Vaskulárna medicína 2/2022

Ischemic stroke – treatment options and results in a comprehensive centre

Purpose: Ischemic stroke is a frequent diagnosis in terms of morbidity and mortality. According to the findings of Eurostat, eleven thousand inhabitants of the Slovak Republic (SR) under the age of 75 die annually from the so-called preventable deaths, specifically 16% of them will die from a stroke. Compared to the other countries of the European Union, only Latvia, Lithuania and Romania are worse off than Slovakia. In the presented work, we compared the results of the treatment of patients with ischemic stroke at CINRE in the normal time-period and during the peaks of the COVID -19 pandemic. Patients and methods: All patients treated in the monitored (three-month) time-period in 2020, 2021 and 2022 at CINRE with a diagnosis of ischemic stroke were included in the comparison. Results: Patient numbers and treatment outcomes were not different from normal interquarter fluctuations. In the monitored months during both peak waves of the COVID -19 pandemic in the Slovak Republic, the number of administered intravenous thrombolysis decreased slightly. In the first wave of the COVID -19 pandemic, the number of patients diagnosed with so-called wake-up stroke increased. According to the data collected by us, the availability and quality of acute health care for patients with ischemic stroke remained unchanged during both peak waves of the COVID -19 pandemic. An interesting finding was (while maintaining the quality and availability of acute care) the deterioration of availability and delay in the initiation of secondary prevention. Conclusion: Despite the high mortality rate and the enormous burden on the health care system of the Slovak Republic because of the epidemic, the diagnosis of COVID -19 did not take away the sad primacy of deaths from circulatory system diagnoses. Therefore, it is advisable to continue to focus as much as possible on developing and maintaining a high level of care for patients with diseases of the circulatory system and above all on prevention (that is, treatment and preventive treatment of diagnoses that usually lead to ischemic stroke).

Keywords: COVID-19 pandemic, ischemic stroke, acute recanalisation treatment