QUALITY OF CARE OF ACUTE STROKE PATIENTS IN LITHUANIA: NATIONAL DATA Aleksandras Vilionskis1,2, Inga Slautaite1,2, Rytis Masiliunas1,3, Jevgenija Zeldakova1,3, Vaidas Matijosaitis4, Antanas Vaitkus4, Povilas Beliaziunas4, Laura Sinkunaite4, Saulius Taroza5, Linas Masiliunas6, Andreea Grecu7, Dalius Jatuzis1,3 1Vilnius University, Faculty of Medicine, Institute of Clinical Medicine, Vilnius, Lithuania 2Republican Vilnius University hospital, Department of Neurology, Vilnius, Lithuania 3Vilnius University Hospital Santaros Klinikos, Department of Neurology, Vilnius, Lithuania 4Lithuanian University of Health Science, Medical Academy, Clinic of Neurology, Kaunas, Lithuania 5Klaipeda Seamen’s Hospital, Department of Neurology, Klaipeda, Lithuania 6Republican Panevezys Hospital, Department of Neurology, Panevezys, Lithuania 7International Clinical Research Center, St. Anne's University Hospital, Department of Clinical Neurology, Brno, Czech Republic Background: Quality of care (QOC) of acute stroke patients (ASP) is essential to improve long-term outcomes, decrease mortality and long-term disability. Recent studies have shown that QOC varies across countries and across hospitals in country. The aim of this study was to estimate the QOC of ASP in Lithuania, identify the gaps and suggest ways to improve it. Methods: All ASP (ischemic stroke, intracerebral hemorrhage and subarachnoid hemorrhage) treated in 5 largest stroke centers in Lithuania during October 2017 were included in our study. The RES-Q questionnaire was used. The questions covered imaging, treatment and secondary prevention topics. Results: 330 ASP (ischemic stroke-92.4%, intracerebral hemorrhage-6.4%, and subarachnoid hemorrhage–1.2%) were included. 63.3% (8.6-93.6%) of all patients were treated in a stroke unit. CT or MRI scans were performed in 99.7% (98.9-100.0%) of all patients on admission. 27.9% (7.8-65.0%) of acute ischemic stroke patients received recanalization therapy; the median door-to-needle time was 41 (39 – 57) min. Only 0.92% (0-2.5%) of ASP were screened for dysphagia. AF screening was done in 10.3% (0-68.9%) of ischemic stroke patients, however, none were screened for ≥24 h. On discharge antiplatelet treatment was given to 91.8% (87.5-97.1%) of non-AF patients; anticoagulant treatment – to 83.0% (66.7-95.7%) of AF patients. Conclusions: We found that the main gaps in QOC of ASP in Lithuania were insufficient screening for dysphagia and cardiac monitoring for AF. Door-to-needle time should be improved as well. Introduction of a dysphagia protocol and education of hospital staff is needed to improve care for ASP.
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