TRAJECTORY OF PATIENTS AFFECTED BY STROKE IN A UNIVERSITY HOSPITAL CENTER IN THE NORTH WEST OF ALGERIA

Abstract

Objective: Describe the path of patients who have suffered a stroke, and have been cared for at the University Hospital of Tlemcen with the aim of proposing strategies allowing the involvement of the various health bodies in the implementation of these trajectories. Design and method: Descriptive observational study over 02 years on stroke patients admitted to TLEMCEN University Hospital. Data collection made using a data collection sheet. Entry and analysis by the EPI info6 software. Results: 1. The alert and the acute phase: the patients who came to the university hospital center of Tlemcen came from 13 municipalities of the Wilaya of Tlemcen and 5.9% from the other wilayas. Patient reception structure: 2. The medical emergency service represented the first reception service for 95.60% of our patients and it is at this level that they are initially taken care of by emergency general practitioners. 21 patients were referred by different health establishments in the Wilaya. 3. Hospitalization 82% of stroke patients were hospitalized directed to a specialized and adapted service, preferentially the neurology service (80.50%). The orientation depends on the cause of the accident and the evolution of the pathology. The practice of brain scan was performed in the public sector in 80.5% of our patients. but 19.5% did so at the private sector level. 93.70% performed this examination the same day of their admission. The mean length of hospitalization was 10.17 ± 7.58 days. Conclusions: Stroke is a pathology that involves the entire healthcare chain. This pathology requires multidisciplinary care, it concerns the hospital sector but also liberal medicine with its medical and paramedical actors. Thus, the trajectory of the stroke patient has several phases and involves a wide variety of actors. Areas for improvement: - Improve the organization of care and management of strokes by creating neurovascular units (UNV). - Multidisciplinary team coordinated and dedicated to pathology neurovascular both in acute and post-acute phase