title: Stroke management in northern Lombardy: organization of an emergency-urgency network and development of a connection between prehospital and in-hospital settings.
abstract: Stroke is the leading cause of disability in adulthood, and the principal aim of care in cerebrovascular disease is the reduction of this negative outcome and mortality. Several studies demonstrated the efficacy of thrombolytic therapy in ischemic stroke, but up to 80% of cases could not be treated because the diagnostic workup exceeds the time limit. In this article, we described the design of a study conducted in the northern Lombardy, within the district of Sondrio, Lecco, Como, and Varese. The awaited results of this study are reduction of avoidable delay, organization of an operative stroke emergency network, and identification of highly specialized structures. The study schedules education and data registration with implementation and training of acute stroke management algorithms. The use of standardized protocols during prehospital and in-hospital phase can optimize acute stroke pathways. The results of this study could contribute to the assessment of an effective and homogeneous health system to manage acute stroke.
authors.affiliation: Department of Neurology, Sant'Anna Hospital, San Fermo della Battaglia, Italy. simone.vidale@hsacomo.org
authors.forename: Simone
authors.initials: S
authors.lastname: Vidale
authors.forename: Elena
authors.initials: E
authors.lastname: Verrengia
authors.forename: Francesca
authors.initials: F
authors.lastname: Gerardi
authors.forename: Marco
authors.initials: M
authors.lastname: Arnaboldi
authors.forename: Giacomo
authors.initials: G
authors.lastname: Bezzi
authors.forename: Giorgio
authors.initials: G
authors.lastname: Bono
authors.forename: Mario
authors.initials: M
authors.lastname: Guidotti
authors.forename: Giampiero
authors.initials: G
authors.lastname: Grampa
authors.forename: Patrizia
authors.initials: P
authors.lastname: Perrone
authors.forename: Davide
authors.initials: D
authors.lastname: Zarcone
authors.forename: Alberto
authors.initials: A
authors.lastname: Zoli
authors.forename: Ettore
authors.initials: E
authors.lastname: Beghi
authors.forename: Elio
authors.initials: E
authors.lastname: Agostoni
authors.forename: Daniele
authors.initials: D
authors.lastname: Porazzi
authors.forename: Mario
authors.initials: M
authors.lastname: Landriscina
mesh_terms: D000465:Algorithms; D016022:Case-Control Studies; D002985:Clinical Protocols; D004059:Diffusion of Innovation; D004632:Emergency Medical Services / Q000458:organization & administration*; D004635:Emergency Medicine / Q000193:education; D006760:Hospitalization; D006801:Humans; D007400:Interprofessional Relations; D007558:Italy; D008505:Medical Staff, Hospital / Q000193:education; D011446:Prospective Studies; D020521:Stroke / Q000628:therapy*; D015912:Thrombolytic Therapy / Q000592:standards