Map of stroke units in Spain: Hospital coverage and capacity

Abstract

Objective

Identify and describe the geographic distribution of hospitals in Spain that offer specialized stroke care as well as available resources.

Methods

Cross-sectional descriptive observational study. Data were collected from hospitals in Spain between February and June 2023 through telephone and email contact with neurology departments. Hospitals had to have a Stroke Unit (SU) and/or the capacity to perform thrombolysis or thrombectomy. Patients without the capacity to manage stroke in the hyperacute phase were excluded. Data on the availability of SUs and beds and the capacity to perform recanalization treatments were collected.

Results

A total of 195 hospitals were included, all of which reported performing thrombolysis; however, only 30.2% offered thrombectomy. The availability of SUs was reported by 43% of the hospitals, with a total of 459 beds. Catalonia and Madrid had the highest number of SUs (14 each) and beds (87 and 71, respectively). In contrast, regions such as La Rioja, the Balearic Islands, and Ceuta and Melilla had limited capacities. Variability in the distribution of resources was significant, with some regions lacking access to thrombectomy.

Conclusion

The results revealed significant disparities in the availability of resources for stroke treatment in Spain, with marked geographic inequalities that could negatively impact clinical outcomes. More equitable resource planning and improvement strategies such as telemedicine and referral networks are necessary to reduce these disparities and improve health outcomes nationwide.