Overview of key factors in improving access to acute stroke care
Overview of key factors in improving access to acute stroke care
复制标题
DOI：
10.1212/wnl.0b013e3182695a2a
复制
发表时间：
2012-09-01
期刊：
影响因子：
9.9
通讯作者：
Zaidat, Osama O.
中科院分区：
文献类型：
--
作者：
El Khoury, Ramy;Jung, Richard;Zaidat, Osama O.
背景：尽管近年来急性脑卒中治疗取得了进展，但只有一小部分急性缺血性脑卒中患者接受静脉注射和血管内血管重建术治疗。这篇文章概述了影响获得中风治疗的因素。方法：总结美国血管与介入神经病学学会（SVIN）圆桌会议上重点讨论的影响卒中患者获得治疗的关键因素。从Medline数据库（1995年至2011年）中选取了有关院前、医院、立法和经济因素影响卒中治疗可及性的相关参考文献。简要总结这些关键因素在改善获得中风治疗提供。结果：院前因素包括社区因素；对医院管理人员和卫生保健人员的教育；调度程序;医疗运输系统；应急医疗服务（EMS）的防范和中风教育。中风准备医院和与其他区域性三级中风医院联网在增加获得中风护理方面发挥着重要作用。此外，州和联邦一级的立法是向一般人群提供高质量、及时的中风护理的关键因素。促进获得脑卒中治疗的策略对于改善死亡率和功能结局以及增加全身性溶栓和血管内入路治疗的患者比例至关重要。结论：本文对影响脑卒中护理可及性的因素进行了简要概述和总结。这些因素分为院前、医院、立法和经济类别。人口、公共卫生保健人员、医院准备以及立法和经济因素的多层次教育对于改善卒中治疗的可及性很重要。神经病学(R) 2012；79（补充1）：S26-S34
Background: Despite recent advances in acute stroke therapy, only a small proportion of patients with acute ischemic stroke receive IV and endovascular revascularization therapies. This article provides an overview of factors influencing access to stroke therapy.Methods: The key factors influencing access to stroke care highlighted during the Society of Vascular and Interventional Neurology (SVIN) roundtable meeting are summarized. Pertinent selected references on prehospital, hospital, and legislative and economic factors influencing access to stroke care, from the Medline database (between 1995 to 2011), are included. A brief summary of these key factors in improving access to stroke therapy is provided.Results: Prehospital factors include the community; education of hospital administrators and health care personnel; dispatchers; the medical transport system; and preparedness and stroke education of emergency medical services (EMS). Stroke-ready hospitals and networking with other regional tertiary stroke hospitals play important roles in increasing access to stroke care. In addition, legislation at the state and federal levels is a key factor in providing high-quality, timely access to stroke care for the population in general. Strategies to facilitate access to stroke therapy are critical to improving mortality and functional outcome and increasing the proportion of patients treated by systemic thrombolysis and endovascular approaches.Conclusion: This is a brief overview and summary of selected factors influencing access to stroke care. These factors are divided into prehospital, hospital, legislative, and economic categories. Multilevel education of the population, public health care personnel, hospital preparedness, and legislative and economic factors are important in improving access to stroke care. Neurology (R) 2012;79 (Suppl 1): S26-S34