ArticleFrontiers in stroke2026
Application of TOAST criteria, comorbidities and outcomes in patients with ischemic stroke: multicenter collaboration in the Dominican Republic.
Article in Frontiers in stroke, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Introduction: Stroke is a leading cause of neurological-related death in the Caribbean. The Dominican Republic has among the highest stroke-related mortality rates in the Americas. We aimed to determine ischemic stroke etiologies, characterize comorbidities, and describe outcomes in the Dominican Republic using the TOAST (Trial of Org 10172 in Acute Stroke Treatment) classification. Methods: We analyzed a multicenter quality registry between January 2022 and October 2024. Statistical analyses included Mann-Whitney Results: The most common stroke subtype was undetermined etiology (54.8%), followed by large artery atherosclerosis (17.2%) and cardioembolism (16.5%). Hypertension (73.8%), diabetes mellitus (47.2%), and prior stroke (19.9%) were the most prevalent risk factors. Cardioembolic stroke had the highest median NIHSS score (6). Prior stroke was associated with increased odds of large artery atherosclerosis (OR 1.53, Conclusions: Most ischemic strokes were of undetermined etiology, with higher severity observed in cardioembolic stroke. Limited diagnostic workup, reperfusion therapies, and rehabilitation access highlight critical gaps in stroke care. These findings provide baseline data to inform targeted prevention and health system interventions in the Dominican Republic and similar settings.
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