Stroke Management in Northern Lombardy: Organization of An Emergency-Urgency Network and Development of a Connection between Prehospital and In-Hospital Settings

Author:

Vidale Simone1,Verrengia Elena2,Gerardi Francesca2,Arnaboldi Marco1,Bezzi Giacomo3,Bono Giorgio4,Guidotti Mario5,Grampa Giampiero6,Perrone Patrizia7,Zarcone Davide8,Zoli Alberto9,Beghi Ettore10,Agostoni Elio11,Porazzi Daniele12,Landriscina Mario13

Affiliation:

1. Department of Neurology, Sant'Anna Hospital, San Fermo della Battaglia, Italy

2. Emergency Stroke Network Project, Lecco, Italy

3. Department of Neurology, Sondrio Hospital, Sondrio, Italy

4. Department of Neurology, University of Insubria, Varese, Italy

5. Department of Neurology, Valduce Hospital, Como, Italy

6. Department of Neurology, Circolo Hospital, Saronno, Italy

7. Department of Neurology, Civic Hospital, Legnano, Italy

8. Department of Neurology, Sant'Antonio Abate Hospital, Gallarate, Italy

9. Emergency Urgency Regional Agency, Milan, Italy

10. Mario Negri Institute, Milan, Italy

11. Department of Neurosciences, A Manzoni Hospital, Lecco, Italy

12. Department of Neurology, Circolo Hospital, Busto Arsizio, Italy

13. Department of Emergency-Urgency, Sant'Anna Hospital, San Fermo della Battaglia, Italy

Abstract

Stroke is the leading cause of disability in adulthood, and the principal aim of care in cerebrovascular disease is the reduction of this negative outcome and mortality. Several studies demonstrated the efficacy of thrombolytic therapy in ischemic stroke, but up to 80% of cases could not be treated because the diagnostic workup exceeds the time limit. In this article, we described the design of a study conducted in the northern Lombardy, within the district of Sondrio, Lecco, Como, and Varese. The awaited results of this study are reduction of avoidable delay, organization of an operative stroke emergency network, and identification of highly specialized structures. The study schedules education and data registration with implementation and training of acute stroke management algorithms. The use of standardized protocols during prehospital and in-hospital phase can optimize acute stroke pathways. The results of this study could contribute to the assessment of an effective and homogeneous health system to manage acute stroke.

Publisher

SAGE Publications

Subject

Neurology

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