Characteristics of patients’ referral with diagnosis of ischemic stroke in Georgia

Abstract Introduction Effective management of stroke at an early stage gives us the opportunity to reduce mortality and morbidity rates, however, early management is impossible without timely assessment of patients and comprehensive diagnosis. Based on scientific evidence, the clinical outcome of stroke is better when the patient is cared for in a stroke unit, which is a good motivation for creating such a service. Methods The electronic database (medical services provided to the citizens of Georgia in 2016-2021, where the reason for the patient's hospitalization was circulatory system diseases) included 851,543 individual cases. Registration, processing, statistical interpretation and analysis of the obtained data were carried out using the SPSS statistical package (IBM SPSS Statistics for Windows version 23.0). A descriptive and analytical study was carried out. Results In patients hospitalized with a diagnosis of ischemic stroke, in accordance with the recommendation of, current guidelines (National Clinical Practice Recommendation ‘Stroke - Diagnosis and Initial Management of Acute Ischemic Stroke and Transient Ischemic Attack’) thrombolysis/thrombectomy was performed in only 0.8% of patients. As a result of the study, it was determined for the first time in Georgia that in case of patient management in accordance with modern guidelines (thrombolysis/thrombectomy), the chance of stabilization increases by 2.6 times (OR = 2.6; 95%CI OR = 1.7-3.9) and the risk of mortality decreases by 2.3 times (OR = 2.3; 95%CI OR = 1.6-3.4) Conclusions In order to reduce the risk of morbidity and mortality rates caused by ischemic stroke, should be produce a stroke registry and implementation of a targeted referral of patients with a suspected stroke diagnosis only in those clinics where there is a stroke management center. We dedicate this work to the beloved memory of our teacher and co-author, Vasil Tkeshelashvili (MD, PhD, MS, Professor) Key messages • Based on scientific evidence, the clinical outcome of stroke is better when the patient is cared for in a stroke unit, which is a good motivation for creating such a service. • A stroke registry and referral to specialized centers are key to reducing stroke burden in Georgia.