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Nationwide Access to Endovascular Treatment for Acute Ischemic Stroke in Portugal

2022-02Journal article Open access
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dc.contributor.authorCarvalho Dias, M
dc.contributor.authorSoares dos Reis, R
dc.contributor.authorSantos, JV
dc.contributor.authorPaiva Nunes, A
dc.contributor.authorFerreira, P
dc.contributor.authorMaia, B
dc.contributor.authorFragata, I
dc.contributor.authorReis, J
dc.contributor.authorRamos Lopes, J
dc.contributor.authorCruz, L
dc.contributor.authorSanto, G
dc.contributor.authorMachado, E
dc.contributor.authorGabriel, D
dc.contributor.authorFelgueiras, R
dc.contributor.authorDória, H
dc.contributor.authorCarneiro, A
dc.contributor.authorCorreia, M
dc.contributor.authorVeloso, LM
dc.contributor.authorBarros, P
dc.contributor.authorGregório, T
dc.contributor.authorCarvalho, A
dc.contributor.authorRibeiro, M
dc.contributor.authorTeotónio, P
dc.contributor.authorNeto, L
dc.contributor.authorPinho e Melo, T
dc.contributor.authorCanhão, P
dc.contributor.authorFilipe, JP
dc.contributor.authorMoreira, G
dc.contributor.authorAzevedo, E
dc.contributor.authorSilva, ML
dc.contributor.authorCampos Costa, E
dc.contributor.authorOliveira, G
dc.contributor.authorPereira, L
dc.contributor.authorNeves, L
dc.contributor.authorRodrigues, M
dc.contributor.authorMarto, JP
dc.contributor.authorCalado, S
dc.contributor.authorGrenho, F
dc.contributor.authorBranco, G
dc.contributor.authorBaptista, T
dc.contributor.authorRocha, J
dc.contributor.authorFerreira, C
dc.contributor.authorPinho, J
dc.contributor.authorAmorim, JM
dc.contributor.authorAraújo, JM
dc.contributor.authorNeiva, RM
dc.contributor.authorViana, J
dc.contributor.authorLobo, M
dc.contributor.authorFreitas, A
dc.contributor.authorTedim Cruz, V
dc.contributor.authorSargento-Freitas, J
dc.contributor.authorCastro Lopes, J
dc.date.accessioned2022-02-22T10:22:48Z
dc.date.available2022-02-22T10:22:48Z
dc.date.issued2022-02
dc.description.abstractIntroduction: Since the publication of endovascular treatment trials and European Stroke Guidelines, Portugal has re-organized stroke healthcare. The nine centers performing endovascular treatment are not equally distributed within the country, which may lead to differential access to endovascular treatment. Our main aim was to perform a descriptive analysis of the main treatment metrics regarding endovascular treatment in mainland Portugal and its administrative districts. Material and methods: A retrospective national multicentric cohort study was conducted, including all ischemic stroke patients treated with endovascular treatment in mainland Portugal over two years (July 2015 to June 2017). All endovascular treatment centers contributed to an anonymized database. Demographic, stroke-related and procedure-related variables were collected. Crude endovascular treatment rates were calculated per 100 000 inhabitants for mainland Portugal, and each district and endovascular treatment standardized ratios (indirect age-sex standardization) were also calculated. Patient time metrics were computed as the median time between stroke onset, first-door, and puncture. Results: A total of 1625 endovascular treatment procedures were registered. The endovascular treatment rate was 8.27/100 000 inhabitants/year. We found regional heterogeneity in endovascular treatment rates (1.58 to 16.53/100 000/year), with higher rates in districts closer to endovascular treatment centers. When analyzed by district, the median time from stroke onset to puncture ranged from 212 to 432 minutes, reflecting regional heterogeneity. Discussion: Overall endovascular treatment rates and procedural times in Portugal are comparable to other international registries. We found geographic heterogeneity, with lower endovascular treatment rates and longer onset-to-puncture time in southern and inner regions. Conclusion: The overall national rate of EVT in the first two years after the organization of EVT-capable centers is one of the highest among European countries, however, significant regional disparities were documented. Moreover, stroke-onset-to-first-door times and in-hospital procedural times in the EVT centers were comparable to those reported in the randomized controlled trials performed in high-volume tertiary hospitals.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationActa Med Port. 2022;35(2):127-134pt_PT
dc.identifier.doi10.20344/amp.15031.pt_PT
dc.identifier.urihttp://hdl.handle.net/10400.17/3971
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherOrdem dos Médicospt_PT
dc.subjectCHLC NEUpt_PT
dc.subjectCHLC NRADpt_PT
dc.subjectHumanspt_PT
dc.subjectBrain Ischemia* / therapypt_PT
dc.subjectCohort Studiespt_PT
dc.subjectPortugalpt_PT
dc.subjectEndovascular Procedures*pt_PT
dc.subjectIschemic Stroke*
dc.subjectRetrospective Studies
dc.subjectStroke* / etiology
dc.subjectStroke* / therapy
dc.subjectTreatment Outcome
dc.titleNationwide Access to Endovascular Treatment for Acute Ischemic Stroke in Portugalpt_PT
dc.title.alternativeAcesso a Tratamento Endovascular para Acidente Vascular Cerebral Isquémico em Portugalpt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.endPage134pt_PT
oaire.citation.startPage127pt_PT
oaire.citation.titleActa Médica Portuguesapt_PT
oaire.citation.volume35pt_PT
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT

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