Aline Palmeira Pires, Kelin Cristine Martin, Thaís L Secchi, Gisele Sampaio Silva, Letícia Costa Rebello, Daniel da Cruz Bezerra, Gabriel R de Freitas, Jamary Oliveira-Filho, Maramelia Miranda-Alves, Gustavo Wruck Kuster, Rodrigo Bazan, Marcos Christiano Lange, João José Freitas de Carvalho, Francisco Jose Arruda Mont'Alverne, José Antonio Fiorot, Viviane F Zetola, Pedro S C Magalhães, Carlos Roberto M Rieder, Luiz Antonio Nasi, Raul Gomes Nogueira, Carla Cabral Moro, Leandro de Assis Barbosa, Wyllians Vendramini Borelli, Octávio Marques Pontes-Neto, Sheila Cristina Ouriques Martins
{"title":"使用世界中风组织路线图评估巴西中风服务质量","authors":"Aline Palmeira Pires, Kelin Cristine Martin, Thaís L Secchi, Gisele Sampaio Silva, Letícia Costa Rebello, Daniel da Cruz Bezerra, Gabriel R de Freitas, Jamary Oliveira-Filho, Maramelia Miranda-Alves, Gustavo Wruck Kuster, Rodrigo Bazan, Marcos Christiano Lange, João José Freitas de Carvalho, Francisco Jose Arruda Mont'Alverne, José Antonio Fiorot, Viviane F Zetola, Pedro S C Magalhães, Carlos Roberto M Rieder, Luiz Antonio Nasi, Raul Gomes Nogueira, Carla Cabral Moro, Leandro de Assis Barbosa, Wyllians Vendramini Borelli, Octávio Marques Pontes-Neto, Sheila Cristina Ouriques Martins","doi":"10.1159/000546276","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>Organizing acute stroke care effectively reduces disability and mortality. Since the Ministry of Health in Brazil established the National Stroke Policy in 2012, stroke care has improved significantly. However, despite the increase in stroke centers, some hospitals have not fully implemented the recommended structure and protocols. This study aims to evaluate the quality of stroke services in Brazil based on the World Stroke Organization (WSO) Roadmap, marking the first step toward the Certification of Stroke Centers in Latin America.</p><p><strong>Method: </strong>From 2020 to 2022, we assessed the structure of stroke centers in Brazil via an online survey based on the WSO Roadmap. When multiple responses came from the same hospital, we checked for consistency and contacted the stroke center coordinator if needed. We then compared these findings to the structure of stroke centers available in 2008, before the national stroke plan began.</p><p><strong>Results: </strong>The number of stroke centers in Brazil increased from 35 in 2008 to 246 in 2022, with 216 centers assessed in this study (102 Essential, 114 Advanced). Advanced centers were mostly private (69%). Of all hospitals, 51% serve public health patients, 75% as Essential centers. The southeast and south region have the highest number of stroke centers (77%). All hospitals provided essential blood tests, CT scans, and thrombolytic therapy, with 97% having pre-hospital emergency services. Neurologists were available 24/7 in 85% of centers (49% on call, 35% on duty, 16% via telemedicine), and 46% of hospitals had stroke units. Nearly 90% had acute neurosurgical care, and 47% offered endovascular thrombectomy 24/7. Advanced centers implemented 85% of the WSO Roadmap items and Essential centers 76%. According to WSO/SIECV Certification, 39 centers were prepared for certification, and 18 were certified (6 private: Advanced, 12 public: 4 Advanced, 8 Essential).</p><p><strong>Conclusion: </strong>Brazil has significantly improved its stroke care structure, but disparities and areas for further enhancement remain, particularly in equity, resource access, and best practices implementation. Certification programs could help address these issues and improve outcomes for stroke patients.</p>","PeriodicalId":9683,"journal":{"name":"Cerebrovascular Diseases","volume":" ","pages":"1-11"},"PeriodicalIF":1.5000,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Assessing the Quality of Stroke Services in Brazil Using the World Stroke Organization Roadmap.\",\"authors\":\"Aline Palmeira Pires, Kelin Cristine Martin, Thaís L Secchi, Gisele Sampaio Silva, Letícia Costa Rebello, Daniel da Cruz Bezerra, Gabriel R de Freitas, Jamary Oliveira-Filho, Maramelia Miranda-Alves, Gustavo Wruck Kuster, Rodrigo Bazan, Marcos Christiano Lange, João José Freitas de Carvalho, Francisco Jose Arruda Mont'Alverne, José Antonio Fiorot, Viviane F Zetola, Pedro S C Magalhães, Carlos Roberto M Rieder, Luiz Antonio Nasi, Raul Gomes Nogueira, Carla Cabral Moro, Leandro de Assis Barbosa, Wyllians Vendramini Borelli, Octávio Marques Pontes-Neto, Sheila Cristina Ouriques Martins\",\"doi\":\"10.1159/000546276\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Introduction: </strong>Organizing acute stroke care effectively reduces disability and mortality. Since the Ministry of Health in Brazil established the National Stroke Policy in 2012, stroke care has improved significantly. However, despite the increase in stroke centers, some hospitals have not fully implemented the recommended structure and protocols. This study aims to evaluate the quality of stroke services in Brazil based on the World Stroke Organization (WSO) Roadmap, marking the first step toward the Certification of Stroke Centers in Latin America.</p><p><strong>Method: </strong>From 2020 to 2022, we assessed the structure of stroke centers in Brazil via an online survey based on the WSO Roadmap. When multiple responses came from the same hospital, we checked for consistency and contacted the stroke center coordinator if needed. We then compared these findings to the structure of stroke centers available in 2008, before the national stroke plan began.