Department of Neurology, University of Texas School of Medicine at Houston, Houston, TX, USA.
Neurology. 2012 Sep 25;79(13 Suppl 1):S26-34. doi: 10.1212/WNL.0b013e3182695a2a.
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.
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.
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.
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.
尽管急性中风治疗最近取得了进展，但只有一小部分急性缺血性中风患者接受静脉内和血管内再灌注治疗。本文概述了影响中风治疗途径的因素。
总结了在血管和介入神经病学学会（SVIN）圆桌会议上强调的影响中风护理途径的关键因素。从 Medline 数据库（1995 年至 2011 年）中选择与影响中风治疗途径的院前、医院、立法和经济因素相关的相关参考文献。简要概述了改善中风治疗途径的这些关键因素。
院前因素包括社区；医院行政管理人员和医护人员的教育；调度员；医疗运输系统；以及急诊医疗服务（EMS）的准备和中风教育。做好中风应对准备的医院以及与其他地区性三级中风医院建立网络，对增加中风护理途径起着重要作用。此外，州和联邦一级的立法是为一般人群提供高质量、及时获得中风护理的关键因素。促进中风治疗途径的策略对于改善死亡率和功能预后以及增加接受系统溶栓和血管内治疗的患者比例至关重要。
这是对影响中风护理途径的选定因素的简要概述和总结。这些因素分为院前、医院、立法和经济类别。人群、公共医疗保健人员、医院准备以及立法和经济因素的多层次教育对于改善中风护理途径至关重要。
