Stroke mortality rate in Romania, twice the European average

To accelerate the prioritization of care for stroke patients, specialists at Philips, the global leader in medical technology, have joined forces with the World Stroke Organization in a strategic partnership to address the significant gaps in stroke care that contribute to high death and disability rates around the world, with a particular focus on countries with the greatest need, such as Romania.

“Stroke is one of the leading causes of disability and the second leading cause of death globally, but it receives far less attention and funding compared to diseases such as cancer. Every year, over 13 million people suffer a stroke and 6.6 million of these patients do not survive. Furthermore, 1 in 4 people over the age of 25 will suffer a stroke in their lifetime. These figures highlight the urgent need to improve stroke care, especially in countries like Romania,” said Véronique Tordoff, European leader of Image Guided Therapy at Philips recently.

Romania: A critical need to improve stroke care

According to the data provided by the Ministry of Health, Romania has the highest stroke mortality rate in Europe (21.64%), and nationally, it is the second leading cause of death after cardiovascular diseases. The prevalence of stroke in Romania is 0.1% for those under 40 years old, 1.8% for those aged 40-55, 4.3% for those aged 55-70, and 13.9% for those over 70 years old. Annually, in Romania, 55,000 people suffer an ischemic stroke, 7,500 a hemorrhagic stroke, and 1,500 a subarachnoid hemorrhage, with modern treatment alternatives being offered at a very low rate compared to the EU.

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The World Stroke Organization has set targets of a 15% treatment rate through thrombolysis and 5% through endovascular treatment. Currently, in Romania, less than 1% (0.24%) of patients with acute ischemic stroke receive endovascular interventional treatment. European targets are at least 5%, and developed countries like Germany and the Netherlands manage to provide endovascular treatment to over 10% of acute ischemic stroke patients. Interventional treatment of acute ischemic stroke is the main method to reduce disability associated with stroke, requiring about 2.5-3 patients to be treated for one to be returned to society as functionally independent.

Furthermore, the development of care networks for medical emergencies, including acute coronary syndromes, stroke, and polytrauma, is a target assumed by the Ministry of Health through the National Health Strategy 2023-2030, and in order to decrease the number of deaths and increase the number of survivors there is an urgent need to improve stroke care.

“Romania faces a worrying reality, with insufficient control of risk factors and disparities in the availability of cardiovascular care,” said Tordoff.

A curable but underfunded disease

Despite its severity, stroke is potentially very curable. If treated promptly, the effects of a stroke can be reversed by minimally invasive thrombectomy procedures or intravenous administration of clot-dissolving drugs. However, speed is of the essence, and current gaps in communication, information and access to stroke expertise lead to loss of valuable time.

“The key to reducing the risk of death or disability from stroke is to treat patients as quickly as possible. However, many countries, including Romania, lack the high-quality stroke infrastructure needed to support widespread access to endovascular therapy (EVT). In Romania, disparities in stroke care are particularly evident, with significant gaps in infrastructure and resources,” Tordoff pointed out.

Health plan: an investment that cuts millions of euros from stroke costs

Globally, the economic burden of stroke is staggering.

In 2017, the global cost of stroke was $912 billion, including both direct costs and lost income, and this figure is expected to rise to $1590 billion by 2050.

Despite these costs, only 3% of countries have allocated funds to address stroke as part of their health plan in 2020.

“Allocating financial resources to stroke care is not just a cost but an investment. Studies have shown that increasing stroke treatment rates can lead to significant net economic benefits. For example, in Germany, increasing the treatment rate from 5% to 20% would lead to a positive net economic effect of €81 million. This is a crucial consideration for countries like Romania, where the economic and social impact of stroke is huge,” said Tordoff.

Disparities in stroke care

Disparities in access to stroke care are evident in both low- and middle-income and high-income countries. In the UK, the chances of receiving thrombectomy vary drastically, from around 10% in London to 0-3% in rural areas.

In Romania, these disparities are even more pronounced, with significant differences in access to care between urban and rural areas.

“We need to ensure that every stroke patient, regardless of where they live, has access to the best possible care. This is particularly important in Romania, where improving access to stroke care can save thousands of lives and reduce the burden on families and the healthcare system,” said Tordoff.

A topic for Romania’s public health agenda

Developing human resources and capacities for the treatment of acute stroke is a priority for the public health system in Romania and will have an important economic effect in the medium and long term on the consolidated budgets of the Ministries of Finance, Health, Labor, and Social Protection by reducing indirect costs resulting from stroke-associated disability. Considering the National Health Strategy 2023-2030 “For Health, Together,” there is a strategic priorty to develop territorial care networks for medical emergencies, including acute coronary syndromes, stroke, polytrauma, that are functional and provide interventions/services with a positive impact on improving health outcomes.

Furthermore, the development of care networks for medical emergencies, including acute coronary syndromes, stroke, and polytrauma, is a target assumed by the Ministry of Health through the National Health Strategy 2023-2030.

Philips and the World Stroke Organization are also committed to improving stroke care through various initiatives. These include the launch of a joint stroke policy paper at the World Health Assembly and the publication of Philips’ position paper, “Shaping the Future of Stroke Care”, which outlines the current landscape of stroke care and the role Philips products can play in advancing it.

“Our partnership with the World Stroke Organization is a crucial step in addressing the gaps in stroke care and improving outcomes for millions of patients worldwide. We are committed to making stroke care a priority on the global health agenda and ensuring that all patients, especially in high-need areas such as Romania, have access to the timely and effective treatment they need,” concluded Tordoff.