1. A snapshot of emergency neurology management in the Lombardy Region, Italy
- Author
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Zanferrari, C, Salmaggi, A, Belcastro, V, Domina, E, Beretta, S, Braga, M, Bonato, S, Ghione, I, Caputi, L, Brusaferri, F, Cavallini, A, Persico, A, Ciccone, A, Silvestrelli, G, Clerici, R, De Piazza, C, Conti, G, Cotelli, M, Turla, M, Dallocchio, C, Mazza, S, Ferrarese, C, Piatti, M, Ferraro, B, Carpo, M, Fanucchi, S, Fiacco, F, Maggio, P, Frediani, F, Tonietti, S, Grampa, G, Russo, L, Savio, F, Magni, E, Palmerini, F, Magoni, M, Marcheselli, S, Corato, M, Mattioli, M, Padovani, A, Pantoni, L, Baso, G, Prelle, A, Muscia, F, Priori, A, Tancredi, L, Santilli, I, Scaccabarozzi, C, Sessa, M, Gioia, S, Zanferrari C., Salmaggi A., Belcastro V., Domina E., Beretta S., Braga M., Bonato S., Ghione I., Caputi L., Brusaferri F., Cavallini A., Persico A., Ciccone A., Silvestrelli G., Clerici R., De Piazza C., Conti G., Cotelli M. S., Turla M., Dallocchio C., Mazza S., Ferrarese C., Piatti M. L., Ferraro B., Carpo M., Fanucchi S., Fiacco F., Maggio P., Frediani F., Tonietti S., Grampa G., Russo L. L., Savio F. L., Magni E., Palmerini F., Magoni M., Marcheselli S., Corato M., Mattioli M., Padovani A., Pantoni L., Baso G., Prelle A., Muscia F., Priori A., Tancredi L., Santilli I., Scaccabarozzi C., Sessa M., Gioia S. L., Zanferrari, C, Salmaggi, A, Belcastro, V, Domina, E, Beretta, S, Braga, M, Bonato, S, Ghione, I, Caputi, L, Brusaferri, F, Cavallini, A, Persico, A, Ciccone, A, Silvestrelli, G, Clerici, R, De Piazza, C, Conti, G, Cotelli, M, Turla, M, Dallocchio, C, Mazza, S, Ferrarese, C, Piatti, M, Ferraro, B, Carpo, M, Fanucchi, S, Fiacco, F, Maggio, P, Frediani, F, Tonietti, S, Grampa, G, Russo, L, Savio, F, Magni, E, Palmerini, F, Magoni, M, Marcheselli, S, Corato, M, Mattioli, M, Padovani, A, Pantoni, L, Baso, G, Prelle, A, Muscia, F, Priori, A, Tancredi, L, Santilli, I, Scaccabarozzi, C, Sessa, M, Gioia, S, Zanferrari C., Salmaggi A., Belcastro V., Domina E., Beretta S., Braga M., Bonato S., Ghione I., Caputi L., Brusaferri F., Cavallini A., Persico A., Ciccone A., Silvestrelli G., Clerici R., De Piazza C., Conti G., Cotelli M. S., Turla M., Dallocchio C., Mazza S., Ferrarese C., Piatti M. L., Ferraro B., Carpo M., Fanucchi S., Fiacco F., Maggio P., Frediani F., Tonietti S., Grampa G., Russo L. L., Savio F. L., Magni E., Palmerini F., Magoni M., Marcheselli S., Corato M., Mattioli M., Padovani A., Pantoni L., Baso G., Prelle A., Muscia F., Priori A., Tancredi L., Santilli I., Scaccabarozzi C., Sessa M., and Gioia S. L.
- 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.
- Published
- 2022