AUTHOR=Sahakyan Greta , Orduyan Mira , Badalyan Sevak , Adamyan Ani , Hovhannisyan Mariam , Manucharyan Hasmik , Egoyan Sagatel , Makaryan Yuri , Manvelyan Hovhannes TITLE=Characteristics of stroke service implementation in Armenia JOURNAL=Frontiers in Neurology VOLUME=13 YEAR=2023 URL=https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2022.1021628 DOI=10.3389/fneur.2022.1021628 ISSN=1664-2295 ABSTRACT=Background

Acute stroke care service in Armenia was established in 2019 after the implementation of the National Stroke Program (NSP). This study aimed to provide an up-to-date account of the current image and clinical characteristics of acute stroke service implementation at a tertiary hospital in Armenia by analyzing the quality of care and identifying the areas that need improvement.

Methods

We analyzed patient data from a single hospital in 1 year after the establishment of acute stroke care service (February 2021–January 2022). We selected patients who were within 0–24 h from symptom onset at admission and included patients who benefited from reperfusion therapies (intravenous thrombolysis (IVT) and/or endovascular thrombectomy (EVT)). A favorable outcome was defined as a drop in the National Institutes of Health Stroke Scale (NIHSS) by more than four points at discharge and a modified Rankin score (mRS) of 0–2 at 90 days.

Results

Of the total 385 patients, 155 underwent reperfusion therapies, 91% of patients (141/155) arrived by ambulance, 79.2% (122/155) had neurological improvement at discharge, and 60.6% (94/155) had an mRS of 0–2 at 3 months. Less than 5% of patients had early direct access to the rehabilitation center.

Conclusion

Our study demonstrated that the implementation of NSP with organized protocol-driven inpatient care led to significant advancement in acute stroke service performance. We believe that our report will serve as a model for achieving advanced and structured stroke care in a resource-limited context and contribute to the future development of the healthcare system in our country.