ABSTRACT NUMBER: ESOC2026A829 ONE-YEAR LONGITUDINAL TRENDS IN ACUTE ISCHEMIC STROKE CARE QUALITY: A REGISTRY-BASED ANALYSIS FROM A TERTIARY STROKE CENTER

Abstract Background and aims Continuous quality monitoring using standardized stroke registries is essential for identifying gaps in care and guiding improvement initiatives.The aim was to assess quarterly trends in acute ischemic stroke care quality over one calendar year at a tertiary stroke center using national registry-based indicators. Methods A retrospective longitudinal analysis of prospectively collected registry data was performed, covering 1 January-31 December 2025 (Q1- Q4). Key indicators comprised stroke volume, admission severity (NIHSS), pre-hospital metrics, imaging performance, reperfusion therapy utilization and workflow times, and discharge outcomes. Trends were analyzed descriptively across quarters. Results A total of 175 stroke patients were treated (Q1: 79; Q2: 28; Q3: 35; Q4: 33). Median admission NIHSS decreased over time (Q1: 14; Q3 - Q4: 11). Median onset-to-door time improved from 240 minutes (Q1) to 130 - 153 minutes (Q2-Q3), with a slight increase in Q4 (140 minutes). EMS prenotification increased transiently in Q3 (17%) but remained low overall. Brain imaging was performed in 100% of cases throughout the year, with door-to-imaging time improving from 26 minutes (Q1) to 20 minutes (Q3-Q4). Intravenous thrombolysis rates peaked in Q3 (43%), with corresponding higher recanalization rates (50%), while Q4 showed reduced thrombolysis use and longer door-to-needle times. Endovascular thrombectomy utilization increased modestly over time (up to 15%). Median discharge NIHSS improved from 6 (Q1) to 4-5.5 (Q3-Q4), while discharge mRS remained stable. Conclusions Registry-based monitoring revealed improvements in imaging workflow and neurological outcomes, alongside variability in reperfusion therapy utilization. Continuous quality surveillance is essential to sustain and optimize acute stroke care. Conflict of interest Nothing to disclose