BACKGROUND: Stroke is a leading cause of death and disability worldwide. Due to the high burden caused by stroke, the Israeli Ministry of Health initiated a national program for the treatment and prevention of stroke, including the establishment of an Israeli National Stroke Registry (INSR). In this article we will demonstrate the use of the INSR as a tool for monitoring the treatment of acute cerebrovascular events (stroke or transient ischemic attack). OBJECTIVES: 1. Assessing incidence rates of acute cerebrovascular events in Israel for the total population and by gender and ethnic group separately. 2. Presenting trends in a number of key indicators related to acute stroke care. METHODS: The INSR is based on data retrieval from hospital electronic medical records of all adult cases discharged with acute cerebrovascular diagnosis from January 1, 2014 on. Included in the current analysis were all cases reported to the INSR until June 31, 2017. RESULTS: The average annual incidence rate of cerebrovascular events in Israel was 3.2 cases per 1,000 people. Age-adjusted rates were significantly higher among Arabs, compared with the Jewish population. From 2014 to 2017 there was a moderate increase in the percentage of arrival by ambulance: from 43.2% to 49.0% and a significant increase in the percentage of head and neck vascular imaging performed: from 50.0% to 72.5%. Between 2014 and 2016 there was a significant increase in the percentage of t-PA administration, and in 2016-2017 the rates stabilized at 9.2%. The proportion of patients hospitalized in neurological wards was 38.0% - a slight increase from 35.0% in 2014. CONCLUSIONS: The INSR is an effective tool for monitoring morbidity and acute stroke care in Israel. Actions should be taken in order to raise public awareness of stroke warning signs and the establishment of stroke units with skilled multidisciplinary teams should become a priority. DISCUSSION: Compared with other western countries, rates of t-PA administration and arrival by ambulance in Israel are slightly low, rates of hospitalization in the neurological ward are significantly lower, and the lack of stroke units is most prominent.
BACKGROUND:Stroke is a leading cause of death and disability worldwide. Due to the high burden caused by stroke, the Israeli Ministry of Health initiated a national program for the treatment and prevention of stroke, including the establishment of an Israeli National Stroke Registry (INSR). In this article we will demonstrate the use of the INSR as a tool for monitoring the treatment of acute cerebrovascular events (stroke or transient ischemic attack). OBJECTIVES: 1. Assessing incidence rates of acute cerebrovascular events in Israel for the total population and by gender and ethnic group separately. 2. Presenting trends in a number of key indicators related to acute stroke care. METHODS: The INSR is based on data retrieval from hospital electronic medical records of all adult cases discharged with acute cerebrovascular diagnosis from January 1, 2014 on. Included in the current analysis were all cases reported to the INSR until June 31, 2017. RESULTS: The average annual incidence rate of cerebrovascular events in Israel was 3.2 cases per 1,000 people. Age-adjusted rates were significantly higher among Arabs, compared with the Jewish population. From 2014 to 2017 there was a moderate increase in the percentage of arrival by ambulance: from 43.2% to 49.0% and a significant increase in the percentage of head and neck vascular imaging performed: from 50.0% to 72.5%. Between 2014 and 2016 there was a significant increase in the percentage of t-PA administration, and in 2016-2017 the rates stabilized at 9.2%. The proportion of patients hospitalized in neurological wards was 38.0% - a slight increase from 35.0% in 2014. CONCLUSIONS: The INSR is an effective tool for monitoring morbidity and acute stroke care in Israel. Actions should be taken in order to raise public awareness of stroke warning signs and the establishment of stroke units with skilled multidisciplinary teams should become a priority. DISCUSSION: Compared with other western countries, rates of t-PA administration and arrival by ambulance in Israel are slightly low, rates of hospitalization in the neurological ward are significantly lower, and the lack of stroke units is most prominent.