharest, Romania
[10] Univ Washington, Dept Med, Div Cardiol, Seattle, WA USA
[11] Copenhagen Univ Hosp, Dept Neurol, Bispebjerg, Copenhagen, Denmark
[12] Univ Med Ctr Hamburg Eppendorf, Dept Diagnost & Intervent Neuroradiol, Hamburg, Germany
[13] San Camillo Forlanini Hosp, Dept Neurosci, Stroke Unit, Rome, Italy
[14] Ludwig Maximilians Univ Munchen, Inst Stroke & Dementia Res, Univ Hosp, Munich, Germany
[15] German Ctr Neurodegenerat Dis DZNE, Munich, Germany
[16] Univ Hosp North Norway, Ctr Res & Educ, Tromso, Norway
[17] UiT Arctic Univ Norway, Dept Clin Med, Tromso, Norway
[18] Mater Univ Hosp, Stroke & Neurol Dept, Dublin, Ireland
[19] Univ Coll Dublin, Stroke Clin Trials Network Ireland, Dublin, Ireland
[20] St Annes Univ Hosp Brno, Int Clin Res Ctr, Brno, Czech Republic
[21] St Annes Univ Hosp Brno, Dept Neurol, Brno, Czech Republic
[22] Masaryk Univ, Fac Med, Brno, Czech Republic
[23] Univ LAquila, Dept Biotechnol & Appl Clin Sci, Laquila, Italy
[24] Univ Perugia, Stroke Unit, Santa Maria Misericordia Hosp, Perugia, Italy
[25] Univ Basel, Univ Hosp Basel, Dept Neurol, Basel, Switzerland
关键词
Europe; acute stroke treatment; health care resources; stroke unit; intravenous thrombolysis; endovascular treatment; stroke care implementation; ACTION PLAN; UNIT; COST;
D O I
10.1177/23969873231186042
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Introduction: We assessed best available data on access and delivery of acute stroke unit (SU) care, intravenous thrombolysis (IVT) and endovascular treatment (EVT) in the European region in 2019 and 2020. Patients and methods: We compared national data per number of inhabitants and per 100 annual incident first-ever ischaemic strokes (AIIS) in 46 countries. Population estimates and ischaemic stroke incidence were based on United Nations data and the Global Burden of Disease Report 2019, respectively. Results: The estimated mean number of acute SUs in 2019 was 3.68 (95% CI: 2.90-4.45) per one million inhabitants (MIH) with 7/44 countries having less than one SU per one MIH. The estimated mean annual number of IVTs was 21.03 (95% CI: 15.63-26.43) per 100,000 and 17.14% (95% CI: 12.98-21.30) of the AIIS in 2019, with highest country rates at 79.19 and 52.66%, respectively, and 15 countries delivering less than 10 IVT per 100,000. The estimated mean annual number of EVTs in 2019 was 7.87 (95% CI: 5.96-9.77) per 100,000 and 6.91% (95% CI: 5.15-8.67) of AIIS, with 11 countries delivering less than 1.5 EVT per 100,000. Rates of SUs, IVT and EVT were stable in 2020. There was an increase in mean rates of SUs, IVT and EVT compared to similar data from 2016. Conclusion: Although there was an increase in reperfusion treatment rates in many countries between 2016 and 2019, this was halted in 2020. There are persistent major inequalities in acute stroke treatment in the European region. Tailored strategies directed to the most vulnerable regions should be prioritised.
引用
收藏
页码:618 / 628
页数:11
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