</p><p><strong>Results: </strong>The number of stroke centers in Brazil increased from 35 in 2008 to 246 in 2022, with 216 centers assessed in this study (102 Essential, 114 Advanced). Advanced centers were mostly private (69%). Of all hospitals, 51% serve public health patients, 75% as Essential centers. The southeast and south region have the highest number of stroke centers (77%). All hospitals provided essential blood tests, CT scans, and thrombolytic therapy, with 97% having pre-hospital emergency services. Neurologists were available 24/7 in 85% of centers (49% on call, 35% on duty, 16% via telemedicine), and 46% of hospitals had stroke units. Nearly 90% had acute neurosurgical care, and 47% offered endovascular thrombectomy 24/7. Advanced centers implemented 85% of the WSO Roadmap items and Essential centers 76%. According to WSO/SIECV Certification, 39 centers were prepared for certification, and 18 were certified (6 private: Advanced, 12 public: 4 Advanced, 8 Essential).</p><p><strong>Conclusion: </strong>Brazil has significantly improved its stroke care structure, but disparities and areas for further enhancement remain, particularly in equity, resource access, and best practices implementation. Certification programs could help address these issues and improve outcomes for stroke patients.</p>\",\"PeriodicalId\":9683,\"journal\":{\"name\":\"Cerebrovascular Diseases\",\"volume\":\" \",\"pages\":\"1-11\"},\"PeriodicalIF\":1.5000,\"publicationDate\":\"2025-05-26\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Cerebrovascular Diseases\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1159/000546276\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"CLINICAL NEUROLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Cerebrovascular Diseases","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1159/000546276","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
Assessing the Quality of Stroke Services in Brazil Using the World Stroke Organization Roadmap.
Introduction: Organizing acute stroke care effectively reduces disability and mortality. Since the Ministry of Health in Brazil established the National Stroke Policy in 2012, stroke care has improved significantly. However, despite the increase in stroke centers, some hospitals have not fully implemented the recommended structure and protocols. This study aims to evaluate the quality of stroke services in Brazil based on the World Stroke Organization (WSO) Roadmap, marking the first step toward the Certification of Stroke Centers in Latin America.
Method: From 2020 to 2022, we assessed the structure of stroke centers in Brazil via an online survey based on the WSO Roadmap. When multiple responses came from the same hospital, we checked for consistency and contacted the stroke center coordinator if needed. We then compared these findings to the structure of stroke centers available in 2008, before the national stroke plan began.
Results: The number of stroke centers in Brazil increased from 35 in 2008 to 246 in 2022, with 216 centers assessed in this study (102 Essential, 114 Advanced). Advanced centers were mostly private (69%). Of all hospitals, 51% serve public health patients, 75% as Essential centers. The southeast and south region have the highest number of stroke centers (77%). All hospitals provided essential blood tests, CT scans, and thrombolytic therapy, with 97% having pre-hospital emergency services. Neurologists were available 24/7 in 85% of centers (49% on call, 35% on duty, 16% via telemedicine), and 46% of hospitals had stroke units. Nearly 90% had acute neurosurgical care, and 47% offered endovascular thrombectomy 24/7. Advanced centers implemented 85% of the WSO Roadmap items and Essential centers 76%. According to WSO/SIECV Certification, 39 centers were prepared for certification, and 18 were certified (6 private: Advanced, 12 public: 4 Advanced, 8 Essential).
Conclusion: Brazil has significantly improved its stroke care structure, but disparities and areas for further enhancement remain, particularly in equity, resource access, and best practices implementation. Certification programs could help address these issues and improve outcomes for stroke patients.
期刊介绍：
A rapidly-growing field, stroke and cerebrovascular research is unique in that it involves a variety of specialties such as neurology, internal medicine, surgery, radiology, epidemiology, cardiology, hematology, psychology and rehabilitation. ''Cerebrovascular Diseases'' is an international forum which meets the growing need for sophisticated, up-to-date scientific information on clinical data, diagnostic testing, and therapeutic issues, dealing with all aspects of stroke and cerebrovascular diseases. It contains original contributions, reviews of selected topics and clinical investigative studies, recent meeting reports and work-in-progress as well as discussions on controversial issues. All aspects related to clinical advances are considered, while purely experimental work appears if directly relevant to clinical issues.
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