Global Health IM Residency Tract – Critically Appraised Topics (CATs) Project 2013 Global Health Critically Appraised Topic: Treatment of Stroke in CT-Poor Settings
نویسنده
چکیده
Stroke remains on top 5 causes of mortality in the world with a higher incidence and higher mortality in developing countries. Standard stroke care in the US and Europe consists of fast presentation to healthcare & frequently specialty stroke centers, diagnosis using neuroimaging and clinical scales, and acute treatment based on stroke sub-type with anti-platelets, thrombolytics, antihypertensives and anti-coagulants followed by long-term treatment with rehabilitation and risk factor management. The hallmarks of stroke management consist of expensive diagnostic imaging; expensive acute interventions and expensive specialty care (both neurology and rehabilitation) making stroke hospitalizations amongst the most expensive in the US, averaging $9,500 (AHRQ 2005). Developing countries face substantial cost barriers at all management levels to improve stroke outcomes and practicing evidence-based medicine in this setting is particularly difficult given that the majority of “standard-of-care” interventions are not feasible in many developing country hospitals
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