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

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AGUIAR de Sousa Diana WILKIE Arlene NORRVING Bo MACEY Chris BASSETTI Claudio TIU Cristina ROTH Greg LUNDE Grethe CHRISTENSEN Hanne FIEHLER Jens PEZZELLA Francesca Romana DICHGANS Martin ROALDSEN Melinda B KELLY Peter MIKULÍK Robert SACCO Simona CASO Valeria FISCHER Urs

Rok publikování 2023
Druh Článek v odborném periodiku
Časopis / Zdroj EUROPEAN STROKE JOURNAL
Fakulta / Pracoviště MU

Lékařská fakulta

Citace
www https://journals.sagepub.com/doi/10.1177/23969873231186042
Doi http://dx.doi.org/10.1177/23969873231186042
Klíčová slova Europe; acute stroke treatment; health care resources; stroke unit; intravenous thrombolysis; endovascular treatment; stroke care implementation
Popis 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.

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