How to Unfasten the Spanish Stroke Belt? Andalusia Chooses Research

Abstract

Andalusia in southern Spain, one of the largest regions in the European Union, has made a profound economic and social transformation that has led to establishment of a modern universal public health care system. However, due to its high stroke mortality rates, Andalusia is still known as the 'Spanish Stroke Belt'. To fight these figures, successive initiatives culminated in the launch of the Andalusian Plan for Stroke Care, to be developed during the period of 2011 to 2014. In addition, involved professionals have hypothesized that clinical and experimental research may contribute to improving stroke care in our community. To that end, one of the leading institutes of biomedical research in Andalusia, the Institute of Biomedicine of Seville (IBiS), has selected stroke as a flagship project in the region. Moreover, Seville, the capital of Andalusia, is now conducting a fusion process of its two largest hospitals, with the potential to generate a stroke alliance that will make it one of the main stroke hospitals in Europe (>2000 cases per year). It is anticipated that this will be an excellent platform to facilitate acute-phase clinical trials and speed the translation process from basic research in IBiS laboratories to the clinical setting. Furthermore, the recently created Andalusian Neurovascular Group is ready to develop prospective, collaborative, multicenter research projects that will evaluate interventions in areas of stroke care uncertainty. If we succeed in forging a link between research and health care quality, we may succeed in lowering the incidence of stroke and related mortality in the region in a short period of time.

Closing the Sex-Based Differences in Stroke Care: Insights from a Large Telestroke Network on Treatment and Postacute Management

“…Prior studies have shown that women are less likely than men to be investigated with standard diagnostic tests and that women admitted to hospitals with stroke are less likely to receive defect-free care. 11 In our study, women had fewer neuroimaging tests after stroke. This fact causes women to have a higher percentage of misdiagnoses.…”

“…In this way, inequalities between areas have been reduced since it has been achieved that almost the entire population is less than an hour away from a center where stroke treatment can be performed. 11 …”

Express improvement of acute stroke care accessibility in large regions using a centralized telestroke network

“…Andalusia has been called the "Spanish Stroke Belt" on account of its extremely high stroke mortality rate, which is as high as 54 per 100,000 inhabitants and exceeds those of other Spanish regions by up to 50%. 11 In addition to the classical factors such as patient age and type of stroke, another factor contributing to this increased mortality rate might be the geographic dispersion of the region, with 3 million inhabitants (36% of the population) living outside urban areas in villages with small populations.…”

Sex Differences in the Management of Suspected Stroke in a Telestroke Network

“…A telestroke network was created to improve this statistic by reorganizing and improving stroke care in the region. In this way, inequalities between areas have been reduced 11 .…”

“…Prior studies have shown that women are less likely than men to be investigated with standard diagnostic tests and that women admitted to hospitals with stroke are less likely to receive defect-free care 11 . In our study, women had fewer neuroimaging tests after stroke.…”