Crude ischaemic stroke admissions declined modestly in Slovenia from 2015–2022 while reperfusion and prevention improved, but the magnitude and pattern of improvement differed by care domain and patient subgroup, supporting continued monitoring and the development of a national stroke registry.
Ischaemic stroke admissions peaked in 2017 and crude admission rates declined modestly over the study period.
Intravenous thrombolysis (IVT) rates more than doubled over the study period.
Mechanical thrombectomy (MT) utilization increased substantially over the study period.
Carotid endarterectomy (CEA) rates increased and showed sex-based differences in utilization.
Five-year mortality was higher with increasing age and comorbidity and lower among patients receiving IVT and several secondary-prevention therapies.
Discharge secondary-prevention prescription rates improved over the study period.
Length of hospital stay decreased over the study period.
Women with ischaemic stroke were older than men, and care pathway differences existed by stroke aetiology and sex.
The study used linked national administrative databases in the absence of a dedicated stroke registry to conduct a nationwide longitudinal analysis.
This research suggests that in Slovenia between 2015 and 2022, the number of people admitted to hospital with an acute ischaemic stroke (caused by a blood clot blocking a blood vessel in the brain) declined slightly, going from about 105 to 99 admissions per 100,000 residents per year. However, the quality and intensity of treatment improved considerably over this period. The use of clot-busting drugs (thrombolysis) more than doubled, mechanical procedures to remove clots (thrombectomy) increased by nearly half, and more patients received surgery or stenting to clear blocked neck arteries. Patients were also more likely to leave the hospital with medications to prevent future strokes, and hospital stays became shorter. The study also found important differences in who received which treatments and what outcomes looked like. Men were more likely to receive artery-opening procedures in the neck, while rates of clot-busting and thrombectomy were similar between men and women. Women tended to be older when they had their stroke. Patients who were older or had more health problems were more likely to die within five years, while those who received clot-busting treatment or were discharged with preventive medications had better survival. The pattern of care also differed depending on the underlying cause of the stroke. This research is notable because it was conducted without a dedicated national stroke registry, instead relying on linked administrative health databases — a method that may be useful for other countries in similar situations. The authors highlight that despite overall improvements, gains were uneven across different patient groups and types of care, and they argue that establishing a formal national stroke registry would allow for more detailed and targeted quality improvement efforts going forward.
Furlan T, Jug B, Nograšek N, Gavrić D, Oblak J, Bonča P, et al.. (2026). Acute ischemic stroke trends in Slovenia, 2015-2022: declining admissions, rising reperfusion, uneven gains.. Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association. https://doi.org/10.1016/j.jstrokecerebrovasdis.2026.108668