ESOC 2024 | Stroke Service Tracker data shows major successes and challenges in European stroke care

The Stroke Service Tracker is a tool related to the action plan for stroke in Europe where we annually make a survey on the status on stroke care and stroke in the European countries. This year we had responses from 42 countries, and when I’m saying this year it means for the 2022 data. What we do is that we look at very basic things like the number of strokes, number of men and women with stroke, mortality and things like that, but then we also look at the key performance indicators of the action plan to see how countries perform. That that was made public yesterday on the 14th, on European Stroke Awareness Day and everybody can go and access this if they google action plan then they get to the right place. So basically this is kind of a thermometer on how stroke care is doing in Europe.

I think the most important thing is that we see progress. We see progress if we look at our overarching targets for the action plan for stroke in Europe which is the number of strokes, access to stroke unit care, having a national stroke plan and last but not least a plan for primary prevention. The number of strokes in Europe is constant so far for the last three years but we do see progress as to access to stroke unit care, we see progress as to having a national stroke plan, and through a plan for primary prevention. The last two are the really, really important things because those are the instruments for planning and improving stroke care so I’m really very optimistic.

Even though, there are certainly also aspects for which optimism is not really required. If we look at the acute care, we have like 14.6% of all people with an ischemic stroke in Europe received IVT thrombolysis in 2022. About 6% of people with an ischemic stroke had the treatment for large vessel occlusion that is mechanical thrombectomy. So these are very nice figures but there’s a massive inequity between countries and I’m also aware that within a number of countries, there’s very good access to acute treatment in urban areas whereas in remote or rural areas the access is insufficient. There’s also significant inequity between countries. Some countries have the possibility of giving like 30% of their population with ischemic stroke thrombolysis whereas in other countries it’s less than 1%. So we need to increase the level in the countries that are lacking behind.

If we look at rehabilitation, if we look at life after stroke programs, it’s really a sad story because very few countries actually provide, or at least are able to document that they provide, just basic rehabilitation options and follow up. It is really necessary to follow up after stroke because you have a lot of risk factors you need to control, you can have expected complications like pain or spasticity and things like that and you need to see people to diagnose this and to treat it.

So there’s a lot of issues we need to work on but there’s certainly also progress and there’s also stories of success. In 2020 I think it was 31 countries that contributed and now it was 42 countries in 2022. There are 52 countries in the WHO Europe region and we do hope to have all of them included. Some of them are very small areas but still we want them included; we want everybody to be part of the SAP-E family.