Results of the RACECAT study quoted in the prestigious journal JAMA, highlighting the quality of the code stroke system in Catalonia

Vall d’Hebron was one of the study promoters, which determined the most effective transfer circuits for patients with severe stroke.


The Journal of the American Medical Association (JAMA), one for the most prestigious and widely distributed medical journals worldwide, has made mention of the RACECAT study, in which Vall d’Hebron took part, which determines the most effective transfer circuits for patients with severe stroke.

The publication highlights the value of the results from this study, headed by the Vall d’Hebron University Hospital Stroke Unit and the Vall d’Hebron Research Institute (VHIR) Stroke Research Group, and how well code stroke works in Catalonia, thanks to excellent coordination between prehospital and hospital care, a well consolidated patient registry with high-quality data, centralised patient follow-up, and open publication of quality metrics.

“This publications positions Catalonia as a model territory and world benchmark in how to organise stroke care. Indeed, the system has been copied and adapted in many countries”, notes Dr Natàlia Pérez de la Ossa, neurologist at the Hospital Germans Trias i Pujol and head of the Catalan Government Stroke Master Plan. “A study of this complexity involving so many people could only have been conducted in our territory, but its results will serve to organise stroke care networks worldwide,” adds Dr Marc Ribó, neurologist at the Vall d’Hebron University Hospital, researcher with the VHIR Stroke Research Group and co-principal investigator for the study.

A study of world interest

The results of the RACECAT study are of worldwide interest, as they help in planning the organisation of stroke patient referrals and transfers. Running from 2017 to the end of 2020, the study aimed to determine where to transfer patients with severe stroke located far from a high-technology hospital providing the endovascular treatment needed in half of most severe stroke cases. Such technology is only available in certain centres in the stroke care network which are often some distance from the patient.

The results of the study show the effectiveness of the stroke care circuits, thanks to close coordination between the Medical Emergencies System (SEM) and hospitals. It concludes that the chances of clinical recovery are positive both if patients are transferred to one of the centres with capacity to provide endovascular treatment and if initial care is provided by a local centre, followed by secondary transfer when necessary.

Specifically, 45% of patients with severe ischaemic stroke receive a thrombectomy, one of the highest rates in Europe, and treatment is started very quickly, at an average of 4.5 hours from the onset of symptoms, even in patients some distance away who are initially attended by a local stroke centre.

Furthermore, in Catalonia, patients receive attention in the first hospital after an average of 88 minutes; they undergo initial tests and are given primary care in less than 40 minutes, and reach the second hospital, where they can undergo the thrombectomy, after an average of 180 minutes. These times are extremely fast compared to other regions, and shows the efficacy of the Catalan stroke care network.

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