Delivery of acute ischaemic stroke treatments in the European region in 2019 and 2020
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Published:2023-07-11
Issue:3
Volume:8
Page:618-628
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ISSN:2396-9873
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Container-title:European Stroke Journal
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language:en
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Short-container-title:European Stroke Journal
Author:
Aguiar de Sousa Diana1ORCID, Wilkie Arlene2, Norrving Bo3, Macey Chris4, Bassetti Claudio5, Tiu Cristina6ORCID, Roth Greg7, Lunde Grethe2, Christensen Hanne8ORCID, Fiehler Jens9, Pezzella Francesca Romana10, Dichgans Martin11, Roaldsen Melinda B12ORCID, Kelly Peter13ORCID, Mikulik Robert14ORCID, Sacco Simona15ORCID, Caso Valeria16, Fischer Urs17, Basha Entela, Yeghiazaryan Nune, Kiechl Stefan, Shiraliyeva Rana, Vanacker Peter, Bender Marija, Emilov Tsalta-Mladenov Mihael, Budincevic Hrvoje, Tomek Ales, Kaponides Georgios, Klingenberg Iversen Helle, Faiss Jürgen, Kõrv Janika, Sairanen Tiina, Igor Sibon, Tsiskaridze Alexander, Ntaios George, Tsivgoulis Georgios, Szapary Laszlo, Logi Thorarinsson Bjorn, Harbison Joe, Bornstein Natan M., Toni Danilo, Fisnik Jashari, Karbozova Kunduz, Miglane Evija, Dalius Jatužis, Droste Dirk, Mallia Maria, Jevto Erakovic, Arsovska Anita, Fromm Annette, Kobayashi Adam, Azevedo Elsa, Groppa Stanislav, Cristina Tiu, Guekht Alla, Zivanovic Zeljko, Nosal Vladimir, Zvan Bojana, López-Cancio Elena, Pérez de la Ossa Natàlia, Norrving Bo, Nedeltchev Krassen, Vrijhoef Bert, Akif Topcuoglu Mehmet, Flomin Yuriy, Ahmed Rubina, Shelesko Andrey, Petrela Mentor, Zubalova Lina, Hasanov Rovshan, Raedt Sylvie De, Nevena Mahmutbegović, Peteva Andonova Silva, Poljakovic Zdravka, Skoda Ondrej, Søren Paaske Johnsen, med. Helmuth Steinmetz Prof. Dr., Kõrv Janika, Sairanen Tiina, Denis Sablot, Lobjanidze Nino, Milionis Haralambos, Mitsias Panagiotis, Tarkanyi MD Gabor, Elisabeth Klinke Marianne, Tanne David, Luca Petraglia, Dren Boshnjaku, Turgumbaev Dzhamal, Guntis Karelis, Dalius Jatužis, Droste Dirk, Mladen Debeljevic, Arsovska Anita, Kurz Martin, Anna Czlonkowska, Eremei Zota, Elena Oana Terecoasa, Martinov Mikhail, Jovanović Dejana, Gdovinova Zuzana, Zvan Bojana, López-Cancio Elena, Camps Renom Pol, Kwa Vincent, Murat Arsava Ethem, Gulyayeva Maryna, Dharmasiri Michelle, Basha Entela, Korompoki Eleni, Vadikolias Konstantinos, Bereczki MD Daniel, Bryndis Einarsdottir Anna, Afrim Blyta, Mamytova Elmira, Kristaps Jurjans, Daiva Rastenytė, Costache Oana, Milovan Roganovic, Fromm Annette, Michal Karlinski, Alexandru Gasnas, Sorin Tuta, Fidler Mikhail, Raičević Ranko, Zaletel Marjan, Castellanos Mar, Gómez-Choco Manuel, Sirin Hadiye, Lebedynets Dmytro, Khaira Jattinder, Enesi Eugen, Sahakyan David, Mammadbayli Ayten, Lemmens Robin, Dževdet Smajlović, Emilov Tsalta-Mladenov Mihael, Budincevic Hrvoje, Sramek Martin, Nabavi med. Darius, Vibo Riina, Strbian Daniel, Aliyev Rahim, Mikulik Robert, Ozretic David, Rocek Miloslav, Trine Stavngaard, med. Claus Zimmer Prof. Dr., Malikov Vladislav, Lappalainen Kimmo, Jerome Berge, Khinikadze Mirza, Brountzos Elias, Vilmarsson Vilhjalmur, Karlis Kupcs, Marius Kurminas, Hoffmann Michel, Grech Reuben, Marija Mitric, Kjellevold Wathle Gaute, Wojciech Poncyljusz, Igor Crivorucica, Bogdan Dorobat, Till Viktor, Klepanec Andrej, Milosevic Zoran, Macho Juan, Ozdemir Ozcan, Shchehlov Dmytro, Dorte Damgaard, Hermanek Peter, Sturua Lela, Siskou Olga, Tsivgoulis Georgios, Libruder Carmit, Indredavik Bent, Azevedo Elsa, Elena Manole, Mijajlović Milija, Turcani Peter, Norrving Bo, Bonati Leo, Nederkoorn Paul, Ertuğrul Eğin Muhammed, Samofalov Dmytro, Diana Ose, Rita Gaidelytė, Droste Dirk
Affiliation:
1. Stroke Center, Lisbon Central University Hospital and Faculty of Medicine, University of Lisbon, Lisbon, Portugal 2. Stroke Alliance for Europe, Brussels, Belgium 3. Department of Clinical Sciences, Section of Neurology, Lund University, Skåne University Hospital, Lund, Sweden 4. Irish Heart Foundation, Dublin, Ireland 5. Department of Neurology, Inselspital Bern and Medical Faculty, University of Bern, Bern, Switzerland 6. Department of Clinical Neurosciences, University of Medicine and Pharmacy ‘Carol Davila’ Bucharest, and Department of Neurology, University Hospital Bucharest, Romania 7. Division of Cardiology, Department of Medicine, University of Washington, Seattle, WA, USA 8. Department of Neurology, Copenhagen University Hospital, Bispebjerg, Copenhagen, Denmark 9. Department of Diagnostic and Interventional Neuroradiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany 10. Stroke Unit, Department of Neuroscience, San Camillo Forlanini Hospital, Rome, Italy 11. Institute for Stroke and Dementia Research, University Hospital, Ludwig Maximilian University, Munich and German Center for Neurodegenerative Diseases (DZNE), Munich, Germany 12. Center for Research and Education, University Hospital of North Norway and Department of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, Norway 13. Stroke and Neurology Department, Mater University Hospital and Stroke Clinical Trials Network Ireland, University College Dublin, Dublin, Ireland 14. International Clinical Research Center and Department of Neurology, St. Anne’s University Hospital in Brno and Faculty of Medicine at Masaryk University, Brno, Czech Republic 15. Department of Biotechnological and Applied Clinical Sciences University of L’Aquila, L’Aquila, Italy 16. Stroke Unit, Santa Maria della Misericordia Hospital, University of Perugia, Perugia, Italy 17. Department of Neurology, University Hospital Basel, University of Basel, Basel, Switzerland
Abstract
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.
Publisher
SAGE Publications
Subject
Cardiology and Cardiovascular Medicine,Neurology (clinical)
Cited by
9 articles.
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