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Coverage of the requirements of first and second level stroke unit in Italy.

  • Bandettini di Poggio, Monica1
  • Toni, Danilo2
  • Gandolfo, Carlo3
  • Paolicelli, Damiano4
  • Zini, Andrea5
  • Agostoni, Elio6
  • Bandini, Fabio7
  • Ragno, Michele8
  • Altavista, Maria Concetta9
  • Bertolotto, Antonio10
  • Siciliano, Gabriele11
  • Vecchio, Michele12
  • Tambasco, Nicola13
  • Gambardella, Antonio14
  • Manganotti, Paolo15
  • Melis, Maurizio16
  • Onofrj, Marco17
  • De Michele, Giuseppe18
  • Reale, Nicoletta19
  • Tedeschi, Gioacchino20
  • And 1 more
  • 1 Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), Policlinic San Martino Hospital, University of Genova, Genoa, Italy. [email protected] , (Italy)
  • 2 Neurovascular Unit, Policlinico Umberto I, Department of Neurology and Psychiatry, University of Rome, 'La Sapienza', Rome, Italy. , (Italy)
  • 3 Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), Policlinic San Martino Hospital, University of Genova, Genoa, Italy. , (Italy)
  • 4 Dipartimento di Scienze Mediche di Base, Neuroscienze ed Organi di Senso, Università degli Studi di Bari "A. Moro", Bari, Italy. , (Italy)
  • 5 IRCCS Istituto di Scienze Neurologiche di Bologna, Maggiore Hospital, Bologna, Italy. , (Italy)
  • 6 Department of Neurology, Niguarda Ca' Granda Hospital, Milan, Italy. , (Italy)
  • 7 Department of Neurology, S.Paolo Hospital, Savona, Italy. , (Italy)
  • 8 Neurologia AV5, Ascoli Piceno-, San Benedetto del Tronto, Italy. , (Italy)
  • 9 UOC di Neurologia, ASL Roma 1, Presidio Ospedaliero San Filippo Neri, Rome, Italy. , (Italy)
  • 10 SCDO Neurologia & CRESM, AOU San Luigi, Orbassano, Italy. , (Italy)
  • 11 Dipartimento di Medicina Clinica e Sperimentale, Clinica Neurologica, Università di Pisa e Azienda Ospedaliero Universitaria Pisana, Pisa, Italy. , (Italy)
  • 12 U.O. of Physical Medicine and Rehabilitation, Policlinico Vittorio Emanuele University Hospital, University of Catania, Catania, Italy. , (Italy)
  • 13 Clinica Neurologica, Azienda Ospedaliera e Universitaria di Perugia, Perugia, Italy. , (Italy)
  • 14 Medical and Surgical Sciences Department, School of Medicine, Magna Græcia University of Catanzaro, Viale Europa, Catanzaro, Italy. , (Italy)
  • 15 Clinical Unit of Neurology, Department of Medicine, Surgery and Health Sciences, Cattinara University Hospital ASUGI, University of Trieste, Trieste, Italy. , (Italy)
  • 16 SC Neurologia e Stroke Unit, Azienda Ospedaliera G.Brotzu, Cagliari, Italy. , (Italy)
  • 17 Clinica Neurologica, Dipartimento di Neuroscienze, Imaging e Scienze Cliniche, Università Chieti-Pescara, Chieti, Italy. , (Italy)
  • 18 Dipartimento di Neuroscienze e Scienze Riproduttive ed Odontostomatologiche, Università di Napoli Federico II, Naples, Italy. , (Italy)
  • 19 Association for the Fight against Stroke (A.L.I.Ce.) Italia Odv, Rome, Italy. , (Italy)
  • 20 Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Naples, Italy. , (Italy)
  • 21 Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genova and IRCCS ICS Maugeri, Genova, Pavia, Italy. , (Italy)
Published Article
Neurological Sciences
Publication Date
Mar 01, 2021
DOI: 10.1007/s10072-020-04616-x
PMID: 32737805


In the scientific literature, there is unanimous consensus that hospitalization in stroke unit (SU) is the most important treatment for stroke patients. In this regard, the Act number 70/2015 by the Italian government identified specific skills that contribute to a classification of SU and outlined a "hub and spoke" stroke network. The aim of our study was to check the coverage of requirements of first and second level SU in the national territory and to shed light on any deficit or misdistribution of resources. In 2019, a survey on the current situation related to stroke care in Italy was carried out by the Italian Society of Neurology (SIN), The Italian Stroke Organization (ISO), and the Association for the Fight against Stroke (A.L.I.Ce). First level SU was found to be 58 against a requirement, according to the Act 70/2015, of 240. Second level SU was found to be 52 compared with an expected requirement of 60. Neurointerventionists were 280 nationally, with a requirement of 240. A misdistribution of resources within individual regions was often seen. The survey demonstrated a severe shortage of beds dedicated to cerebrovascular diseases, mainly because of lack of first level SU, especially in central and southern Italy. It also suggests that the current hub and spoke system is not yet fully implemented across the country and that resources should be better distributed in order to ensure uniform and fair care for all stroke patients on the whole territory.

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