Article Text
PDF
Abstract
Introduction West Georgia Medical Centre (WGMC) and the 1st Lviv Territorial Medical Union (1TMU) serve as the exclusive comprehensive stroke centers in West Georgia and West Ukraine, respectively. WGMC spans 31,500 km2, serving 950,000 residents in 23 cities/towns, while 1TMU extends over 21,833 km2, catering to 2,478,100 residents across 78 cities/towns. Despite distances of up to 220 km from WGMC and 138 km from 1TMU, patient transfer delays vary, highlighting their vital roles in stroke care.
Aim of Study To evaluate the quality and performance of stroke services provided by these institutions.
Methods Retrospective analysis was conducted on electronic medical records of patients undergoing mechanical thrombectomy (MT) at both institutions. Ukrainian data covers September 2022 to August 2023, while WGMC data spans from July 2019 to August 2023. Assessment parameters included the National Institutes of Health Stroke Scale (NIHSS), Alberta Stroke Program Early CT Score (ASPECTS), and Modified Rankin Scale (mRS).
Results Enrollment comprised 72 1TMU and 65 WGMC patients. NIHSS scores, initial ASPECTS, and mRS upon discharge showed no significant differences. Symptom onset-to-admission time averaged 294 minutes at WGMC and 115 minutes at 1TMU. Sedation was prevalent in 91% of cases at 1TMU versus 41% at WGMC, with thrombolysis employed in 53% and 5% of cases, respectively. mTICI-3 reperfusion rates were 74% at WGMC and 85% at 1TMU.
Conclusion Middle-income countries can deliver effective endovascular treatment for ischemic stroke with prompt patient arrival. However, substantial organizational and logistical enhancements within regional healthcare systems and hospitals are necessary to reduce delays and enhance workflow efficiency.
