ArticleFrontiers in stroke2026
Improving stroke outcomes through progressive implementation of stroke unit care in Brazil: a longitudinal observational study.
Article in Frontiers in stroke, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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11 authors.
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Abstract
Introduction: Stroke remains a leading cause of death and disability worldwide, with a disproportionate burden in low- and middle-income countries (LMICs). Although stroke unit (SU) care improves outcomes, evidence from LMIC settings is still limited. We evaluated the impact of three sequential stroke-care models implemented in a Brazilian public university hospital. Patients and methods: This longitudinal observational study included 1,889 patients with ischemic or hemorrhagic stroke across three care models: before stroke unit (BSU), acute stroke unit (ASU), and comprehensive stroke unit (CSU). Demographic characteristics, stroke subtype, baseline severity, imaging metrics, and outcomes were collected using retrospective and prospective approaches. Primary outcomes were 90-day case fatality and functional status assessed by the modified Rankin scale (mRS). Secondary outcomes included door-to-CT time, thrombolysis rates, pneumonia, access to rehabilitation, and length of stay. Multivariable logistic regression was used to identify predictors of mortality and excellent functional outcome (mRS 0-1). Results: The implementation of structured stroke-care models was associated with significant improvements in outcomes. Functional independence at 90 days (mRS 0-2) increased from 45.6% (BSU) to 60.3% (ASU) and 56.3% (CSU) ( Conclusion: Stepwise implementation of structured stroke-care models significantly reduced mortality and improved functional outcomes in this LMIC setting. These findings support the effectiveness and scalability of SU-particularly comprehensive models-as key strategies to strengthen stroke systems of care.
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