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A snapshot of emergency neurology management in the Lombardy Region, Italy
BACKGROUND: The assessment of human and diagnostic resources is a prerequisite to improving the management of emergency neurology. OBJECTIVE: To provide a landscape on the organization of the Lombardy Region hospitals for emergency neurological care management. METHODS: We designed an anonymized que...
Autores principales: | , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer International Publishing
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9020758/ https://www.ncbi.nlm.nih.gov/pubmed/35445306 http://dx.doi.org/10.1007/s10072-022-06062-3 |
Sumario: | BACKGROUND: The assessment of human and diagnostic resources is a prerequisite to improving the management of emergency neurology. OBJECTIVE: To provide a landscape on the organization of the Lombardy Region hospitals for emergency neurological care management. METHODS: We designed an anonymized questionnaire including 6 sections with 21 questions on facilities, human and diagnostic resources, and intra- and between-hospital connections. The time needed to fill the questionnaire was estimated not to exceed 6 min. RESULTS: The questionnaire was returned by 33/41 (80.5%) hospitals, 22 classified as level 1 (spoke), and 11 as level 2 (hub). Five of 33 (15%) did not have a neurology unit. The mean annual rate of neurological consultations accounted for 5–6% of all admissions (range 2–8%) and did not differ between levels 1 and 2 hospitals. Neurologists were 24-h available in 21/33 (64%) hospitals, 12-h and on call at night in 6 (18%), less than 12 h without nocturnal availability in 5 (15%), and neither present nor available in 1 (3%). Brain CT and CSF examinations were 24-h universally available, whereas EEG and neurosonology were not in most hospitals. Despite angio-CT was 24-h available in more than 75% of the hospitals, only 45% of them had 24-h availability of diffusion/perfusion imaging, and 43% were not available at any time. Only 12% of the hospitals had 24-h availability of neuroradiologists and 6% of interventional neuroradiologists. CONCLUSION: Our data, while emphasizing current critical issues, offer clues for identifying priorities and improving the management of emergency and time-dependent neurological diseases. |
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