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. 2022 Aug;43(8):4917-4923.
doi: 10.1007/s10072-022-06062-3. Epub 2022 Apr 20.

A snapshot of emergency neurology management in the Lombardy Region, Italy

Carla Zanferrari  1 , Andrea Salmaggi  2 ; Lombardy section of the Italian Association for Emergency Neurology (ANEU)
Collaborators, Affiliations

A snapshot of emergency neurology management in the Lombardy Region, Italy

Carla Zanferrari et al. Neurol Sci. 2022 Aug.

Erratum in

Abstract

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.

Keywords: Emergency neurology; Healthcare management; Lombardy Region; Stroke.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Distribution of the number of admissions/year to the emergency departments in level 1 and level 2 hospitals of the Lombardy Region in 2019
Fig. 2
Fig. 2
Percentage of neurological consultations compared to the total number of accesses to the emergency departments in level 1 (mean 5.2%) and level 2 (5.5%) hospitals of the Lombardy Region in 2019 (range 2.2 to 15.7%). Red squares indicate no data available
Fig. 3
Fig. 3
Accessibility/availability of the main examinations of neurological diagnosis and neuroradiology in an emergency setting. EEG, electroencephalography; MRI, magnetic resonance imaging; CT, computed tomography
Fig. 4
Fig. 4
Interhospital neuroradiology and neurosurgery network in the Lombardy Region
See this image and copyright information in PMC

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