Stroke services in the Middle East and adjacent region: A survey of 34 hospital-based stroke services

• Published in: Frontiers in neurology Vol. 13; p. 1016376
• Main Authors: Al Hashmi, Amal. M., Shuaib, Ashfaq, Imam, Yahia, Amr, Dareen, Humaidan, Hani, Al Nidawi, Firas, Sarhan, Ahmed, Mustafa, Wessam, Khalefa, Wael, Ramadan, Ismail, Usman, Fritz Sumantri, Hokmabadi, Elyar Sadeghi, Ghorbani, Mohammed, Nassir, Temeem, Aladham, Farid, Salmeen, Athari, Kikano, Raghid, Muda, Sobri, Jose, Sachin, Bulushi, Manal Al, Sajwani, Badrai, Wasay, Mohammad, Bashir, Qasim, Al Hazzani, Adel, Khoja, Waleed, Alkadere, Radwan, Osman, Haytham, Hussein, Abbashar, Churojana, Anchalee, Hammami, Nadia, Ozdemir, Atilla Ozcan, Giray, Semih, Gurkas, Erdem, Hussain, Seyd Irteza, Sallam, Abdul Rahman, Mansour, Ossama Yassin
• Format: Journal Article
• Language: English
• Published: Frontiers Media S.A 28.10.2022
• Subjects: MENA+ region; MENA-SINO; Neurology; stroke care; stroke centers; stroke units
• ISSN: 1664-2295; 1664-2295
• DOI: 10.3389/fneur.2022.1016376

Acute stroke care is complex and requires multidisciplinary networking. There are insufficient data on stroke care in the Middle East and adjacent regions in Asia and Africa.BackgroundAcute stroke care is complex and requires multidisciplinary networking. There are insufficient data on stroke care in the Middle East and adjacent regions in Asia and Africa.Evaluate the state of readiness of stroke programs in the Middle East North Africa and surrounding regions (MENA+) to treat acute stroke.ObjectiveEvaluate the state of readiness of stroke programs in the Middle East North Africa and surrounding regions (MENA+) to treat acute stroke.Online questionnaire survey on the evaluation of stroke care across hospitals of MENA+ region between April 2021 and January 2022.MethodOnline questionnaire survey on the evaluation of stroke care across hospitals of MENA+ region between April 2021 and January 2022.The survey was completed by 34/50 (68%) hospitals. The median population serviced by participating hospitals was 2 million. The median admission of patients with stroke/year was 600 (250-1,100). The median length of stay at the stroke units was 5 days. 34/34 (100%) of these hospitals have 24/7 CT head available. 17/34 (50%) have emergency guidelines for prehospital acute stroke care. Mechanical thrombectomy with/without IVT was available in 24/34 (70.6%). 51% was the median (IQR; 15-75%) of patients treated with IVT within 60 min from arrival. Thirty-five minutes were the median time to reverse warfarin-associated ICH.ResultsThe survey was completed by 34/50 (68%) hospitals. The median population serviced by participating hospitals was 2 million. The median admission of patients with stroke/year was 600 (250-1,100). The median length of stay at the stroke units was 5 days. 34/34 (100%) of these hospitals have 24/7 CT head available. 17/34 (50%) have emergency guidelines for prehospital acute stroke care. Mechanical thrombectomy with/without IVT was available in 24/34 (70.6%). 51% was the median (IQR; 15-75%) of patients treated with IVT within 60 min from arrival. Thirty-five minutes were the median time to reverse warfarin-associated ICH.This is the first large study on the availability of resources for the management of acute stroke in the MENA+ region. We noted the disparity in stroke care between high-income and low-income countries. Concerted efforts are required to improve stroke care in low-income countries. Accreditation of stroke programs in the region will be helpful.ConclusionThis is the first large study on the availability of resources for the management of acute stroke in the MENA+ region. We noted the disparity in stroke care between high-income and low-income countries. Concerted efforts are required to improve stroke care in low-income countries. Accreditation of stroke programs in the region will be helpful.