title: Detecting in-hospital stroke: Assessment of results from a training programme for medical personnel.
abstract: BACKGROUND
  In-hospital stroke (IHS) is a frequent event, but its care priority level is not well established in many hospitals. IHS care at our centre has been redefined by implementing a training programme for medical personnel not usually involved in stroke management, in order to optimise IHS detection and treatment. This study evaluates results from the training programme.
  
  
  METHODS
  Prospective longitudinal intervention study. Neurologists experienced in vascular diseases developed a training programme for medical personnel. We recorded incidence, epidemiological data, reason for hospitalisation, department, aetiology, severity (NIHSS), time from symptom onset to neurological assessment, use of endovascular thrombolysis, exclusion criteria for untreated patients, and 90-day outcome (mortality/disability) in 2 patient groups: patients experiencing IHS in the 6 months before (PRE) and the 6 months after the training programme (POST).
  
  
  RESULTS
  Sixty patients were included (19 PRE, 41 POST) with a mean age of 75.3 ± 12.5; 41% were male. There were no differences between groups regarding assessment time, treatment administered, or morbidity/mortality. Overall, 68.3% of the patients were assessed in < 4.5hours; however, only 6 patients (10%) were able to undergo endovascular therapy. This situation was mainly due to pre-existing disability (26%) and comorbidity (13%).
  
  
  CONCLUSIONS
  More IHS code activations were recorded after the training programme. However, that increase was not accompanied by a higher percentage of treated patients or improvements in patient prognosis during the study period, and these findings could probably be explained by the high rates of pre-existing disability and comorbidity in this series.
authors.affiliation: Departament de Medicina, Universitat Autònoma de Barcelona, Unidad de Ictus, Servicio de Neurología, Hospital del Mar, Grupo de investigación Neurovascular, IMIM-Hospital del Mar (Institut Hospital del Mar d'Investigacions Mèdiques); Barcelona, España. Electronic address: 92269@hospitaldelmar.cat.
authors.forename: A
authors.initials: A
authors.lastname: Rodríguez Campello
authors.affiliation: DCEXS, Universitat Pompeu Fabra, Unidad de Ictus, Servicio de Neurología, Hospital del Mar, Grupo de investigación Neurovascular, IMIM-Hospital del Mar (Institut Hospital del Mar d'Investigacions Mèdiques), Barcelona, España.
authors.forename: E
authors.initials: E
authors.lastname: Cuadrado Godia
authors.affiliation: Departament de Medicina, Universitat Autònoma de Barcelona, Unidad de Ictus, Servicio de Neurología, Hospital del Mar, Grupo de investigación Neurovascular, IMIM-Hospital del Mar (Institut Hospital del Mar d'Investigacions Mèdiques); Barcelona, España.
authors.forename: E
authors.initials: E
authors.lastname: Giralt Steinhauer
authors.affiliation: Departament de Medicina, Universitat Autònoma de Barcelona, Unidad de Ictus, Servicio de Neurología, Hospital del Mar, Grupo de investigación Neurovascular, IMIM-Hospital del Mar (Institut Hospital del Mar d'Investigacions Mèdiques); Barcelona, España.
authors.forename: E
authors.initials: E
authors.lastname: Rodríguez Fernández
authors.affiliation: Departament de Medicina, Universitat Autònoma de Barcelona, Unidad de Ictus, Servicio de Neurología, Hospital del Mar, Grupo de investigación Neurovascular, IMIM-Hospital del Mar (Institut Hospital del Mar d'Investigacions Mèdiques); Barcelona, España.
authors.forename: A
authors.initials: A
authors.lastname: Domínguez
authors.affiliation: Departament de Medicina, Universitat Autònoma de Barcelona, Unidad de Ictus, Servicio de Neurología, Hospital del Mar, Grupo de investigación Neurovascular, IMIM-Hospital del Mar (Institut Hospital del Mar d'Investigacions Mèdiques); Barcelona, España.
authors.forename: G
authors.initials: G
authors.lastname: Romeral
authors.affiliation: Departament de Medicina, Universitat Autònoma de Barcelona, Unidad de Ictus, Servicio de Neurología, Hospital del Mar, Grupo de investigación Neurovascular, IMIM-Hospital del Mar (Institut Hospital del Mar d'Investigacions Mèdiques); Barcelona, España.
authors.forename: E
authors.initials: E
authors.lastname: Muñoz
authors.affiliation: DCEXS, Universitat Pompeu Fabra, Unidad de Ictus, Servicio de Neurología, Hospital del Mar, Grupo de investigación Neurovascular, IMIM-Hospital del Mar (Institut Hospital del Mar d'Investigacions Mèdiques), Barcelona, España.
authors.forename: J
authors.initials: J
authors.lastname: Roquer
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015897:Comorbidity; D042241:Early Diagnosis; D005260:Female; D006282:Health Personnel / Q000193:education*; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D000072141:Neurologists / Q000193:education; D011379:Prognosis; D011446:Prospective Studies; D020521:Stroke / Q000175:diagnosis* / Q000453:epidemiology / Q000401:mortality
keywords: Código ictus; Ictus intrahospitalario; In-hospital stroke; Programa de formación; Stroke code; Training programme