LOOKING BACK, BEFORE LOOKING FORWARD. FIVE YEARS DATA FROM RES-Q REGISTRY IN ROMANIA

ABSTRACT

Background and aims: RES-Q Registry is the first stroke database in Romania. The aim is to map key performance indicators for quality of stroke care and to improve stroke management Methods: Each center registers all stroke patients hospitalized in march, yearly. Results: The number of participated centers has increased from 10 in 2017 to 36 in 2021. In five years we have registered 8467 patients. The median age was 71.46 years, median NIHSS at admittance 7.8 points, 82.8% ischemic strokes. Despite improvement in revascularization procedures (intravenous thrombolysis increased from 2.27% in 2017 to 10.56 in 2021, and mechanical thrombectomy from 0,1% to 1,7%) median Modified Rankin Score at discharge did not change significantly and mortality has increased (from 15.09% in 2017 to 19.03% in 2021). A reason for increased mortality is due to Covid-19 pandemic (poor access to primary care, more severely ill, increased door to needle time due to epidemiologic circuits), but beside this, there are unsolved problems, such as the very low percentage (below 1%) of decompressive hemicraniectomy, the reduced capacity to actively detect atrial fibrillation ( 36.9% of patients are still screened for AF only by repeated ECG), the low percentage of carotid imaging (56.7%) and revascularization procedures (less than 7% of symptomatic carotid stenosis). Conclusion: For a better prognosis of stroke we need to increase the number of properly financed stroke units, the educational activities, and to elaborate and implement a national stroke plan.