Sección de Neurología, Hospital Dr. Negrín, Las Palmas, España.
Neurologia. 2011 Oct;26(8):449-54. doi: 10.1016/j.nrl.2010.10.014. Epub 2011 Mar 26.
Stroke is currently a major social health problem. For this reason, the Spanish Ministry of Health approved the Stroke National Strategy (SNS) in 2008 to improve the prevention, treatment and rehabilitation of stroke patients. This plan intends to guarantee 24-hour, 365-days neurological assistance in the whole country by the end of 2010. Our aim was to analyse the situation of stroke assistance in Spain in 2009.
A committee of neurologists practicing in the different autonomous communities (AC), and who had not participated in the preparation of the SNS, was created. A national survey was performed including the number of stroke units (SU) and their characteristics (monitoring, 24-h/7-day on-call neurology service, nursing staff ratio and the use of protocols), bed ratio of SU/100,000 people, availability of intravenous thrombolysis therapy, neurovascular intervention (NI) and telemedicine.
We included data from 145 hospitals. There are 39 SU in Spain, unevenly distributed. The ratio between SU bed/number of people/AC varied from 1/75,000 to 1/1,037,000 inhabitants; Navarra and Cantabria met the goal. Intravenous thrombolysis therapy is used in 80 hospitals; the number of treatments per AC was between 7 and 536 in 2008. NI was performed in the 63% of the AC, with a total of 28 qualified hospitals (although only 1 hospital performed it 24h, 7 days a week in 2009). There were 3 hospitals offering clinical telemedicine services.
Assistance for stroke patients has improved in Spain compared to previous years, but there are still some important differences between the AC that must be eliminated to achieve the objectives of the SNS.
中风目前是一个重大的社会健康问题。出于这个原因，西班牙卫生部于 2008 年批准了国家中风战略（SNS），以改善中风患者的预防、治疗和康复。该计划旨在到 2010 年底在全国范围内保证 24 小时、365 天的神经科援助。我们的目的是分析 2009 年西班牙中风援助的情况。
成立了一个由在不同自治区（AC）执业的神经科医生组成的委员会，他们没有参与 SNS 的准备工作。进行了一项全国性调查，包括中风单元（SU）的数量及其特点（监测、24 小时/7 天随叫随到的神经科服务、护理人员比例和使用方案）、SU/每 10 万人床位的比例、静脉内溶栓治疗、神经血管介入（NI）和远程医疗的可用性。
我们纳入了来自 145 家医院的数据。西班牙有 39 个 SU，分布不均。SU 床位/人口/AC 的比例在 1/75,000 到 1/1,037,000 居民之间；纳瓦拉和坎塔布里亚符合目标。80 家医院使用静脉内溶栓治疗；2008 年，每个 AC 的治疗次数在 7 到 536 之间。63%的 AC 进行了 NI，共有 28 家合格的医院（尽管只有 1 家医院在 2009 年每周 7 天、每天 24 小时进行）。有 3 家医院提供临床远程医疗服务。
与前几年相比，西班牙中风患者的援助有所改善，但自治区之间仍存在一些重要差异，必须消除这些差异，以实现 SNS 的目标。
