Background:Global access to acute stroke treatment is variable worldwide, with notable gaps in low and middle-income countries (LMIC), especially in rural areas. Ensuring a standardized method for pinpointing the existing regional coverage and proposing potential sites for new stroke centers is essential to change this scenario.Aims:To create and apply computational strategies (CS) to determine optimal locations for new Acute Stroke Centers (ASCs), with a pilot application in nine Latin-American regions/countries.Methods:Hospitals treating Acute Ischemic Stroke (AIS) with intravenous thrombolysis (IVT) and meeting the minimum infrastructure requirements per structured protocols were categorized as ASCs. Hospitals with emergency departments, non-contrast CT scanners, and 24/7 laboratories were identified as Potential Acute Stroke Centers (PASCs). Hospital geolocation data were collected and mapped using the OpenStreetMap® dataset. A 45-minute drive radius was considered the ideal coverage area for each hospital based on the drive speeds from the OpenRouteService® database. Population data, including demographic density, was obtained from the Kontur Population® datasets. The proposed CS assessed the population covered by ASCs and proposed new ASCs or artificial points (APs) settled in densely populated areas to achieve a target population coverage (TPC) of 95%.Results:The observed coverage in the region presented significant disparities, ranging from 0% in the Bahamas to 73.92% in Trinidad and Tobago. No country/region reached the 95% TPC using only its current ASCs or PASCs, leading to the proposal of APs. For example, in Rio Grande do Sul, Brazil, the introduction of 132 new centers was suggested. Furthermore, It was observed that most ASCs were in major urban hubs or university hospitals, leaving rural areas largely underserved.Conclusions:The MAPSTROKE project has the potential to provide a systematic approach to identify areas with limited access to stroke centers and propose solutions for increasing access to AIS treatment.Data Access Statement:Data used for this publication are available from the authors upon reasonable request.

中文翻译：

---

MAPSTROKE 项目：改善急性中风护理机会的计算策略

背景：全球急性卒中治疗的可及性存在差异，低收入和中等收入国家（LMIC）存在显着差距，特别是在农村地区。确保采用标准化方法来确定现有区域覆盖范围并提出新卒中中心的潜在地点对于改变这种情况至关重要。目标：创建并应用计算策略 (CS) 来确定新急性卒中中心 (ASC) 的最佳位置，在九个拉丁美洲地区/国家进行试点应用。方法：通过静脉溶栓 (IVT) 治疗急性缺血性中风 (AIS) 并满足结构化方案最低基础设施要求的医院被归类为 ASC。设有急诊科、非造影 CT 扫描仪和 24/7 实验室的医院被确定为潜在急性卒中中心 (PASC)。使用 OpenStreetMap® 数据集收集和绘制医院地理位置数据。根据 OpenRouteService® 数据库的行驶速度，45 分钟的行驶半径被认为是每家医院的理想覆盖区域。人口数据，包括人口密度，是从 Kontur Population® 数据集中获得的。拟议的 CS 评估了 ASC 覆盖的人口，并建议在人口稠密地区安置新的 ASC 或人工点 (AP)，以实现 95% 的目标人口覆盖率 (TPC)。结果：观察到的该地区的覆盖率存在显着差异，范围从巴哈马的 0% 到特立尼达和多巴哥的 73.92%。没有一个国家/地区仅使用其现有的ASC或PASC就达到了95%的TPC，从而导致了AP的提议。例如，建议在巴西南里奥格兰德州设立 132 个新中心。此外，据观察，大多数 ASC 都位于主要城市中心或大学医院，而农村地区基本上得不到服务。 结论：MAPSTROKE 项目有潜力提供一种系统方法来识别卒中中心访问受限的地区，并提出解决方案访问 AIS 处理。数据访问声明：本出版物中使用的数据可根据合理要求向作者提供。