Barragán-Prieto Ana, Pérez-Sánchez Soledad, Moniche Francisco, Moyano Roberto Valverde, Delgado Fernando, Martínez-Sánchez Patricia, Moya Miguel, Oropesa Juan M, Mínguez-Castellanos Adolfo, Villegas Inmaculada, Álvarez Soria María José, Tamayo Toledo Jose Antonio, de la Cruz Cosme Carlos, Canto Neguillo Rafael, Herrerías Esteban Juan Manuel, Montero Cobos Daniel José, Moreno Muñoz Jose Antonio, González Alejandro, Montaner Joan
Department of Neurology, Hospital Universitario Virgen Macarena, Sevilla, Spain.
Neurovascular Research Laboratory, Instituto de Biomedicina de Sevilla, Sevilla, Spain.
Eur Stroke J. 2022 Sep;7(3):259-266. doi: 10.1177/23969873221101282. Epub 2022 May 25.
Acute ischemic stroke therapy has improved in recent decades, decreasing the rates of disability and death among stroke patients. Unfortunately, all health care systems have geographical disparities in infrastructure for stroke patients. A centralized telestroke network might be a low-cost strategy to reduce differences in terms of geographical barriers, equitable access, and quality monitoring across different hospitals.
We aimed to quantify changes in stroke patients' geographic access to specialized evaluation by neurologists and to intravenous acute stroke reperfusion treatments following the rapid implementation of a centralized telestroke network in the large region of Andalusia (8.5 million inhabitants).
We conducted an observational study using spatial and analytical methods to examine how a centralized telestroke network influences the quality and accessibility of stroke care for a large region.
In the pre-implementation period, 5,005,477 (59.72% of the Andalusian population) had access to specialized stroke care in less than 30 min. After the 5-month process of implementing the telestroke network, 7,832,988 (93.5%) inhabitants had an access time of less than 30 min, bridging the gap in acute stroke care in rural hospitals.
A centralized telestroke network may be an efficient tool to reduce the differences in stroke care access and quality monitoring across different hospitals, especially in large regions with low population density.
近几十年来，急性缺血性中风的治疗方法有所改进，降低了中风患者的残疾率和死亡率。不幸的是，所有医疗保健系统在中风患者的基础设施方面都存在地域差异。集中式远程中风网络可能是一种低成本策略，可减少不同医院在地理障碍、公平获取和质量监测方面的差异。
我们旨在量化在安达卢西亚大区（850万居民）快速实施集中式远程中风网络后，中风患者获得神经科医生专业评估和静脉急性中风再灌注治疗的地理可及性变化。
我们进行了一项观察性研究，使用空间和分析方法来研究集中式远程中风网络如何影响一个大区域中风护理的质量和可及性。
在实施前阶段，5,005,477人（占安达卢西亚人口的59.72%）能够在不到30分钟内获得专业的中风护理。在实施远程中风网络的5个月过程后，7,832,988人（93.5%）的获取时间不到30分钟，弥合了农村医院急性中风护理的差距。
集中式远程中风网络可能是一种有效的工具，可减少不同医院在中风护理可及性和质量监测方面的差异，特别是在人口密度低的大区域。
