• Assessing the Quality of Strok...

Treffer: Assessing the Quality of Stroke Services in Brazil Using the World Stroke Organization Roadmap.

Title:
Assessing the Quality of Stroke Services in Brazil Using the World Stroke Organization Roadmap.
Authors:
Pires AP; Postgraduate Program in Medical Sciences, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.; Postgraduate Program in Vascular Neurology, Hospital Moinhos de Vento, Porto Alegre, Brazil.; Neurology Service, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil., Martin KC; Fellowship Program in Neurohospitalism, Hospital Moinhos de Vento, Porto Alegre, Brazil., Secchi TL; Postgraduate Program in Vascular Neurology, Hospital Moinhos de Vento, Porto Alegre, Brazil., Silva GS; Neurology Service, Hospital Albert Einstein, São Paulo, Brazil., Rebello LC; Neurology Service, Hospital de Base, Brasília, Brazil., Bezerra DDC; Neurology Service, Hospital Pró-Cardíaco, Rio de Janeiro, Brazil., de Freitas GR; Neurology, D'Or Institute for Research and Education, Rio de Janeiro, Brazil., Oliveira-Filho J; Institute of Health Sciences, Universidade Federal da Bahia, Salvador, Brazil., Miranda-Alves M; Neurology Service, Universidade Federal de São Paulo, São Paulo, Brazil., Kuster GW; Neurology Service, Américas Serviços Médicos, São Paulo, Brazil., Bazan R; Neurology Service, Universidade Estadual Paulista, Botucatu, Brazil., Lange MC; Neurology Division, Hospital de Clínicas Universidade Federal do Paraná, Curitiba, Brazil., de Carvalho JJF; Neurology, Hospital Geral de Fortaleza, Fortaleza, Brazil., Mont'Alverne FJA; Neurology, Hospital Geral de Fortaleza, Fortaleza, Brazil., Fiorot JA Jr; Stroke Unit, Hospital Estadual Central, Vitória, Brazil., Zetola VF; Neurology Division, Hospital de Clínicas Universidade Federal do Paraná, Curitiba, Brazil., Magalhães PSC; Stroke Service, Hospital Municipal São José, Joinville, Brazil., Rieder CRM; Neurology, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, Brazil., Nasi LA; Cardiology Service, Hospital Moinhos de Vento, Porto Alegre, Brazil., Nogueira RG; UPMC Stroke Institute, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA., Moro CC; Stroke Service, Hospital Municipal São José, Joinville, Brazil., Barbosa LA; Stroke Unit, Hospital Estadual Central, Vitória, Brazil., Borelli WV; Postgraduate Program in Vascular Neurology, Hospital Moinhos de Vento, Porto Alegre, Brazil., Pontes-Neto OM; Neurology Service, Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto, USP, Ribeirao Preto, Brazil., Martins SCO; Postgraduate Program in Medical Sciences, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil, sheila.ouriques.martins@gmail.com.; Postgraduate Program in Vascular Neurology, Hospital Moinhos de Vento, Porto Alegre, Brazil, sheila.ouriques.martins@gmail.com.; Neurology Service, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil, sheila.ouriques.martins@gmail.com.
Source:
Cerebrovascular diseases (Basel, Switzerland) [Cerebrovasc Dis] 2026; Vol. 55 (1), pp. 72-82. Date of Electronic Publication: 2025 May 26.
Publication Type:
Journal Article
Language:
English
Journal Info:
Publisher: Karger Country of Publication: Switzerland NLM ID: 9100851 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1421-9786 (Electronic) Linking ISSN: 10159770 NLM ISO Abbreviation: Cerebrovasc Dis Subsets: MEDLINE
Imprint Name(s):
Original Publication: Basel ; New York : Karger, 1990-
MeSH Terms:
Stroke*/therapy , Stroke*/diagnosis , Stroke*/epidemiology , Quality Indicators, Health Care*/standards , Quality Improvement*/standards , Outcome and Process Assessment, Health Care*/standards , Process Assessment, Health Care*/standards, Humans ; Brazil/epidemiology ; Health Care Surveys ; Certification/standards
Contributed Indexing:
Keywords: Acute stroke care; Acute stroke therapy; Stroke unit; Thrombectomy; Thrombolysis
Entry Date(s):
Date Created: 20250526 Date Completed: 20260112 Latest Revision: 20260112
Update Code:
20260113
DOI:
10.1159/000546276
PMID:
40418926
Database:
MEDLINE

Weitere Informationen

Introduction: Organizing acute stroke care effectively reduces disability and mortality. Since the Ministry of Health in Brazil established the National Stroke Policy in 2012, stroke care has improved significantly. However, despite the increase in stroke centers, some hospitals have not fully implemented the recommended structure and protocols. This study aims to evaluate the quality of stroke services in Brazil based on the World Stroke Organization (WSO) Roadmap, marking the first step toward the Certification of Stroke Centers in Latin America.
Method: From 2020 to 2022, we assessed the structure of stroke centers in Brazil via an online survey based on the WSO Roadmap. When multiple responses came from the same hospital, we checked for consistency and contacted the stroke center coordinator if needed. We then compared these findings to the structure of stroke centers available in 2008, before the national stroke plan began.
Results: The number of stroke centers in Brazil increased from 35 in 2008 to 246 in 2022, with 216 centers assessed in this study (102 Essential, 114 Advanced). Advanced centers were mostly private (69%). Of all hospitals, 51% serve public health patients, 75% as Essential centers. The southeast and south region have the highest number of stroke centers (77%). All hospitals provided essential blood tests, CT scans, and thrombolytic therapy, with 97% having pre-hospital emergency services. Neurologists were available 24/7 in 85% of centers (49% on call, 35% on duty, 16% via telemedicine), and 46% of hospitals had stroke units. Nearly 90% had acute neurosurgical care, and 47% offered endovascular thrombectomy 24/7. Advanced centers implemented 85% of the WSO Roadmap items and Essential centers 76%. According to WSO/SIECV Certification, 39 centers were prepared for certification, and 18 were certified (6 private: Advanced, 12 public: 4 Advanced, 8 Essential).
Conclusion: Brazil has significantly improved its stroke care structure, but disparities and areas for further enhancement remain, particularly in equity, resource access, and best practices implementation. Certification programs could help address these issues and improve outcomes for stroke patients.
(© 2025 S. Karger AG, Basel.)