Global Stroke Statistics 2023: Availability of Reperfusion Services Around the World

Kim, Joosup
Olaiya, Muideen T
De Silva, Deidre Anne
Norrving, Bo
Bosch, Jackie
Aguiar de Sousa, Diana
Christensen, Hanne
Ranta, Anna
Donnan, Geoffrey
Feigin, Valery L
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Journal Article
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SAGE Publications

BACKGROUND: Disparities in the availability of reperfusion services for acute ischaemic stroke are considerable globally, and require urgent attention. Contemporary data on the availability of reperfusion services in different countries provide the necessary evidence to prioritise where access to acute stroke treatment is needed.

AIMS: To provide a snapshot of published literature on the provision of reperfusion services globally, including when facilitated by telemedicine or mobile stroke unit services. Methods: We searched PubMed to identify original papers, published up to January 2023, with the most recent, representative and relevant data for each country. Keywords included thrombolysis and telemedicine. We also screened reference lists of review papers, citation history of papers, and the grey literature. The information is provided as a narrative summary.

RESULTS: Of 11,222 potentially eligible papers retrieved, 148 were included for review following de-duplications and full text review. Data were also obtained from national stroke clinical registry reports, Registry of Stroke Care Quality (RES-Q) and Pre-hospital Stroke Treatment Organization (PRESTO) repositories, and other national sources. Overall, we found evidence of the provision of intravenous thrombolysis services in 70 countries (6463% high-income countries (HICs)) and endovascular thrombectomy services in 33 countries (68% HICs), corresponding to far less than half of the countries in the world. Recent data (from 2019 or later) were lacking for 35 of 67 countries with known year of data (52%). We found published data on 74 different stroke telemedicine programs (93% in HICs) and 14 active mobile stroke unit pre-hospital ambulances services (80% in HICs) around the world.

CONCLUSION: Despite remarkable advancements in reperfusion therapies for stroke, it is evident from available data that their availability remains unevenly distributed globally. Contemporary published data on availability of reperfusion services remain scarce, even in HICs, thereby making it difficult to reliably ascertain current gaps in the provision of this vital acute stroke treatment around the world.

endovascular thrombectomy , mobile stroke unit , Reperfusion , review , Stroke , Telemedicine , Thrombolysis , worldwide , Stroke , mobile stroke unit , reperfusion , telemedicine , worldwide , 4203 Health Services and Systems , 42 Health Sciences , Cerebrovascular , Brain Disorders , Clinical Research , Stroke , Health Services , 8.1 Organisation and delivery of services , 8 Health and social care services research , Stroke , 1103 Clinical Sciences , 1109 Neurosciences , Neurology & Neurosurgery , 3202 Clinical sciences , 3209 Neurosciences , 4201 Allied health and rehabilitation science
International Journal of Stroke, ISSN: 1747-4930 (Print); 1747-4930 (Online), SAGE Publications, 19(3), 253-270. doi: 10.1177/17474930231210448
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© 2023 World Stroke Organization. Creative Commons License (CC BY-NC 4.0). This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License ( which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access page (