[An improvement of step-by-step medical care for patients with ischemic stroke in Orel region]

In Orel region, standardized mortality rates of cerebrovascular disorders (CVD) are one of the lowest in Russian Federation (RF)--200.1 per 100,000 population as compared to 316 per 100,000 in the country. According to the brain stroke register, CVD mortality in Orel city was evaluated as 79 per 100,000 population. The causes of such decrease are as follows: (1) people are well informed about the first signs of stroke and 60% of patients referred to medical services after the first signs; (2) Municipal Health Care department issued an instruction on the immediate hospitalization, with a small number of contra-indications, of all patients with acute lesions of brain blood circulation (ABBC)--as a result, 70% of patients were admitted within the first 6 hours from stroke development; (3) an efficient system of the first pre-hospital care performed by an emergency team, with delivering stroke patients to hospitals by the team that first diagnosed ABBC; (4) sufficient hospital facilities (100 beds for vascular neurological patients with 12 beds for intensive therapy per 331,300 population); (5) hospitalization of all patients with acute stroke to vascular neurological departments with intensive therapy wards and neurologists trained all the methods of critical care and intensive therapy; (6) a sufficient supply of all medications necessary for treatment of the acute stage of stroke. The scheme of therapeutic and diagnostic care for patients with ischemic stroke is proposed that could be recommended for organization of medical care to patients with ABBC in RF cities and towns.