1
|
Kim J, Olaiya MT, De Silva DA, Norrving B, Bosch J, De Sousa DA, Christensen HK, Ranta A, Donnan GA, Feigin V, Martins S, Schwamm LH, Werring DJ, Howard G, Owolabi M, Pandian J, Mikulik R, Thayabaranathan T, Cadilhac DA. Global stroke statistics 2023: Availability of reperfusion services around the world. Int J Stroke 2024; 19:253-270. [PMID: 37853529 PMCID: PMC10903148 DOI: 10.1177/17474930231210448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2023] [Accepted: 10/09/2023] [Indexed: 10/20/2023]
Abstract
BACKGROUND Disparities in the availability of reperfusion services for acute ischemic stroke are considerable globally and require urgent attention. Contemporary data on the availability of reperfusion services in different countries are used to provide the necessary evidence to prioritize where access to acute stroke treatment is needed. AIMS To provide a snapshot of published literature on the provision of reperfusion services globally, including when facilitated by telemedicine or mobile stroke unit services. METHODS We searched PubMed to identify original articles, published up to January 2023 for the most recent, representative, and relevant patient-level data for each country. Keywords included thrombolysis, endovascular thrombectomy and telemedicine. We also screened reference lists of review articles, citation history of articles, and the gray literature. The information is provided as a narrative summary. RESULTS Of 11,222 potentially eligible articles retrieved, 148 were included for review following de-duplications and full-text review. Data were also obtained from national stroke clinical registry reports, Registry of Stroke Care Quality (RES-Q) and PRE-hospital Stroke Treatment Organization (PRESTO) repositories, and other national sources. Overall, we found evidence of the provision of intravenous thrombolysis services in 70 countries (63% high-income countries (HICs)) and endovascular thrombectomy services in 33 countries (68% HICs), corresponding to far less than half of the countries in the world. Recent data (from 2019 or later) were lacking for 35 of 67 countries with known year of data (52%). We found published data on 74 different stroke telemedicine programs (93% in HICs) and 14 active mobile stroke unit pre-hospital ambulance services (80% in HICs) around the world. CONCLUSION Despite remarkable advancements in reperfusion therapies for stroke, it is evident from available patient-level data that their availability remains unevenly distributed globally. Contemporary published data on availability of reperfusion services remain scarce, even in HICs, thereby making it difficult to reliably ascertain current gaps in the provision of this vital acute stroke treatment around the world.
Collapse
Affiliation(s)
- Joosup Kim
- Stroke and Ageing Research, Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, VIC, Australia
- Stroke Theme, The Florey Institute of Neuroscience and Mental Health, Heidelberg, VIC, Australia
| | - Muideen T Olaiya
- Stroke and Ageing Research, Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, VIC, Australia
| | - Deidre A De Silva
- Department of Neurology, Singapore General Hospital Campus, National Neuroscience Institute, Singapore
| | - Bo Norrving
- Department of Clinical Sciences, Section of Neurology, Lund University, Skåne University Hospital, Lund, Sweden
| | - Jackie Bosch
- School of Rehabilitation Science, Population Health Research Institute, McMaster University, Hamilton, ON, Canada
| | - Diana A De Sousa
- Department of Neurosciences (Neurology), Hospital de Santa Maria, University of Lisbon, Lisbon, Portugal
| | - Hanne K Christensen
- Department of Neurology, University of Copenhagen and Bispebjerg Hospital, Copenhagen, Denmark
| | - Anna Ranta
- Department of Medicine, University of Otago, Wellington, Wellington, New Zealand
| | - Geoffrey A Donnan
- Melbourne Brain Centre, The University of Melbourne, Royal Melbourne Hospital, Parkville, VIC, Australia
| | - Valery Feigin
- National Institute for Stroke and Applied Neurosciences, Auckland University of Technology, Auckland, New Zealand
| | - Sheila Martins
- Neurology Department, Hospital Moinhos de Vento, Porto Alegre, Brazil
| | | | - David J Werring
- Stroke Research Centre, Department of Brain Repair and Rehabilitation, UCL Queen Square Institute of Neurology, London, UK
| | - George Howard
- Department of Biostatistics, School of Public Health, The University of Alabama at Birmingham, Birmingham, AL, USA
| | - Mayowa Owolabi
- Center for Genomic and Precision Medicine, University of Ibadan, Ibadan, Nigeria
| | - Jeyaraj Pandian
- Department of Neurology, Christian Medical College and Hospital, Ludhiana, India
| | - Robert Mikulik
- Health Management Institute, Brno, Czech Republic
- Neurology Department, Bata Hospital, Zlin, Czech Republic
| | - Tharshanah Thayabaranathan
- Stroke and Ageing Research, Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, VIC, Australia
| | - Dominique A Cadilhac
- Stroke and Ageing Research, Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, VIC, Australia
- Stroke Theme, The Florey Institute of Neuroscience and Mental Health, Heidelberg, VIC, Australia
| |
Collapse
|
2
|
