Considering the high incidence of cerebrovascular diseases, it therefore seems obvious how, in order to be able to demonstrate causal links and to search for prognostic factors with a high level of evidence, a systematic collection of large-scale data involving different facilities scattered throughout the country is necessary. Such systematic collection would allow both, as just mentioned, to obtain valid data on high-prevalence diseases, such as stroke, and to obtain sufficient evidence for the diagnostic and prognostic framing of those cerebrovascular diseases with lower incidence. In addition, considering the large amount of data, it seems clear that there is a need for a rapid and efficient information collection system that can guarantee an optimal result without overburdening the work of healthcare personnel. In this context, in 2017 the Ministry of Health established the IRCCS Network of Neuroscience and Neurorehabilitation (RIN).
Within this framework, numerous Virtual Institutes, specialized by disease areas, are being developed in a cross-cutting manner to provide the Network with its own strong identity, harmonize IRCCS activities, rationalize investments and resources, build large cohorts, and interact with international networks. To this end, a survey was sent to all Network members in October 2020 to indicate, in the specific area of Cerebrovascular Diseases: the human, infrastructural and technological resources available; and the volume and type of specific clinical activity carried out in the year 2019.
Thirty-two centers responded to the survey, expressing interest in the participation of the forming Virtual National Institute (IVN) of Cerebrovascular Diseases. The geographical distribution of participating centers is as follows: 22 in the North, 6 in the Center and 4 in the South. Peculiarities of this IVN are the high volume of patients with such frequent diseases, the great clinical specialization, the high technological level of care at all stages of the disease, and the required and necessary dynamism and timeliness of intervention.
The individual members of this IVN possess a great and diverse expertise in both care activities and clinical and pre-clinical research. In addition, considering the high sociomedical burden of the set of these pathologies, largely related to the permanent disability they entail, the IVN of Cerebrovascular Diseases will have the peculiarity of being able to follow the entire pathway of the Patient from the acute phases (hospital) to those of rehabilitation (in neurorehabilitation centers) until the return home. Through this study, the aim is to create a national registry for these diseases.
The primary objective of the study is to identify and define the various subtypes of each cerebrovascular disease falling under the following codes of the International Classification of Diseases, 9th revision (ICD-9): ICD-9 430-438, associated with poor prognosis.
Secondary objectives:
* Identification of clinical variables of each cerebrovascular pathology correlated with the prognosis of the same;
* Identification of biomarkers of each cerebrovascular pathology correlated with the prognosis of the same;
* Identification of the radiological variables of each cerebrovascular pathology correlated with the prognosis of the same;
* Identification of neurophysiological variables of each cerebrovascular pathology correlated with the prognosis of the same;
* Identification of prognostic scores for each cerebrovascular disease based on the combination of clinical, radiological, neurophysiological and biomarker variables;
* Identification of the clinical, radiological and neurophysiological variables and biomarkers of each cerebrovascular disease that will help the clinician in early differential diagnosis;
* Identifications of the clinical, radiological, and neurophysiological variables and biomarkers of each cerebrovascular pathology that can predict the development of spontaneous or procedure-related complications of treatment;
* Identifications of the clinical, radiological, and neurophysiological variables and biomarkers of each cerebrovascular pathology capable of predicting the successful outcome of pharmacological or procedural therapies;
* Identification of clinical, radiological, and neurophysiological variables and biomarkers of each cerebrovascular pathology useful for personalization of rehabilitation treatment and able to predict good functional outcome following the same rehabilitation treatments.
