ABSTRACT NUMBER: ESOC2026A683 STRENGTHENING OF STROKE CARE IN UKRAINE DESPITE THE COVID-19 AND WARTIME CHALLENGES

Abstract Background and aims In Ukraine, a country with very high stroke burden, healthcare reforms continued in the face of the pandemic and ongoing war. We aimed to assess the trends in acute stroke treatments, poststroke rehabilitation, and early stroke mortality since 2021 when the Program of Medical Guarantees, a new state-funded system ensuring free access to essential healthcare services, was implemented. Methods Aggregated dataset on stroke care was obtained from eHealth, the national centralized database, and a set of metrics was calculated for 2021 through Q3 2025, including the rate of intravenous thrombolysis and mechanical thrombectomy in ischemic stroke, utilization of in-patient rehabilitation services within the first 3 months, in-hospital and 30-day stroke mortality. Results Over the last 5 years, rates of intravenous thrombolysis and mechanical thrombectomy in acute ischemic stroke along with access to in-patient post-stroke rehabilitation have been improving, while in-hospital and 30-day mortality have shown no trend to reduction over time (table). Conclusion In Ukraine, despite clear progress in reperfusion interventions and rehabilitation utilization, early stroke mortality remains high and largely unchanged highlighting the need to address the gap between service availability and better outcomes. Conflict of interest Flomin: nothing to disclose; Tsyhanii: nothing to disclose; Orlovska: nothing to disclose; Guliaieva: nothing to disclose; Skipalskyi: nothing to disclose. Table 1 - belongs to Results