AUTHOR=Sahakyan Greta , Orduyan Mira , Badalyan Sevak , Adamyan Ani , Hovhannisyan Mariam , Manucharyan Hasmik , Egoyan Sagatel , Makaryan Yuri , Manvelyan Hovhannes 

TITLE=Characteristics of stroke service implementation in Armenia

JOURNAL=Frontiers in Neurology

VOLUME=Volume 13 - 2022

YEAR=2023

URL=https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2022.1021628

DOI=10.3389/fneur.2022.1021628

ISSN=1664-2295

ABSTRACT=Background: Acute stroke care service in Armenia was established in 2019 after the implementation of
the National Stroke Program (NSP). This study aimed to provide an up-to-date account of the current
image and clinical characteristics of acute stroke service implementation at a tertiary hospital in Armenia
by analyzing the quality of care and identifying the areas that need improvement.
Methods: We analyzed patient data of a single hospital in one year after the establishment of acute stroke
care service (February 2021-January 2022). We selected patients who were within 0-24h from symptom
onset at admission and included patients who benefited from reperfusion therapies (intravenous
thrombolysis (IVT) and/or endovascular thrombectomy (EVT)). A favorable outcome was defined as a
drop of the National Institutes of Health Stroke Scale (NIHSS) by more than 4 points at discharge and a
modified Rankin Score (mRS) of 0-2 at 90 days.
Results: Of the total 385 patients, 155 underwent reperfusion therapies, 91% of patients (141/155) arrived
by ambulance, 79.2% (122/155) had neurological improvement at discharge, and 60.6% (94/155) had an
mRS 0-2 at 3 months. Less than 5% of patients had direct early access to the rehabilitation center.
Conclusion: Our study demonstrated that the implementation of NSP with organized protocol-driven
inpatient care led to significant advancement in acute stroke service performance. We believe that our
report will serve as a model for achieving advanced and structured stroke care in a resource-limited
context and contribute to the future development of the healthcare system in our country.