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Definition and Implications of the Preventable Stroke.

Mark Fisher1, Lisa Moores2, Mohamad N Alsharif1

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Most acute strokes are preventable. This study found that highly preventable strokes were paradoxically more likely to receive acute treatment, highlighting a gap in stroke prevention strategies.

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Area of Science:

  • Neurology
  • Public Health
  • Preventive Medicine

Background:

  • Acute stroke evaluation routinely focuses on treatability, not preventability.
  • Understanding stroke preventability is crucial for improving patient outcomes and reducing healthcare burden.

Purpose of the Study:

  • To systematically analyze the preventability of acute ischemic stroke.
  • To develop and apply a scale to quantify stroke preventability based on modifiable risk factors.

Main Methods:

  • Retrospective analysis of 274 ischemic stroke patient records from a university medical center.
  • Development of a 10-point scale assessing preventability based on hypertension, hyperlipidemia, atrial fibrillation, and antithrombotic treatment adherence.
  • Correlation of stroke preventability scores with demographic data, stroke severity, and acute stroke treatment received.

Main Results:

  • 75.5% of patients had strokes with some degree of preventability (score ≥1).
  • 25.9% of strokes were highly preventable (score ≥4).
  • Highly preventable strokes were paradoxically more likely to receive acute treatment (29.6%) compared to non-preventable strokes (19.4%).

Conclusions:

  • The majority of acute ischemic strokes exhibit some level of preventability.
  • A significant association exists between stroke preventability and the receipt of acute treatment.
  • Findings suggest a need to re-evaluate and enhance primary and secondary stroke prevention strategies.