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Vaskulárna medicína 1/2025
Assessing the quality of care to improve stroke management
Introduction: A measurable assessment of quality care for patients with ischemic stroke (IS) is crucial for further improving care. The aim of the study was to compare data on acute care and subsequent rehabilitation of patients with IS at Dept. of Neurology UNLP and UPJŠ Košice.
Materials and Methods: We compared data from the National Center for Health Information (NCZI) on acute stroke treatment at Dept. of Neurology in Košice in the years 2017-2024 with the recommendations of the European Stroke Organization’s Stroke Action Plan. The subsequent rehabilitation care of stroke patients since 2023 was compared with data from the Slovak Republic.
Results: We found that UNLP Košice reached the percentages of recanalization treatment recommended by the Action plan already in 2017 and by 2024 the percentage was increasing, mainly due to the increase in the number of mechanical thrombectomies. Another important evaluation parameter is door-to-needle time (DNT) within 45, or 60 min. We achieved the recommended values only in 2021, for 4 years (2018, 2019, 2021, 2022) we achieved the recommended percentage of patients treated within 45 minutes. In 2023, we began to analyze rehabilitation care and found that in Slovakia 3.8% of patients were transferred to a rehabilitation facility, while in UNLP Košice this was 16% of patients with stroke.
Conclusion: Through an annual ongoing analysis of data with subsequent measures taken (increasing the number of radiologists, streamlining care), it was possible to ensure 24/7 availability of the thrombectomy center, increase the number and proportion of acute reperfusion therapy, and shorten DNT. The results are comparable to European standards. Analysis of data on subsequent rehabilitation treatment in 2023 indicates its insufficient availability, including in the case of UNLP Košice, where the proportion of rehabilitated patients is above the Slovak average.
Keywords: stroke, registry, quality assessment, recanalization treatment, rehabilitation
