Stroke. 2019 Jul;50(7):e187-e210. doi: 10.1161/STR.0000000000000173. Epub 2019 May 20.
In 2005, the American Stroke Association published recommendations for the establishment of stroke systems of care and in 2013 expanded on them with a statement on interactions within stroke systems of care. The aim of this policy statement is to provide a comprehensive review of the scientific evidence evaluating stroke systems of care to date and to update the American Stroke Association recommendations on the basis of improvements in stroke systems of care. Over the past decade, stroke systems of care have seen vast improvements in endovascular therapy, neurocritical care, and stroke center certification, in addition to the advent of innovations, such as telestroke and mobile stroke units, in the context of significant changes in the organization of healthcare policy in the United States. This statement provides an update to prior publications to help guide policymakers and public healthcare agencies in continually updating their stroke systems of care in light of these changes. This statement and its recommendations span primordial and primary prevention, acute stroke recognition and activation of emergency medical services, triage to appropriate facilities, designation of and treatment at stroke centers, secondary prevention at hospital discharge, and rehabilitation and recovery.
2005 年，美国卒中协会发布了建立卒中医疗服务体系的建议，并于 2013 年发表了关于卒中医疗服务体系内部相互作用的声明。本政策声明的目的是对迄今为止评估卒中医疗服务体系的科学证据进行全面审查，并根据卒中医疗服务体系的改进更新美国卒中协会的建议。在过去的十年中，卒中医疗服务体系在血管内治疗、神经重症监护和卒中中心认证方面取得了巨大进展，此外，随着美国医疗保健政策组织的重大变化，远程卒中和移动卒中单元等创新也应运而生。本声明对先前的出版物进行了更新，以帮助政策制定者和公共医疗保健机构根据这些变化不断更新其卒中医疗服务体系。本声明及其建议涵盖了原始和一级预防、急性卒中识别和紧急医疗服务的启动、分诊至适当的医疗机构、卒中中心的指定和治疗、出院后的二级预防以及康复和恢复。
