Diagnostics, treatment and secondary prevention of ischemic stroke in the Silesian Province, Poland between 2009 and 2015

Background The available data on diagnostics and treatment of ischemic stroke (IS) in Poland come mainly from non-representative cohorts or are outdated. Objective Therefore, the current study was done to access the most recent data on IS in the industrial region that covers 12% of the country's population. Materials & methods Analysis of the data from stroke questionnaires, obligatory for all patients hospitalized due to acute stroke and administered by the National Health Fund (the only public health insurer in Poland) between 2009 and 2015 (n=81,193). Results The number of hospitalizations due to IS in the Silesian Province was 69,403 and constituted 85.5% of all stroke cases reported to the NHF between 2009 and 2015. Neuroimaging of the brain (CT/MRI) was performed in 68,696 (99%) subjects, while ultrasonography of extra- and/or intracranial arteries in 57,886 (83.4%). The rtPA therapy was applied in 3282 patients (4.7% of all IS subjects). The rate of patients treated with rtPA gradually increased (1.2% in 2009, 9.3% in 2015). Among all patients with IS, 57,636 (83.1%) subjects were administered antiplatelet drugs, 16,199 (23.3%) – oral anticoagulants, and 55,971 (80.7%) – antihypertensive drugs. Also, 2260 (3.3%) patients were referred for vascular intervention. In subjects with cardioembolic stroke etiology, 37.8% were treated with anticoagulants. Conclusions There has been observed a significant improvement in the quality of diagnosis and treatment of acute ischemic stroke during recent years. However, further actions are required both in terms of reperfusion treatment (thrombolysis and/or thrombectomy) and secondary prevention of stroke