Stroke Care

Fast, Effective Stroke Treatment

Stroke is one of the leading causes of serious, long-term disability. Skåne University Hospital’s stroke unit is one of Sweden’s leading academic stroke centres, with over 70 active researchers and two full-time stroke professors. We treat 1,200 patients per year in Malmö and Lund and provide a full range of services including primary, secondary and tertiary care.

In acute stroke care, it is crucial to treat as quickly as possible as “time is brain”, and it is necessary to minimize timely aspects from debut of symptoms until treatment is initiated. Our unique, fast-track solution is built on a multidisciplinary collaboration between the ambulance staff, emergency wards, radiology and neurology departments.

In Skåne, we have installed a regional stroke network with a drip and ship approach to acute stroke care, i.e. stroke patients are taken to the closest hospital where they undergo acute investigations. Clot-dissolving treatment (i.v. thrombolysis) is provided at all these 8 stroke centres; if indicated this is followed by direct transport to the neuroradiological stroke centre in Lund for mechanical thrombectomy. We have established the concept of 10/30, i.e. we aim at starting acute clot-dissolving treatment within 10 minutes from arrival at the hospital (door-to-needle time), and within 30 minutes the patient should be on the way to Lund if endovascular treatment is necessary.

All stroke centres have access to advanced radiological solutions including CT perfusion with automatically delivered brain maps (Rapid software). Endovascular treatment in the prolonged time window up to 24 hours is, according to several international trials, associated with a significantly better outcome for selected patients, and this treatment option is well established in Skåne. In cases of doubt, there is a 24/7 access to a regional stroke specialist for support and guidance.

Rates of clot-dissolving treatment and mechanical thrombectomy are among the highest in Sweden. In 2020, 13% of ischemic stroke patients in Skåne received clot-dissolving treatment, 7% mechanical thrombectomy, and 2% both. Corresponding figures for Sweden are 11%, 3%, and 2%.

Our stroke units are composed of a wide range of professionals specializing in stroke management, from physicians and occupational therapists to neuropsychologists and social workers.

The core function of these units is to provide a full range of services, including early acute management and rehabilitation. A regional network is continuously evaluating and supporting improvement of stroke care in our region with focus on incorporating new evidence-based standards and above all best outcome for our patients.

Continuously, we evaluate our work based on data from Riksstroke, the Swedish stroke registry and the Worlds’ first national quality registry for stroke. These data cover demography, risk factors, functional ability and symptoms preadmission, level of medical care, acute stroke treatment, diagnostic measures, medical treatment at admission and discharge, stroke-related complications, rehabilitation, mortality, and follow-up, and are reported yearly towards the public, patient organizations, health professionals, and politicians. Data is also used for scientific evaluation, and a large range of publications is based on data from Riksstroke.

Case Study

Over two years (2017-2019) Skåne Care supported Sheikh Khalifa Medical City Ajman (SKMCA), United Arab Emirates, with developing and improving their stroke process to match international standards. The work was initiated by a thorough gap analysis followed by tailormade educational and advisory services, with regular local presence at SKMCA by Swedish expertise from Skåne University Hospital. The result from the strong partnership between Skåne Care and SKMCA is an improved stroke care for local patients in Ajman, who benefit from access to thrombolysis, a stroke pathway, stroke guidelines in line with international best practice, and more.