Natalia Pérez de la Ossa1, Sònia Abilleira2, Laura Dorado2, Xabier Urra2, Marc Ribó2, Pere Cardona2, Eva Giralt2, Joan Martí-Fàbregas2, Francisco Purroy2, Joaquín Serena2, David Cánovas2, Moisés Garcés2, Jurek Krupinski2, Anna Pellisé2, Júlia Saura2, Carlos Molina2, Antoni Dávalos2, Miquel Gallofré2. 1. From the Hospital Germans Trias i Pujol, Badalona, Barcelona, Spain (N.P.d.l.O.); Stroke Program/Agency for Health Quality and Assessment of Catalonia (CIBER Epidemiología y Salud Pública, CIBERESP) (S.A.); Hospital Germans Trias i Pujol, Badalona, Barcelona, Spain (L.D.); Hospital Clínic, Barcelona, Spain (X.U.); Hospital Vall d'Hebrón, Barcelona, Spain (M.R.); Hospital Bellvitge, Barcelona, Spain (P.C.); Hospital del Mar, Barcelona, Spain (E.G.); Hospital Santa Creu i Sant Pau, Barcelona, Spain (J.M.-F.); Hospital Arnau de Vilanova, Lleida, Spain (F.P.); Hospital Josep Trueta, Girona, Spain (J. Serena); Hospital Parc Taulí, Sabadell, Spain (D.C.); Hospital Verge de la Cinta, Tortosa, Spain (M.G.); Hospital Terrassa, Terrassa, Spain (J.K.); Hospital Joan XXIII, Tarragona, Spain (A.P.); Hospital Althaia, Manresa, Spain (J. Saura); Hospital Vall d'Hebrón, Barcelona, Spain (C.M.); Hospital Germans Trias i Pujol, Badalona, Barcelona, Spain (A.D.); and Stroke Program/Agency for Health Quality and Assessment of Catalonia (CIBER Epidemiología y Salud Pública, CIBERESP) (M.G.). natperezossa@gmail.com. 2. From the Hospital Germans Trias i Pujol, Badalona, Barcelona, Spain (N.P.d.l.O.); Stroke Program/Agency for Health Quality and Assessment of Catalonia (CIBER Epidemiología y Salud Pública, CIBERESP) (S.A.); Hospital Germans Trias i Pujol, Badalona, Barcelona, Spain (L.D.); Hospital Clínic, Barcelona, Spain (X.U.); Hospital Vall d'Hebrón, Barcelona, Spain (M.R.); Hospital Bellvitge, Barcelona, Spain (P.C.); Hospital del Mar, Barcelona, Spain (E.G.); Hospital Santa Creu i Sant Pau, Barcelona, Spain (J.M.-F.); Hospital Arnau de Vilanova, Lleida, Spain (F.P.); Hospital Josep Trueta, Girona, Spain (J. Serena); Hospital Parc Taulí, Sabadell, Spain (D.C.); Hospital Verge de la Cinta, Tortosa, Spain (M.G.); Hospital Terrassa, Terrassa, Spain (J.K.); Hospital Joan XXIII, Tarragona, Spain (A.P.); Hospital Althaia, Manresa, Spain (J. Saura); Hospital Vall d'Hebrón, Barcelona, Spain (C.M.); Hospital Germans Trias i Pujol, Badalona, Barcelona, Spain (A.D.); and Stroke Program/Agency for Health Quality and Assessment of Catalonia (CIBER Epidemiología y Salud Pública, CIBERESP) (M.G.).
Abstract
BACKGROUND AND PURPOSE: Since demonstration of the benefit of endovascular treatment (EVT) in acute ischemic stroke patients with proximal arterial occlusion, stroke care systems need to be reorganized to deliver EVT in a timely and equitable way. We analyzed differences in the access to EVT by geographical areas in Catalonia, a territory with a highly decentralized stroke model. METHODS: We studied 965 patients treated with EVT from a prospective multicenter population-based registry of stroke patients treated with reperfusion therapies in Catalonia, Spain (SONIIA). Three different areas were defined: (A) health areas primarily covered by Comprehensive Stroke Centers, (B) areas primarily covered by local stroke centers located less than hour away from a Comprehensive Stroke Center, and (C) areas primarily covered by local stroke centers located more than hour away from a Comprehensive Stroke Center. We compared the number of EVT×100 000 inhabitants/year and time from stroke onset to groin puncture between groups. RESULTS: Baseline characteristics were similar between groups. Throughout the study period, there were significant differences in the population rates of EVT across geographical areas. EVT rates by 100 000 in 2015 were 10.5 in A area, 3.7 in B, and 2.7 in C. Time from symptom onset to groin puncture was 82 minutes longer in group B (312 minutes [245-435]) and 120 minutes longer in group C (350 minutes [284-408]) compared with group A (230 minutes [160-407]; P<0.001). CONCLUSIONS: Accessibility to EVT from remote areas is hampered by lower rate and longer time to treatment compared with areas covered directly by Comprehensive Stroke Centers.
