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Acute Stroke in northern Portugal: outcomes and characteristics of patients in a Medical-Surgical Emergency Department

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Summary:Introduction: Stroke is a leading cause of morbidity and long-term disability worldwide, significantly impacting health systems and personal lives. Disparities in European access to stroke care suggest an increased burden on individuals and society. Effective management of acute stroke in emergency departments is critical, requiring a rapid and coordinated response to optimize clinical outcomes. Objective: Characterize the hospital approach to acute stroke patients attended through the Stroke Pathway (Via Verde AVC) protocol in a Medical-Surgical Emergency Department in northern Portugal. Methods: Retrospective observational study of 1153 patients admitted through the Acute Stroke Care Pathway from 2019 to 2023. Data on patient demographics, clinical characteristics, treatments, and outcomes were collected from electronic medical records. Statistical analysis included chi-square tests, ANOVA, Kruskal-Wallis tests, trend analysis, and logistic regression. Results: Stroke Pathway activations increased from 0.28% in 2019 to 0.31% in 2023 (p<0.05). Ischemic stroke was most common (64.8%, 95% CI: 62.1-67.4%). Thrombolysis rates increased from 21.96% to 27.27% (p<0.01), and thrombectomy from 4.67% to 21.21% (p<0.001). Age >70 years (OR 1.8, 95% CI: 1.3-2.5) and arrival within 3 hours (OR 2.3, 95% CI: 1.7-3.1) predicted reperfusion therapy. Female patients surpassed males in 2023 (51.01% vs 48.99%). Conclusion: The Emergency Department demonstrated improvement in acute stroke care. Enhanced systematic data recording and new technologies are needed to optimize care. Future research should focus on long-term outcomes and quality-of-life measures.
Main Authors:Domingues, Sandra
Other Authors:Barros, Tiago; Correia, João; Cruz, Arlindo; Araújo, Nuno; Silva, Liliana
Subject:Life and Healthcare Sciences
Year:2025
Country:Portugal
Document type:article
Access type:open access
Associated institution:Instituto Politécnico de Viseu
Language:English
Origin:Millenium

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