Crozier-Shaw G, Hughes AJ, Cashman J, Synnott K. Instant messaging apps and data protection: combining to improve hip fracture care? Ir J Med Sci 2021; 191:765-769. [PMID: 33818739 PMCID: PMC8020372 DOI: 10.1007/s11845-021-02612-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Accepted: 03/28/2021] [Indexed: 12/31/2022]
Abstract
Introduction The General Data Protection Regulation (GDPR) continues to have implications for how healthcare information is managed and shared. This presents challenges as telemedicine plays a more central role in service healthcare service provision, particularly since the beginning of 2020. We aim to measure how improved communication through a GDPR-compliant messaging app can influence time-dependent key performance indicators for hip fracture management in a tertiary-referral trauma hospital. Methods Using an instant messaging service, a hip fracture group was created and access was provided to all stakeholders in hip fracture care—trainee and consultant emergency physicians and orthopaedic surgeons, as well as advanced nurse practitioners, bed managers, ward managers and theatre managers. Irish Hip Fracture Database (IHFD) standard compliance was compared from April to December 2017 and April to December 2018. Results Two periods in 2017 and 2018 saw 121 and 122 hip fracture patients admitted, respectively. Mean time to admission to an orthopaedic ward in 2017 was 47 ± 42.9 h and 33.3 ± 42 h in 2018 (P = 0.5). Mean time to surgery in 2017 was 83.66 ± 53.46 h and 39.11 ± 10.84 h in 2018 (p = 0.026). Conclusions Irish Hip Fracture Database Standards present a challenge to orthopaedic departments competing with other hospital specialties for access to beds and theatre space. The introduction of a GDPR-compliant social media messaging service has contributed to significantly reducing the time to surgery for these patients. Streamlining communication through messaging services has and continues to be vital to improving care for hip fracture patients, both in the healthcare environment and beyond.
Collapse
Affiliation(s)
- Geoff Crozier-Shaw
- Department of Trauma & Orthopaedic Surgery, Mater Misercordiae University Hospital, Eccles Street, Dublin, Ireland. .,Royal College of Surgeons in Ireland, Dublin, Ireland.
| | - Andrew J Hughes
- Department of Trauma & Orthopaedic Surgery, Mater Misercordiae University Hospital, Eccles Street, Dublin, Ireland.,Royal College of Surgeons in Ireland, Dublin, Ireland
| | - James Cashman
- Department of Trauma & Orthopaedic Surgery, Mater Misercordiae University Hospital, Eccles Street, Dublin, Ireland.,National Orthopaedic Hospital Cappagh, Dublin, Ireland.,Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Keith Synnott
- Department of Trauma & Orthopaedic Surgery, Mater Misercordiae University Hospital, Eccles Street, Dublin, Ireland.,National Orthopaedic Hospital Cappagh, Dublin, Ireland.,Royal College of Surgeons in Ireland, Dublin, Ireland
| |
Collapse
|
3
|
Bashir A. Stroke and Telerehabilitation: A Brief Communication. JMIR Rehabil Assist Technol 2020; 7:e18919. [PMID: 32706739 PMCID: PMC7395243 DOI: 10.2196/18919] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Revised: 04/21/2020] [Accepted: 06/14/2020] [Indexed: 01/07/2023] Open
Abstract
This rapid communication highlights stroke telerehabilitation, a health care service that provides daily monitoring of the care of patients recovering from stroke, delivering convenient and immediate feedback for patients, family, and caregivers. The delivery, management, and coordination of nursing care services, provided via telecommunications technology, is a convenient method of delivering health care to patients recovering from stroke. It is important to assess the service quality of the telehealth process and to establish the role of telehealth nursing and related technologies in the care of patients recovering from stroke. Studies show that even though both health professionals and participants have reported high levels of satisfaction and acceptance of telerehabilitation interventions, the quality of the evidence on telerehabilitation in poststroke care remains low. Conducting a quality study of telehealth rehabilitation for patients recovering from stroke will help assess if home health agencies with telehealth capabilities caring for patients recovering from stroke and patients with chronic diseases can provide quality care to patients in their home and fill this health care gap. Patients that are severely handicapped and impaired and unable to reside in their home environment are not included in telerehabilitation services provided by the home care agency. It would be informative to study the benefits of telerehabilitation and the care provided to patients recovering from stroke within nursing homes, given the need for social distancing to reduce disease transmission during the current coronavirus disease (COVID-19) global health pandemic. Using telerehabilitation would mean that patients have a lower risk of exposure to infectious agents. Further research into telehealth interventions and stroke management in home care is crucial.
Collapse
Affiliation(s)
- Ayisha Bashir
- Department of Biomechanics, University of Nebraska, Omaha, NE, United States
| |
Collapse
|