Citation
Mikulik, Robert and Neto, Geraldo and Sedani, Rupal and Ameriso, Sebastian F. and Mammadova, Nargiz and Marchenko, Sergey and Martins, Sheila and Milanov, Ivan and Constanzo, Freddy and Muñoz, Mario and Budincevic, Hrvoje and Šrámek, Martin and Ramos, Cristina and Zakaria, Magd Fouad and Kõrv, Janika and Tsivgoulis, Georgios and Szapary, Laszlo and Pandian, Jeyaraj and Nulkhasanah, Adin and Batayha, Waleed and Medukhanova, Sabina and Karbozova, Kunduz and Miglane, Evija and Vilionskis, Aleksandras and Kee, Hoo Fan and Gongora-Rivera, Fernando and Cantu Brito, Carlos and Groppa, Stanislav and Ciobanu, Natalia and Paudel, Raju and Abanto, Carlos and Collantes, Maria Epifania and San Jose, Maria Cristina and Kobayashi, Adam and Gomes, Ana and Tiu, Cristina and Shamalov, Nikolay and Mijajlovic, Milija and Gdovinová, Zuzana and Kroon, Louis and Sohn, Sung Il and Moniche, Francisco and Towanabut, Somchai and Moskovko, Sergii and AlOmar, Ammar and Huy Thang, Nguyen and Middleton, Sandy and Barrientos-Guerra, José Domingo
(2026)
Differences in acute ischemic stroke treatment: a cross-sectional study from International Registry of Stroke Care Quality (RES-Q).
International Journal of Stroke, 21 (2).
pp. 188-199.
ISSN 1747-4930; eISSN: 1747-4949
Abstract
Background: Stroke globally impacts mortality and disability. Compliance with international standards and evidence-based practices for acute stroke management would improve patient outcomes. Objectives: We aimed to present a descriptive analysis of the quality of acute stroke care across different countries using the Registry of Stroke Care Quality (RES-Q). Method: In a cross-sectional study, data from key quality indicators such as Emergency Medical Services (EMS) deployment rates, hospital arrival to imaging time (door-to-imaging: DIT), hospital arrival to thrombolysis time (door-to-needle: DNT), and Stroke Unit Care/Intensive Care Unit (SU/ICU) admission frequencies were examined. The analysis employed descriptive statistics and Spearman correlation tests. Results: Of 334,184 patients from 1130 hospitals in 70 countries, 218,832 patients (65.5%) from 47 countries were diagnosed with acute ischemic stroke after exclusions. The number of patients per country ranged from 226 to 62,080. International variability in care quality was observed: EMS (7–97%); SU/ICU (12–100%); and median DIT (7–41 min); and DNT (20–75 min). IVT rates varied markedly across countries, ranging from <1% to 52%. Higher patient volumes were positively correlated with SU/ICU admission and negatively with DIT and DNT (ρ = 0.10, –0.22, –0.42, respectively). Conclusion: This study demonstrates substantial international variation in the use of quality monitoring in clinical practice as well as in key indicators of acute ischemic stroke care, including intravenous thrombolysis rates and treatment timelines. The extent of variability highlights opportunities for benchmarking and targeted quality improvement efforts across diverse healthcare systems.
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