The silent predator: What you don’t know about stroke
Stroke can come out of the blue, even in people who have been healthy all their lives. Unlike some other health conditions that develop gradually, a stroke occurs suddenly when blood flow to the brain is blocked in a cerebral artery, causing the brain to essentially stop functioning almost immediately. What’s remarkable about stroke treatment is its extreme time sensitivity. If a blockage is removed quickly, the brain can often resume normal function with minimal damage. But if the blockage lasts only a few hours, the brain damage can be permanent.
Although effective treatments exist, they are not available in many countries. The quality of stroke care varies dramatically across different regions of Europe, leading to significant differences in patient outcomes. This critical gap in healthcare was the catalyst for the COST Action Implementation Research Network in Stroke Care Quality (IRENE), led by Professor Robert Mikulik from the International Clinical Research Center of the St. Anne’s University Hospital in Brno, Czech Republic, where he leads the Stroke Research Programme.
Monitoring the quality of stroke care
The RES-Q (Registry of Stroke Care Quality) was an existing registry originally developed under the umbrella of the European Stroke Organisation in 2016. IRENE’s main contribution was to develop a methodology and strategy for monitoring the quality of stroke care, to adapt the registry to new requirements and to provide evidence on the quality of stroke care.
The registry contains standardised data on treatment times, protocols, and outcomes, allowing hospitals to benchmark their performance against their peers. This approach identifies specific gaps in the care pathway for targeted improvement and tracks changes in care delivery over time.
“In the Czech Republic and other countries, we can see that patients are now being treated more quickly upon arriving at the hospital,” says Prof. Mikulik. “Since every minute saved in providing treatment adds several more weeks to a patient’s life, we know that patient outcomes are improving.” These efficiency gains are directly improving survival and reducing disability in all participating countries.
- There are 1.1 million strokes in Europe every year, causing an estimated 460,000 deaths
- Nearly 10 million people in Europe live with the long-term effects of stroke
- Cost of stroke care in EU countries expected to rise to €86 billion by 2040
Quantifiable social and economic impact
IRENE’s work has concrete benefits for society as a whole. “Improved quality of stroke care reduces hospital readmissions, long-term rehabilitation costs and the economic burden of disability on patients, families and healthcare systems,” says Professor Mikulik. By enabling more stroke survivors to return to work or maintain their independence, the registry contributes to societal productivity.
An analysis of participating hospitals shows that the implementation of improvement strategies has led to an average 15% reduction in the length of hospital stay and significant improvements in the percentage of patients treated within guideline-recommended timeframes.
“Improved quality of stroke care reduces hospital readmissions, long-term rehabilitation costs and the economic burden of disability on patients, families and healthcare systems“
Prof. Robert Mikulik, Chair of the Action IRENE
Building a network for change
The IRENE COST Action has built a collaborative network of 188 members from 30 countries focused on a clear mission: to develop a standardised methodology for monitoring the quality of stroke care. This approach has enabled researchers to assess the quality of stroke care across Europe, particularly in Inclusiveness Target Countries (ITCs) where the level of stroke care has never been systematically assessed.
“The significant accomplishment of the network is the development of methodology of stroke care quality monitoring,” explains Professor Mikulik. “This has allowed us to assess and understand the level of stroke care quality in ITCs across Europe, which is crucial for identifying gaps and driving improvements.”
The Action worked with various partners, and representatives from organisations such as the European Stroke Organisation (ESO) took part in joint meetings to discuss stroke care monitoring and improvement strategies. They worked in the context of the Stroke Action Plan Europe, the largest stroke project ever undertaken in Europe, which sets targets to improve stroke care across the continent by 2030.
IRENE organised specific activities to support researchers from Inclusiveness Target Countries, providing hands-on training with leading experts. Action events were held in Moldova and Croatia, and a meeting was held in Armenia. Specialised workshops on neuro-rehabilitation techniques and quality measurement systems facilitated skills transfer.
These activities have trained many researchers in previously underserved regions. Skilled specialists have successfully implemented modern rehabilitation methods in their home countries, directly contributing to improved stroke care at the national level in 12 ITC countries.
Technology integration and future directions
IRENE’s achievements have laid the foundation for the Horizon Europe-funded RES-Q+ project, which will continue until at least 2026. This next phase will develop two new AI-powered voice assistants, one to help patients give feedback on their health and the other to help doctors manage stroke care. The project is expected to reduce the number of deaths by 40,000 and save more than €0.5 billion per year in Europe.
By connecting stroke healthcare professionals and IT experts, IRENE has created a sustainable infrastructure for continuous improvement that serves as a model for addressing healthcare inequalities across Europe.
Additional information
View the Action website
Discover the Horizon Europe project RES-Q+ Global registry for stroke care improvement