ABSTRACT NUMBER: ESOC2026A1234 THE MAPSTROKE ASSESSMENT OF THE STROKE UNIT BED GAP IN ITALY

Abstract Background and aims Stroke Action Plan for Europe benchmarks recommend that ≥90% of stroke patients are admitted to a dedicated Stroke Unit (SU). This MAPSTROKE analysis quantified Italy’s capacity-constrained SU coverage and the national/regional SU bed gap needed to reach the 90% target. Methods MAPSTROKE modelled capacity for hospitals with SUs (Primary and Comprehensive Stroke Centres) by estimating annual SU admissions from reported SU bed counts and mean SU length of stay (LOS). Capacity-constrained catchment areas allocated incident strokes until local SU capacity was exhausted, producing regional coverage (proportion of incident strokes that available SU beds could accommodate). The SU bed gap was computed as additional beds required to admit ≥90% of regional incidence; a scenario analysis assumed an ideal LOS of 3.65 days (≈100 strokes/bed/year). Results PSCs reported a median of 4 SU beds (IQR 4–6) and CSCs 8 (IQR 6–8), with a median LOS of 5 days in both. National SU capacity was 86,090 admissions/year, covering 79.2% of annual stroke incidence. Only five regions reached ≥90% SU coverage (Abruzzo, Lombardia, Toscana, Umbria, Valle d’Aosta), while Basilicata had the lowest coverage (40.6%). The national SU bed deficit to achieve the 90% target was 255 beds, decreasing to 158 beds under the ideal LOS scenario. Conclusions Italy shows marked regional disparities and an overall shortfall in SU beds; reducing LOS could partially mitigate—but not eliminate—the SU bed gap. Funded by the WSO Pilot Research Proposal Grant 2022 and the Angels Initiative/Boehringer Ingelheim (contract nos. 782566 and 1005232). Conflict of interest E.N. is member of the medical and scientific advisory board of Cercare Medical. L.A.C. acknowledges receiving a grant from the World Stroke Organization and the Angels Initiative/Boehringer Ingelheim (contract nos. 782566 and 1005232) for this work. A.C., E.F., A.S.F., L.L.D., M.B., M.D., P.S., V.C., and D.T. havd nothing to disclose. Figure 1 - belongs to Results