ESO East Supplement 2023 - 44

1108746
research-article2022
ESO0010.1177/23969873221108746European Stroke JournalTiu et al.
ESO EAST Project Supplement
Quality of acute stroke care in Romania:
Achievements and gaps between
2017 and 2022
Cristina Tiu1,2 , Elena Oana Terecoasă1,2 , Sorin Tuță2,3,
Rodica Bălașa4, Mihaela Simu5, Monica Sabău6, Adina Stan7
Răzvan Alexandru Radu2 , Vlad Tiu2,8 , Bogdan Cășaru1
Anca Negrilă1 and Cristina Panea2,8
,
,
European Stroke Journal
2023, Vol. 8(1S) 44 -51
© European Stroke Organisation 2022
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DOI: 10.1177/23969873221108746
journals.sagepub.com/home/eso
https://doi.org/10.1177/23969873221108746
Abstract
Romania has one of the highest incidences of stroke and one of the highest mortality rates in Europe. The mortality rate
due to treatable causes is also very high and is associated with the lowest public spending on healthcare in the European
Union. Nonetheless, significant achievements in acute stroke care have been made in Romania in the last 5 years,
most notably the increase of the national thrombolysis rate from 0.8% to 5.4%. Numerous educational workshops
and constant communication with the stroke centers led to a solid and active stroke network. Due to the joint efforts
of this stroke network and the ESO-EAST project, the quality of stroke care has significantly improved. However,
Romania still faces many problems: a major lack of specialists in interventional neuroradiology and consequently a low
number of stroke patients treated by thrombectomy and carotid revascularization procedures, a low number of neurorehabilitation
centers and a country-wide lack of neurologists.
Keywords
Acute stroke care, Romania, stroke network, thrombolysis, thrombectomy
Date received: 30 April 2022; accepted: 2 June 2022
Country background
European Stroke Organization (ESO) initiated a quality
improvement project in 2015 dedicated to acute stroke care
across Eastern Europe, having as a background the alarmingly
high incidence and mortality rates in this geopolitical
region and aiming to offer patients equal chances to access
treatment. Romania was in a challenging situation, with one
of the highest incidences of stroke and the highest mortality
rate in the region. Joining ESO EAST was the first step
toward improvement in the quality of stroke care and contributed
essentially to creating a stroke network in our
country.
An important issue for Romania is the inconsistency of
the epidemiological data. The existing statistical data are
usually generated by extrapolating the data that have been
obtained from a reduced number of hospitals. The Integrated
Unique Information System (SIUI http://siui.casan.ro/cnas/)
can be used as a primary and concise source of information.
However, the data are distorted due to the DRG-based coding
system, which generates errors by classifying another
1 Department of Neurology, University Emergency Hospital Bucharest,
Bucharest, Romania
2 University of Medicine and Pharmacy " Carol Davila " Bucharest,
Bucuresti, Romania
3 Department of Neurology, National Institute of Neurology and
Neurovascular Disorders, Bucharest, Romania
4 Department of Neurology, University of Medicine, Pharmacy, Science
and Technology " George Emil Palade " Tg. Mures, Emergency Clinical
County Hospital Tg. Mures, Targu Mures, Romania
5 Department of Neurology, University of Medicine and Pharmacy
" Victor Babes " Timisoara, County Hospital Timisoara " Pius Brinzeu, "
Timisoara, Romania
6 Department of Neurology, County Hospital Bihor, Oradea, Romania
7 Department of Neurology, University of Medicine and Pharmacy " Iuliu
Hațieganu " Cluj Napoca, Cluj Napoca, Romania
8 Department of Neurology, University Emergency Hospital Elias,
Bucharest, Romania
Corresponding author:
Elena Oana Terecoasă, Department of Neurology, University
Emergency Hospital Bucharest, Splaiul Independenței No 169, Sector 5,
Bucharest 050098, Romania.
Email: oana_ter@yahoo.com
http://www.sagepub.com/journals-permissions https://www.doi.org/10.1177/23969873221108746 http://journals.sagepub.com/home/eso http://siui.casan.ro/cnas/
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