BACKGROUND AND PURPOSE: Since demonstration of the benefit of endovascular treatment (EVT) in acute ischemic strokepatients with proximal arterial occlusion, stroke care systems need to be reorganized to deliver EVT in a timely and equitable way. We analyzed differences in the access to EVT by geographical areas in Catalonia, a territory with a highly decentralized stroke model. METHODS: We studied 965 patients treated with EVT from a prospective multicenter population-based registry of strokepatients treated with reperfusion therapies in Catalonia, Spain (SONIIA). Three different areas were defined: (A) health areas primarily covered by Comprehensive Stroke Centers, (B) areas primarily covered by local stroke centers located less than hour away from a Comprehensive Stroke Center, and (C) areas primarily covered by local stroke centers located more than hour away from a Comprehensive Stroke Center. We compared the number of EVT×100 000 inhabitants/year and time from stroke onset to groin puncture between groups. RESULTS: Baseline characteristics were similar between groups. Throughout the study period, there were significant differences in the population rates of EVT across geographical areas. EVT rates by 100 000 in 2015 were 10.5 in A area, 3.7 in B, and 2.7 in C. Time from symptom onset to groin puncture was 82 minutes longer in group B (312 minutes [245-435]) and 120 minutes longer in group C (350 minutes [284-408]) compared with group A (230 minutes [160-407]; P<0.001). CONCLUSIONS: Accessibility to EVT from remote areas is hampered by lower rate and longer time to treatment compared with areas covered directly by Comprehensive Stroke Centers.
Authors: Natalia Pérez de la Ossa; Sònia Abilleira; Tudor G Jovin; Álvaro García-Tornel; Xavier Jimenez; Xabier Urra; Pere Cardona; Dolores Cocho; Francisco Purroy; Joaquin Serena; Luis San Román Manzanera; Rosa Maria Vivanco-Hidalgo; Mercè Salvat-Plana; Angel Chamorro; Miquel Gallofré; Carlos A Molina; Erik Cobo; Antoni Davalos; Marc Ribo Journal: JAMA Date: 2022-05-10 Impact factor: 157.335
Authors: Gordian J Hubert; Nikolai D Hubert; Christian Maegerlein; Frank Kraus; Hanni Wiestler; Peter Müller-Barna; Wolfgang Gerdsmeier-Petz; Christoph Degenhart; Katharina Hohenbichler; Dennis Dietrich; Thomas Witton-Davies; Angelika Regler; Laura Paternoster; Miriam Leitner; Florian Zeman; Michael Koller; Ralf A Linker; Philip M Bath; Heinrich J Audebert; Roman L Haberl Journal: JAMA Date: 2022-05-10 Impact factor: 157.335
Authors: Sònia Abilleira; Cristian Tebé; Natalia Pérez de la Ossa; Marc Ribó; Pere Cardona; Xabier Urra; Eva Giralt-Steinhauer; David Cánovas; Pol Camps-Renom; Miquel Gallofré Journal: Eur Stroke J Date: 2017-02-27
Authors: J Barlinn; S Winzer; H Worthmann; C Urbanek; K G Häusler; A Günther; H Erdur; M Görtler; L Busetto; C Wojciechowski; J Schmitt; Y Shah; B Büchele; P Sokolowski; T Kraya; S Merkelbach; B Rosengarten; K Stangenberg-Gliss; J Weber; F Schlachetzki; M Abu-Mugheisib; M Petersen; A Schwartz; F Palm; A Jowaed; B Volbers; P Zickler; J Remi; J Bardutzky; J Bösel; H J Audebert; G J Hubert; C Gumbinger Journal: Nervenarzt Date: 2021-05-27 Impact factor: 1.214