World Stroke Day, serious shortage of Stroke Units in the South

World Stroke Day, serious shortage of Stroke Units in the South

Remembering World Stroke Day, next October 29th, is important for many reasons. And one is certainly this: reporting the fact that someone lives in the South is less likely to be treated promptly, and survive, than someone who lives in the North. The calculation is easy to do: in the North there are 108 Stroke Units, in the Center 55 and in the South just 45. In percentages this translates into 52%, 26% and 22% of the total 208 Stroke Units respectively. This great and serious territorial discrepancy is denounced ISA-AII (Italian Stroke Association), who conducted the survey from which the reported data emerge. The first step that the ISA-AII experts ask for, precisely on the occasion of World Stroke Day, is the signing of the Declaration of Action for the strengthening of the entire treatment path, i.e. the Stroke Action Plan For Europe (SAP-E), by the Italian Minister of Health, as a symbolic gesture of institutional commitment.

What is the Stroke Action Plan For Europe and what is it for?

Every year, 120 thousand people suffer from a stroke: 40 thousand do not survive 12 months after the event, while another 40 thousand have significant disabilities, with total dependence on the caregiver. To help support all patients, the ESO – European Stroke Organization and SAFE – Stroke Alliance For Europe have launched a plan to implement the Stroke Action Plan for Europe, a project to implement guidelines aimed at establishing, by 2030, national plans shared in all 53 European countries for the treatment of stroke. This is why ISA-AII calls for the signature of the SAP-E Declaration of Action. “Patients must be guaranteed, throughout the territory, rapid treatment and complete rehabilitation. This requires a commitment especially at an institutional level,” he says Danilo ToniPast President ISA-AII.

Incidence (and costs) increasing

What is worrying is not only the current incidence, but the fact that it will increase: “The number of people affected by stroke every year is high – underlines Toni – and an increase of 26% is estimated in the near future. It would mean a significant increase in healthcare costs linked to the management of the disease, which in Europe are already estimated at 60 billion euros and which could reach 86″.

Today, in Italy, there are 913 thousand people who have had a stroke and survived – he adds Paola Santalucia, ISA-AII President Elect: “Many of them have more or less serious disabilities, such as paralysis, motor and language difficulties. Among the most common disorders is spasticity, which affects 20% of patients 3 months after the event. In order to best manage these problems it is necessary to undertake rehabilitation programs in the shortest possible time, starting already in the Stroke Unit that hosted the patient following the event. Unfortunately this does not always happen. With the Strike on Stroke campaign, which we promoted as ISA-AII, we set ourselves the goal of investigating this situation and working towards improvement. Today we ask that Italian institutions show their commitment by signing the Declaration of Action of the Stroke Action Plan for Europe, as already done by 12 other countries, for the strengthening of the entire treatment path”.

“Careful monitoring is necessary throughout the entire territory, from North to South of the country – he also underlines Francesca Romana PezzellaISA-AII Secretary and co-chair Stroke Action Plan for Europe of ESO – Inhomogeneity of care is a phenomenon that unfortunately affects our country, but on which it is important to intervene”.

Act on risk factors

Primary prevention plays a very important role, through the reduction of risk factors, such as smoking, excessive consumption of alcohol and junk food and a sedentary lifestyle. Obesity, hypertension and diabetes are pathologies that can favor their onset. “In 2018 we therefore launched the Stroke Action Plan for Europe with the aim of achieving four primary objectives by 2030: a 10% reduction in strokes in Europe, the treatment of 90% or more of patients in Stroke Units, the implementation of national plans from primary prevention to post-illness life and the implementation of national strategies for the reduction of risk factors – remember Simona Sacco, President of ESO, European Stroke Organization – These recommendations were created thanks to the commitment of 70 experts who analyzed the current state of treatment of the disease and highlighted its critical issues. 5 years after the birth of the project, it is important that Italy also launches active policies in this regard”.

The patients’ point of view

The voice of the clinicians is joined by that of the patients: “We need functional and homogeneous pathways throughout the territory, greater awareness of prevention, which is too often neglected, indications on where to be treated and the importance of being admitted to the Units Neurovascular (Stroke Unit) – concludes Nicoletta Reale, Past president of ALICE. Italy – Association for the Fight against Cerebral Stroke –. Last, but certainly not least, it is essential that everyone knows where and how to carry out rehabilitation and how essential it is to be able to recover residual abilities and ‘take back’ one’s life. The more the affected person and the caregiver are informed, the more they can assert their right to treatment.”

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