ESO East Supplement 2023 - 48

48
European Stroke Journal 8(1S)
Table 2. Median door- to needle time interval (in minutes) registered in RES-Q registry from 2017 to 2022.
Year
DTN (min)
2017
67
2018
58
2019
53
2020
43
2021
49
2022
60
Figure 4. (a) CTA availability for acute stroke patients. In Bucharest there are seven stroke centers and only one, Fundeni Clinical
Institute (FCI) does not perform CTA. (b) CTP availability: only one center: Tg. Mures County Hospital.
Table 3. Criteria for stroke units in Romania as defined by OMS No. 1408/2015.
Minimum required infrastructure
Number of beds: 4-20
Vital signs monitoring for 4-10 beds
Permanent oxygen supply for all beds
Tracheal aspiration systems for all beds
2-4 Portable mechanical ventilators
1 Defibrillator
At least two orotracheal intubation kits
1 Portable ECG device
Automated syringe pumps for all beds
1 Portable ultrasound Doppler echography device (including probe for TCD monitoring)
24/7 access to in-hospital CT
Rapid automated hematologic and biochemical analyzer and/or 24/7 access to the hospital's central/emergency laboratory
Minimum required personnel
1 Neurologist for every 4 beds
1-2 Physiotherapists (with university degree)
1 Speech therapist and/or 1 psychologist
1 Nurse for every 1-4 bed per shift
1 Nurse assistant for every 1-4 beds per shift
1 Porter per stroke unit per shift
1 Housekeeper for every 200 m2 per shift
We need to increase the number of stroke units, but this is
limited by bureaucratic inertia, as any change in the administrative
structure of a hospital should be centrally approved by the
Ministry of Health and by the shortage of medical personnel.
Other quality indicators
Some of the quality indicators of stroke care have improved
since 2017 (Table 4). Centers were motivated by ESO Awards
and by the constant feedback given by the national coordinator
of the stroke network (Figure 2). In 2017 only County
Hospital Oradea (Bihor County) has qualified for Gold Status,
while in 2021 we had three Diamond Hospitals (Emergency
Clinical Hospital Bucharest, County Emergency Clinical
Hospital Brasov, Emergency Clinical County Cluj Napoca).
In 2017, when RES-Q Registry was implemented,
slightly more than 50% of stroke patients were evaluated
with the NIHSS scale, while in 2022 the percentage has

ESO East Supplement 2023

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