Only 48% of Spanish provinces have stroke units, according to the latest report of the SEN.

-La Rioja is the only autonomous community that has no UI. Andalusia, Castile – La Mancha, Spain and Galicia have to increase their UI as urgent

– by 2025, 1,200,000 Spaniards have survived a stroke, of whom 500,000 will have a disability

-the GEECV of the SEN carried out a review of the PASI due to new advances in the treatment of the acute phase of cerebral infarction: promote the reference hospitals, fewer restrictions in the activation of the Ictus code, the establishment of the neurovascular intervention and telemedicine and the definition of transfers, essential circuits

Spain, 2011-October according to reveals the report produced by the Group of study diseases stroke (GEECV) of the society Spanish of Neurology (SEN)Health care resources in stroke in Spain, the introduction of the stroke units in Spain is insufficient and, above all, uneven. While the stroke care Plan (PASI) and its subsequent update, prepared by the GEECV, established welfare levels reflected in the document strategy in the national system of health (EI) ictus ” prepared by the Ministry of health and Social policy and signed by all the regional GovernmentsIt is far from the objective that the attention to the stroke in Spain is the best possible, regardless of where the patient lives and time of day that occurs.

The introduction of stroke units (IU) is uneven throughout the national territory. Although they are present in almost all the autonomous regions (94%), only has them in 48% of the provinces. This situation is especially striking in communities such as Andalucia (which only has UI in 2 of the 8 provinces), Castile – La Mancha, Spain and Galicia (which only have one) or La Rioja (which does not have any).

On the other hand, to analyse the ratio bed of UI/number of inhabitants, we note that only Cantabria and Navarra meet the goal of having a bed for every 100,000 inhabitants. Asturias has joined this list at the opening, the last year, the stroke unit of the Hospital Central de Asturias. The tail in this indicator lies again Andalusia with a ratio of one bed for every 1.037.500 people or La Rioja, which does not have any.

In recent years, it has been demonstrated that the existence of units of Ictus (UI) specialized hospitals dramatically improves health care for stroke and is an effective measure to reduce mortality and neurological sequelae. However, despite the evidence of the benefit of the UI and the treatment of intravenous Thrombolysis on the prognosis of the patient, the lack of a system of care to the well-organized ictus and the lack of adequate resources, makes that most cases of stroke in Spain are not conducive to these advantages ”says Dr. Jaime Masjuán, Coordinator of the GEECV of the SEN.

Intravenous Thrombolysis therapy has proved to be the most effective against acute cerebral infarction, although the UI are most often used, due to the low percentage of patients who, for different risk factors, can receive it (between 10 and 15 per cent). There are 80 hospitals where intravenous Thrombolysis is available, but 12.5% is not more than 5 patients to the year in Spain

The study also results in 65% of the autonomous communities there some hospital experience in interventionism neurovascular, treatment must be given when intravenous Thrombolysis fails or not can be administered. However, are very few the CCAA with this treatment 24 hours a day and 7 days a week. Elsewhere, only given in Schedule 8 to 15. This leads to the situation that the patient may benefit or not depending on the time of the day in which occurs the ictus ”, explains Dr. Jaime Masjuán.

In the light of this study , it is necessary to find solutions to adapt the resources existing in each geographical area, as well as search for new resources to ensure optimal and equitable health care of acute brain infarction. An alternative, still to be put in place, could be telemedicine, until now only present in Barcelona, Madrid, Baleares and Seville, with good results in terms of safety, efficacy and early access to treatment ”, concludes Dr. Jaime Masjuán.

Review of the Plan of care of the ictus (PASI)

In order to develop a system organized in response to the stroke to give response to the needs of each patient and optimize the use of health resources, the Group of study diseases stroke (GEECV) of the SEN released in 2006 the Plan of health care of the Ictus (PASI). However, the new advances in the treatment of the acute phase of cerebral infarction have determined the need for a revision of the same and, therefore, an update of the previous organizational models.

According to this new review from GEECV it is estimated that:

– should be more emphasis on the characteristics of the different levels of care with the empowerment of the reference hospitals.

-Needs to establish new less restrictive criteria for activation of the Ictus code covering the new therapeutic possibilities.

-Is necessary to establish organizational measures for the implementation of the interventionism neurovascular.

-Allow the use of telemedicine. Only Balearic, Seville, Madrid and Catalonia Tele-Ictus. telemedicine systems have been implemented in Spain

-In addition, it is essential to facilitate circuits of transportation previously defined and coordinated emergency Extrahospitalarios services.

29 October: World stroke day

Stroke is the leading cause of mortality of women and the second overall, as well as being the first unit at Spain. A problem which will be clearly exacerbated within a few years due to the progressive ageing of the population about 75% of the stroke affect patients over 65 years of age and it has been estimated that by 2025, 1,200,000 Spaniards have survived a stroke, of whom 500,000 will have a disability.

The Group of study diseases stroke (GEECV) of the society Spanish of Neurology (SEN), joins the awareness actions that take place on the occasion of the world stroke day, on 29 October. The organisation of this day in Spain is an initiative led by this entity, carried out in parallel in all the autonomous communities. Its objective is to publicize all aspects related to the disease being a reference point for social knowledge, prevention and treatment.