Stroke systems of care in high-income countries: what is optimal?

Langhorne, P. , Audebert, H. J., Cadilhac, D. A., Kim, J. and Lindsay, P. (2020) Stroke systems of care in high-income countries: what is optimal? Lancet, 396(10260), pp. 1433-1442. (doi: 10.1016/S0140-6736(20)31363-5) (PMID:33129394)

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Stroke is a complex, time-sensitive, medical emergency that requires well functioning systems of care to optimise treatment and improve patient outcomes. Education and training campaigns are needed to improve both the recognition of stroke among the general public and the response of emergency medical services. Specialised stroke ambulances (mobile stroke units) have been piloted in many cities to speed up the diagnosis, triage, and emergency treatment of people with acute stroke symptoms. Hospital-based interdisciplinary stroke units remain the central feature of a modern stroke service. Many have now developed a role in the very early phase (hyperacute units) plus outreach for patients who return home (early supported discharge services). Different levels (comprehensive and primary) of stroke centre and telemedicine networks have been developed to coordinate the various service components with specialist investigations and interventions including rehabilitation. Major challenges include the harmonisation of resources for stroke across the whole patient journey (including the rapid, accurate triage of patients who require highly specialised treatment in comprehensive stroke centres) and the development of technology to improve communication across different parts of a service.

Item Type:Articles
Glasgow Author(s) Enlighten ID:Langhorne, Professor Peter
Authors: Langhorne, P., Audebert, H. J., Cadilhac, D. A., Kim, J., and Lindsay, P.
College/School:College of Medical Veterinary and Life Sciences > Institute of Cardiovascular and Medical Sciences
Journal Name:Lancet
Publisher:Lancet Publishing Group
ISSN (Online):1474-547X
Published Online:29 October 2020
Copyright Holders:Copyright © 2020 Elsevier Ltd.
First Published:First published in Lancet 396(10260): 1433-1442
Publisher Policy:Reproduced in accordance with the publisher copyright policy

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