Robert Mikulík

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Acta Clin Croat,  Vol. 50,  (Suppl) No. 2,  2011 57Acta Clin Croat (Suppl. 2) 2011; 4th international epilepsy symposium in Pula – how to start seizure treatmentSTROKE SERVICES AND PUBLIC AWARENESS ABOUT STROKE IN THE CZECH REPUBLICRobert MikulíkNeurology Department, International Clinical Research Center, St Anne’s Hospital, Brno, Czech RepublicSince the nineties of the last century, stroke ser-vices started to be established in the Czech Republic. In the majority of cases, stroke services were estab-lished within already existing neurology departments. Th e major driving force for establishment of stroke unit network was the introduction of thrombolytic treatment into the clinical practice. Th e fi rst use of the thrombolysis in the Czech Republic was reported in 1997, but the offi  cial approval was not until 2004. Starting in 2004, all centers performing thrombolytic therapy were urged to participate in Safe Implementa-tion of Th rombolysis in Stroke (SITS) registry. Partici-pation had to be approved by the national coordinator. As part of the approval process, all local coordinators provided data on center characteristics (which later on allowed us to analyze the effi  cacy of stroke services based on their characteristics). Th e centers participat-ing in the SITS registry agreed to enter all patients treated with tissue plazminogen activator (tPA) into the database. Th e volume of thrombolytic treatments in each center is monitored and annually reported to the regulatory authorities (e.g. Ministry of Health) as part of a quality control process. Since 2007, the Czech Republic has also partici-pated in the SITS-EAST project, which was launched within SITS, to support evidence-based stroke treat-ments, including thrombolytic treatments in the Cen-tral and Eastern Europe.Th e number of stroke units performing throm-bolytic treatment was growing in the Czech Republic from 2004 every year and reached 50 in 2007. Al-though the number of thrombolytic centers did not increase since 2007, the number of thrombolytic treat-ments has been further growing. One possible expla-nation is that such grow is due to nation-wide stroke awareness campaign, which was launched in 2006 and is still ongoing. To determine the effi  cacy of this campaign and to improve its effi  cacy, a nation-wide survey throughout the CR was conducted in 2005 in 2009 to measure the level of stroke awareness about stroke in the Czech population and assess the predic-tors of calling 911.Several scientifi c undertakings have been per-formed using Czech national data and data from SITS registry, to understand better how the effi  cacy of thrombolytic stroke unit network can be increased including the above mentioned analysis of the effi  cacy of stroke awareness campaign. Also, we are currently investigating how the time from stroke symptom on-set can be shortened so patients with stroke obtain maximum benefi t from the treatment. As the fi rst step, data on more than 5000 patients treated with thrombolysis and enrolled in the SITS-EAST regis-try, are analyzed. Th e lecture will cover the results of all these analysis.

Stroke Services and Public Awareness about Stroke in The Czech Republic

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