Leys D, Falcou A, Mas J-L
University of Lille, Inserm U 1172, Lille, France.
Emergency Department, Umberto 1 Hospital, University La Sapienza, Rome, Italy.
Rev Neurol (Paris). 2022 Dec;178(10):1072-1078. doi: 10.1016/j.neurol.2022.07.010. Epub 2022 Nov 3.
According to the French regulation, stroke units (SU) include both an intensive (I-SU) and a non-intensive (NI-SU) component. Their standard operating procedures have been detailed in governmental directives in 2003 and 2007.
To evaluate (i) resources available in French SU, (ii) differences between regions, and between France and the 2 close European countries of similar size, and (iii) to identify avenues for improvement.
We performed a survey of all French SU, with an online questionnaire, to evaluate available resources and activity. We compared the 17 French regions, and France, with Germany and Italy. We used 2019 as year of reference.
The 138 French SU, shared 911 I-SU beds; 123 SU (89.1%) answered the questionnaire. The number of I-SU beds per million inhabitants was 13.6 for the whole country, with important differences between regions, ranging from 7.0 (Reunion Island) to 20.9 (Occitanie region). Per million inhabitants, France had fewer I-SU beds than Germany and Italy (13.5 vs. 29.9 and 23.2 respectively), and fewer thrombectomy centres (0.6 vs. 1.8 and 1.0). Per million inhabitants, France had also lower thrombolysis (203 vs. 402) and thrombectomy (104 vs. 194) rates than Germany, but, compared with Italy, similar thrombolysis rates (203 vs. 202) and higher thrombectomy rates (104 vs. 81).
There are still avenues for improvement in acute stroke care in France, especially concerning the number and regional repartition of I-SU beds, and access to reperfusion therapies.
根据法国法规，卒中单元（SU）包括重症（I-SU）和非重症（NI-SU）两个部分。其标准操作程序已在2003年和2007年的政府指令中详细说明。
评估（i）法国卒中单元可用资源，（ii）不同地区之间以及法国与两个规模相近的欧洲邻国之间的差异，（iii）确定改进途径。
我们通过在线问卷对所有法国卒中单元进行了调查，以评估可用资源和活动情况。我们将法国的17个地区以及法国与德国和意大利进行了比较。我们以2019年作为参考年份。
138个法国卒中单元共有911张I-SU床位；123个卒中单元（89.1%）回答了问卷。全国每百万居民的I-SU床位数为13.6，各地区之间存在显著差异，从7.0（留尼汪岛）到20.9（奥克西塔尼地区）不等。每百万居民中，法国的I-SU床位比德国和意大利少（分别为13.5张对29.9张和23.2张），血栓切除术中心也更少（0.6个对1.8个和1.0个）。每百万居民中，法国的溶栓率（203例对402例）和血栓切除术率（104例对194例）也低于德国，但与意大利相比，溶栓率相似（203例对202例），血栓切除术率更高（104例对81例）。
法国急性卒中护理仍有改进空间，特别是在I-SU床位的数量和地区分布以及再灌注治疗的可及性方面。
