Journal Article

Accessibility and use of organised stroke care and reperfusion therapies in Europe: results from the SAP-E Stroke Service Tracker 2023

de Sousa, Diana Aguiar, Sacco, Simona, Thórarinsson, Björn Logi, Wilkie, Arlene, Wassvik, Lejla, Tomek, Ales, Norrving, Bo, Santo, Gustavo, Christensen, Hanne, Tiu, Cristina, Grundtvig, Josefine, Budincevic, Hrvoje, Ovesen, Christian, Vilionskis, Aleksandras, Pezzella, Francesca Romana, Roaldsen, Melinda Berg

2026

Overview

Organised stroke care and reperfusion therapies are key components of modern stroke treatment. We assessed accessibility of organised stroke care and reperfusion therapies in Europe and explored its association with key organisational indicators. Stroke Action Plan for Europe (SAP-E) Stroke Service Tracker data from 2023 reported by 47 European countries was assessed. Accessibility indicators included stroke unit (SU) admission proportions, intravenous thrombolysis (IVT) and EVT treatment proportions. Organisational indicators included the facility density of SU, IVT-capable centres and EVT-capable centres per capita (number of centres per 100,000 population), presence of national stroke plans and quality programmes. Across Europe, marked variations were observed in facility density of SU (0.21-0.48), IVT-capable centres (0.19-0.45) and EVT-capable centres (0.06-0.15). SU admission proportions ranked from 0.8% to 96.7%, IVT treatment proportions from 1.3% to 34.7% and EVT treatment proportions from 0.2% to 14.3%. Stroke unit admission proportions were associated with SU density (r = 0.42, P = .03). Density of reperfusion-capable centres showed a possible trending association with IVT treatment proportions (r = 0.34, P = .08), but no association with EVT treatment proportions (r = 0.22, P = .23). Neither the presence of a national stroke plan nor a quality programme were associated with accessibility of SU care, IVT or EVT. Large inequities in access to organised stroke care and reperfusion therapies persist across Europe. At the country level, national stroke plans and quality programmes have not yet translated into effect on accessibility indicators, suggesting that achieving effective implementation takes time or could primarily manifest as within-country improvements.

• Publisher: Oxford University Press
• Subject: Europe / Health Services Accessibility - statistics & numerical data / Humans / Original Research / Reperfusion / Stroke / Stroke - therapy / Thrombolytic Therapy - statistics & numerical data