Stroke Care Performance in the Baltic States: A Multicenter Registry‐Based Observational Study

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Background Stroke remains a major public health challenge in Europe with regional disparities. Although the Baltic states share similar demographic and socioeconomic profiles, they differ in stroke care networks and treatment infrastructure. To date, no direct cross‐country comparison of stroke care has been published. Methods We conducted a multicenter cross‐sectional analysis of ischemic stroke patients, prospectively recorded in the Registry of Stroke Care Quality (RES‐Q) by 23 of 26 primary and comprehensive stroke centers across the Baltic states during at least 1 month of the first quarter of 2022. Data on demographic characteristics, stroke risk factors, acute management, and discharge destinations were compared with assess intercountry differences. Results A total of 897 ischemic stroke patients were analyzed: 479 from Lithuania, 294 from Latvia, and 124 from Estonia. Although atrial fibrillation (AF) rates were uniformly high (overall 37.2%), anticoagulant use at stroke onset among patients with known AF was significantly higher in Estonia (72.7%) compared with Latvia (34.9%) and Lithuania (48.8%, p = 0.032). Estonia reported the highest intravenous thrombolysis (IVT) rates (44.4%), whereas Lithuania achieved the highest endovascular treatment (EVT) rates (17.7%). In contrast, Latvia had the lowest recanalization therapy rates (IVT 21.1%, EVT 5.1%). Rehabilitation access varied strikingly: Only 2.7% of Latvian patients were transferred to inpatient rehabilitation compared with 30.5% in Lithuania and 20.2% in Estonia ( p < 0.001). Conclusions This first comprehensive comparison of stroke care in the Baltic states highlights a high AF burden and important disparities in recanalization therapy and poststroke rehabilitation pathways. Data Access Statement The data supporting this study′s findings are available from the corresponding author upon reasonable request.

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