The state of stroke services across the globe: Report of World Stroke Organization–World Health Organization surveys

THIS IS WHY THE WSO IS SO FUCKING USELESS! Measuring services rather than recovery results. They need to be destroyed and run by survivors who would never take their eyes off the only goal in stroke;100% recovery.

The state of stroke services across the globe: Report of World Stroke Organization–World Health Organization surveys

Mayowa O Owolabi1, Amanda G Thrifthttps://orcid.org/0000-0001-8533-41702, Sheila Martins3, Walter Johnson4, Jeyaraj Pandianhttps://orcid.org/0000-0003-0028-19685, Foad Abd-Allah6, Cherian Varghese7, Ajay Mahal8, Joseph Yariahttps://orcid.org/0000-0002-1899-08539, Hoang T Phan10, Gregory Roth11, Seana L Gall10, Richard Beare12, Thanh G Phanhttps://orcid.org/0000-0003-3400-632313, Robert Mikulik14, Bo Norrving15, Valery L Feiginhttps://orcid.org/0000-0002-6372-174016, The Stroke Experts Collaboration Group, S.F. Abera, A. Addissie, A. Adeleye, Y. Adilbekov, B. Adilbekova, T.A. Adoukonou, de Sousa D. Aguiar, Z. Akhmetzhanova, R.O. Akinyemi, A. Akpalu, S.F. Ameriso, S. Andonova, C. Abanto, F.E. Awoniyi, M. Bakhiet, H. Basri, P.M. Bath, D. Bereczki, S. Beretta, A.L. Berkowitz, J. Bernhardt, G. Berzina, B. Bhavsar, M.S. Bisharyan, P. Bovet, M. Brainin, H. Budincevic, N.L. Cabral, D A. Cadilhac, V. Caso, C. Chen, J.H. Chin, H Christensen, K. Chwojnicki, A.B. Conforto, V.T. Cruz, M. D'Amelio, K.E. Danielyan, S. Davis, V Demarin, R.J. Dempsey, M. Dichgans, Dokova, G. Donnan, J. Duran, M.A.B. Elizondo, M.S. Elkind, M. Endres, I. Etedal, M.E. Faris, U. Fischer, F. Gankpe, M. Gavidia, A. Gaye-Saavedra, M. Giroud, F. Gongora-Rivera, V. Hachinski, W. Hacke, R.R. Hamadeh, T.K. Hamzat, G.J. Hankey, M.R. Heldner, N.M. Ibrahim, M. Inoue, S. Jee, J. Jiann-Shing, S. Johnston, Y. Kalkonde, S. Kamenova, P. Kelly, T. Khan, S. Kiechl, A. Kondybayeva, J. Kõrv, M. Kravchenko, R. Krishnamurthi, P. Langhorne, Z.L. Kang, J. Kruja, P.M. Lavados, D. Lebedynets, T.W. Leung, D.S. Liebeskind, P. Lindsay, L. Liu, P. López-Jaramillo, P.A. Lotufo, J.M. Machline-Carrion, H.S. Markus, J.M. Marquez-Romero, M.T. Medina, S. Medukhanova, M.M. Mehndiratta, E. Mirrakhimov, S. Mohl, S. Murphy, K.I. Musa, A. Nasreldein, R. Nogueira, C.H. Nolte, B. Norrving, J.J. Noubiap, N. Novarro-Escudero, M. O'Donnell, V. Ogun, M.I. Oraby, B. Ovbiagele, D.N. Ōrken, A.O. Ōzdemir, S. Ozturk, M. Paccot, A. Peters, M. Piradov, T. Platz, T. Potpara, A. Ranta, F.A. Rathore, G. Roth, R.L. Sacco, R. Sahathevan, I.C. Santos, G. Saposnik, F.S. Sarfo, M. Sharma, K.N. Sheth, A. Shobhana, S.N. Silva, N. Suwanwela, P.N. Sylaja, K. Thakur, D. Toni, M.A. Topcuoglu, J. Torales, A. Towfighi, T. Truelsen, A. Tsiskaridze, L. Tsong-Hai, M. Tulloch-Reid, J.N. Useche, P. Vanacker, S. Vassilopoulou, N. Venketasubramanian, G. Vukorepa, V. Vuletic, K.W. Wahab, W. Wang, T. Wijeratne, C Wolfe, M.Y. Yifru, A. Yock-Corrales, N. Yonemoto, L. Yperzeele, and on behalf of the Stroke Experts Collaboration Group
Background

Improving stroke services is critical for reducing the global stroke burden. The World Stroke Organization–World Health Organization–Lancet Neurology Commission on Stroke conducted a survey of the status of stroke services in low and middle-income countries (LMICs) compared to high-income countries.
Methods

Using a validated World Stroke Organization comprehensive questionnaire, we collected and compared data on stroke services along four pillars of the stroke quadrangle (surveillance, prevention, acute stroke, and rehabilitation) in 84 countries across World Health Organization regions and economic strata. The World Health Organization also conducted a survey of non-communicable diseases in 194 countries in 2019.
Results

Fewer surveillance activities (including presence of registries, presence of recent risk factors surveys, and participation in research) were reported in low-income countries than high-income countries. The overall global score for prevention was 40.2%. Stroke units were present in 91% of high-income countries in contrast to 18% of low-income countries (p < 0.001). Acute stroke treatments were offered in ∼ 60% of high-income countries compared to 26% of low-income countries (p = 0.009). Compared to high-income countries, LMICs provided less rehabilitation services including in-patient rehabilitation, home assessment, community rehabilitation, education, early hospital discharge program, and presence of rehabilitation protocol.
Conclusions

There is an urgent need to improve access(WRONG, WRONG, WRONG, you blithering idiots. Access to stroke services that don't work is fuckingly stupid. Are you that brain dead?) to stroke units and services globally especially in LMICs. Countries with less stroke services can adapt strategies from those with better services. This could include establishment of a framework for regular monitoring of stroke burden and services, implementation of integrated prevention activities and essential acute stroke care services, and provision of interdisciplinary care for stroke rehabilitation.