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Delivery of acute ischaemic stroke treatments in the European region in 2019 and 2020
D. Aguiar de Sousa, A. Wilkie, B. Norrving, C. Macey, C. Bassetti, C. Tiu, G. Roth, G. Lunde, H. Christensen, J. Fiehler, FR. Pezzella, M. Dichgans, MB. Roaldsen, P. Kelly, R. Mikulik, S. Sacco, V. Caso, U. Fischer, Steering Committee for the...
Jazyk angličtina Země Anglie, Velká Británie
Typ dokumentu časopisecké články
- MeSH
- cévní mozková příhoda * epidemiologie MeSH
- endovaskulární výkony * MeSH
- ischemická cévní mozková příhoda * epidemiologie MeSH
- ischemie mozku * epidemiologie MeSH
- lidé MeSH
- trombolytická terapie MeSH
- výsledek terapie MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
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.
Department of Biotechnological and Applied Clinical Sciences University of L'Aquila L'Aquila Italy
Department of Neurology Copenhagen University Hospital Bispebjerg Copenhagen Denmark
Department of Neurology Inselspital Bern and Medical Faculty University of Bern Bern Switzerland
Department of Neurology University Hospital Basel University of Basel Basel Switzerland
Division of Cardiology Department of Medicine University of Washington Seattle WA USA
Irish Heart Foundation Dublin Ireland
Stroke Alliance for Europe Brussels Belgium
Stroke Unit Department of Neuroscience San Camillo Forlanini Hospital Rome Italy
Stroke Unit Santa Maria della Misericordia Hospital University of Perugia Perugia Italy
Citace poskytuje Crossref.org
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- $a Aguiar de Sousa, Diana $u Stroke Center, Lisbon Central University Hospital and Faculty of Medicine, University of Lisbon, Lisbon, Portugal $1 https://orcid.org/0000000267027924
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- $a 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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