Résumé :
|
[BDSP. Notice produite par INIST oR7fPR0x. Diffusion soumise à autorisation]. Objective To develop recommendations for the establishment and operation of primary stroke centers as an approach to improve the medical care of patients with stroke. Participants Members of the Brain Attack Coalition (BAC), a multidisciplinary group of representatives from major professional organizations involved with delivering stroke care. Supplemental input was obtained from other experts involved in acute stroke care. Evidence A review of literature published from 1966 to March 2000 was performed using MEDLINE. More than 600 English-language articles that had evidence from randomized clinical trials, meta-analyses, care guidelines, or other appropriate methods supporting specific care recommendations for patients with acute stroke that could be incorporated into a stroke center model were selected. Consensus Process Articles were reviewed initially by 1 author (M.J.A.). Members of the BAC reviewed each recommendation in the context of current practice parameters, with special attention to improving the delivery of care to patients with acute stroke, cost-effectiveness, and logistical issues related to the establishment of primary stroke centers. Consensus was reached among all BAC participants before an element was added to the list of recommendations. Conclusions Randomized clinical trials and observational studies suggest that several elements of a stroke center would improve patient care and outcomes. (...)
|