title: [Urgent stroke care in hospitals with a stroke unit. Quick Project].
abstract: BACKGROUND
  A stroke is a time-dependent medical emergency. Swiftness in its recognition and in the care received by the patients plays a key role in the prognosis.
  
  
  OBJECTIVE
  To analyse the medical intervention times, to evaluate possible areas where improvements can be made and to examine the allocation of resources in the centres.
  
  
  METHODS
  The study was based on a prospective register of patients with suspected stroke and stroke code activation treated in eight experienced Spanish stroke units. Onset-to-door, door-to-computed tomography (CT), door-to-needle, CT-to-needle and onset-to-needle times were collected. Information about the means of transport used to get to the hospital, the type of stroke and reperfusion therapies was also collected. With regard to the structural resources of the centres, data were gathered about the nurse-to-patient ratio, bed monitoring, availability of multimodal CT and magnetic resonance, and doing information or training courses.
  
  
  RESULTS
  Altogether 197 patients were included, of whom 181 (151 infarctions and 30 brain haemorrhages) were valid. The medians (p25-p75) in minutes were: onset-to-door, 104 (70-188); door-to-CT, 27 (19-41); CT-to-needle, 30 (21-43); door-to-needle, 64 (49-83); and onset-to-needle, 156 (129-202). Reperfusion therapies were applied in 68 patients (45% of the cerebral infarctions), of which 81% were intravenous thrombolyses; 7%, endovascular treatments; and 12%, a combination of the two. The resources available in the centres were in accordance with those recommended by the clinical guidelines. There was a low percentage of patients who were studied by means of magnetic resonance.
  
  
  CONCLUSIONS
  The percentage of patients treated with thrombolysis was very high and although the times of the in-hospital circuits were good, there is still room for further improvement.
authors.affiliation: Hospital Universitario Ramon y Cajal, 28034 Madrid, Espana.
authors.forename: Jaime
authors.initials: J
authors.lastname: Masjuán
authors.affiliation: Hospital Universitario Vall d'Hebron, Barcelona, Espana.
authors.forename: José
authors.initials: J
authors.lastname: Álvarez-Sabín
authors.affiliation: Complejo Hospitalario Universitario de Santiago de Compostela, 15706 Santiago de Compostela, Espana.
authors.forename: Susana
authors.initials: S
authors.lastname: Arias-Rivas
authors.affiliation: Complejo Hospitalario Universitario de Santiago de Compostela, 15706 Santiago de Compostela, Espana.
authors.forename: Miguel
authors.initials: M
authors.lastname: Blanco
authors.affiliation: Hospital Universitario Ramon y Cajal, 28034 Madrid, Espana.
authors.forename: Alicia
authors.initials: A
authors.lastname: de Felipe
authors.affiliation: Hospitales Universitarios Virgen del Rocio, 41013 Sevilla, Espana.
authors.forename: Irene
authors.initials: I
authors.lastname: Escudero-Martínez
authors.affiliation: Hospital Universitario La Paz, Madrid, Espana.
authors.forename: Blanca
authors.initials: B
authors.lastname: Fuentes
authors.affiliation: Hospital de Navarra, 31008 Pamplona, Espana.
authors.forename: Jaime
authors.initials: J
authors.lastname: Gállego-Culleré
authors.affiliation: Hospitales Universitarios Virgen del Rocio, 41013 Sevilla, Espana.
authors.forename: Francisco
authors.initials: F
authors.lastname: Moniche-Álvarez
authors.affiliation: Hospital Universitari Germans Trias i Pujol, 08916 Badalona, Espana.
authors.forename: Lucía
authors.initials: L
authors.lastname: Muñoz
authors.affiliation: Hospital Universitari Germans Trias i Pujol, 08916 Badalona, Espana.
authors.forename: Natalia
authors.initials: N
authors.lastname: Pérez de la Ossa-Herrero
authors.affiliation: Hospital Universitario La Fe, Valencia, Espana.
authors.forename: Patricia
authors.initials: P
authors.lastname: Sahuquillo
authors.affiliation: Hospital Universitario Vall d'Hebron, Barcelona, Espana.
authors.forename: Estevo
authors.initials: E
authors.lastname: Santamarina
authors.affiliation: Hospital Universitario La Paz, Madrid, Espana.
authors.forename: Borja
authors.initials: B
authors.lastname: Sanz
authors.affiliation: Hospital Universitario La Fe, Valencia, Espana.
authors.forename: José I
authors.initials: JI
authors.lastname: Tembl
authors.affiliation: Hospital de Navarra, 31008 Pamplona, Espana.
authors.forename: Beatriz
authors.initials: B
authors.lastname: Zandio
mesh_terms: D000553:Ambulatory Care / Q000706:statistics & numerical data*; D059019:Clinical Coding / Q000706:statistics & numerical data; D004630:Emergencies; D004632:Emergency Medical Services / Q000706:statistics & numerical data; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D005343:Fibrinolytic Agents / Q000008:administration & dosage / Q000627:therapeutic use; D006757:Hospital Units / Q000706:statistics & numerical data*; D006801:Humans; D008279:Magnetic Resonance Imaging; D010360:Patient Transfer / Q000706:statistics & numerical data; D011446:Prospective Studies; D013030:Spain / Q000453:epidemiology; D020521:Stroke / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000453:epidemiology; D015912:Thrombolytic Therapy / Q000706:statistics & numerical data*; D061665:Time-to-Treatment / Q000706:statistics & numerical data*; D014057:Tomography, X-Ray Computed
chemical_list: D005343:Fibrinolytic Agents