Improving quality of ischemic stroke patients requires substantial changes in hospitalization plan and treatment intensification in Latvia

To investigate causal relationship of stroke mortality in relation to the patient’s treatment site and provided treatment in 2019. Administrative data for 3982 major manipulations applied for treatment of stroke patients admitted to hospitals were studied by the treatment site. 30-day mortality rates for hospitals were obtained from the NHS public data base. In total 5077 ischemic stroke patients were admitted to 21 treatment site in 2019, 13,8% of which did not represent stroke unit. Mortality rate in hospitals without stroke unit is 1,38 times higher and is in range from 16,5% to 66,7%, but in hospitals with stroke unit is in range from 16,% to 38,9%. Thrombolysis therapy was administered to 24% of patients admitted to hospitals without stroke unit and 47% in stroke units. Percutaneous transluminal angioplasty was administered to 23% of patients and intra-arterial embolization was administered to 11% of patients admitted to stroke units. Ischemic stroke patients admitted to hospitals without stroke units do not receive appropriate treatment and are at higher risk of 30-day mortality. Improving the quality of ischemic stroke treatment and reducing the 30-day mortality rates requires providing treatment only in hospitals with stroke units and the treatment used should be intensified. The hospitalization plan for stroke patients and treatment guidelines needs to be revised.