ORIGINAL ARTICLE   

Il Giornale Italiano di Radiologia Medica 2019 Gennaio-Febbraio;6(1):1-7

DOI: 10.23736/S2283-8376.19.00162-1

Copyright © 2019 EDIZIONI MINERVA MEDICA

language: English, Italian

The stroke network of the Campania Region: critical issues regarding two peripheral hospitals

Roberta SILVESTRI ✉, Paola GAGLIARDI, Gianpaolo ANTONUCCI, Marcello TUOSTO, Fabio PINTO

Unit of Radiology, Hospital of Marcianise, ASL Caserta, Caserta, Italy

BACKGROUND: The aim of this study was to evaluate the managerial impact of the CT scans of the brain performed in the emergency setting, as well as the transportation means by whom patients are referred (self-transported or managed by the public emergency services) to the peripheral hospitals, with respect to the organization of the upcoming STROKE network of the Campania Region.
METHODS: We analyzed the data stored in our RIS & PACS regarding all the CT scans of the brain performed in the emergency setting between 2014 and 2017 at Marcianise and Maddaloni hospitals. We also looked at the clinical records, with particular regard to initial access of all the patients to the hospitals (whether self-transported or managed by the public emergency services).
RESULTS: Overall 12,662 patients (age range from 5 to 92 years old) underwent an emergent CT exam of the brain: 3981/12,662 scans were performed at Marcianise Hospital whereas the remaining 8681/12662 scans were performed at Maddaloni Hospital. After 3 years (from 2014 to 2017), our workload improved in both Marcianise (12.84%) and Maddaloni (34.03%) Hospitals, respectively. Moreover, we realized that 2269/3981 (56.99%) cases as for Marcianise Hospital and 4514/8681 (52%) cases as for Maddoloni Hospital, had been self-transported to the above-mentioned hospitals.
CONCLUSIONS: Likewise the data reported in the recent literature, the neuro-CT workload in the emergency setting is progressively increasing at Marcianise and Maddaloni Hospitals. The stroke network, if based on a Hub & Spokes model, can be seriously threatened by an uncontrollable number of patients with clinically suspected cerebral ischemia/hemorrhage self-presenting, without the management of the local public emergency services. It is desirable that a massive communicative campaign shall explain the operative strategies of the upcoming Stroke network in the Campania Region.

KEY WORDS: Emergencies - Radiology - Stroke