Department of Neurology, G. da Saliceto Hospital, Via Cantone del Cristo, 29100 Piacenza, Italy.
Neurol Sci. 2013 Jul;34(7):1087-92. doi: 10.1007/s10072-012-1226-3. Epub 2012 Nov 18.
The stroke units (SUs) have been demonstrated to be efficient and cost effective for acute stroke care. Nevertheless, the level of stroke unit implementation in Italy does not correspond to expectations yet. This study is a survey, which aims at assessing the current status of in-hospital stroke care in the Italian regions and at updating SUs. The survey was conducted by means of a semi-structured questionnaire, based on 18 stroke care "quality indicators", submitted to all the Italian centres that had taken part in the SITS-MOST study, and to other centres advised by the coordinator of SITS studies and by regional opinion leaders of stroke. SUs were defined as acute wards, with stroke-dedicated beds and dedicated teams that had been formally authorised to administer rt-PA. A statistical analysis was performed by a descriptive statistics and logistic regression model. The study was carried out from November 2009 to September 2010. A total of 168 forms were sent out and 153 replies received. Seven centres, which had not performed any thrombolytic treatment, and 16 which did not fulfil the criteria for the definition of SU were excluded from the study. Most of the centres reported more than 100 stroke patient admissions per year, i.e., 122 (84%) from 100 to 500, 18 (12%) more than 500. The 19% of the centres admitted more than 30% of patients within 3 h from the symptom onset and only 30% admitted more than 30% of patients within 4.5 h. The mean number of thrombolyses performed in the last 6 months was 10 for centres with a doctor on duty 24 h a day, 6 for those that have a doctor on duty from 8 a.m. to 8 p.m. and a doctor on call for night, and 5 for centres with a doctor on call 24 h a day. The territorial distribution of the SUs is remarkably heterogeneous: 87 SUs (67%) are located in the North of Italy, 28 (22%) in the central part of Italy and only 15 (11%) in the South. The last few years have witnessed a rise in both the diffusion of SUs and access to thrombolytic therapy in Italy. Despite this, there are a few large areas, mostly in the south, where the requirements of healthcare legislation are not met, and access to a dedicated SU and thrombolytic treatment is still limited and poor.
卒中单元（SU）已被证明在急性卒中治疗中是有效且具有成本效益的。然而，意大利卒中单元的实施水平尚未达到预期。本研究是一项调查，旨在评估意大利各地区院内卒中治疗的现状，并更新卒中单元。该调查采用半结构化问卷进行，基于 18 项卒中护理“质量指标”，提交给所有参与 SITS-MOST 研究的意大利中心以及协调员和地区卒中意见领袖建议的其他中心。卒中单元被定义为配备专门床位和团队的急性病房，这些团队已获得正式授权使用 rt-PA。通过描述性统计和逻辑回归模型进行统计分析。该研究于 2009 年 11 月至 2010 年 9 月进行。共发出 168 份表格，收到 153 份回复。由于未进行任何溶栓治疗的 7 个中心和未满足 SU 定义标准的 16 个中心被排除在研究之外。大多数中心报告每年收治超过 100 例卒中患者，即 122 例（84%）为 100-500 例，18 例（12%）为 500 例以上。19%的中心在症状出现后 3 小时内收治超过 30%的患者，只有 30%的中心在 4.5 小时内收治超过 30%的患者。在过去 6 个月内进行的溶栓治疗中位数为 10 例，其中 24 小时有医生值班的中心为 10 例，上午 8 点至晚上 8 点有医生值班和夜间值班医生的中心为 6 例，24 小时有值班医生的中心为 5 例。卒中单元的地域分布差异很大：87 个（67%）位于意大利北部，28 个（22%）位于意大利中部，只有 15 个（11%）位于意大利南部。过去几年，意大利的卒中单元和溶栓治疗的应用都有所增加。尽管如此，在意大利仍有一些较大的地区，主要在南部，不符合医疗保健法规的要求，专用卒中单元和溶栓治疗的机会仍然有限且不足。
