Stroke Incidence, Rate of Thrombolytic Therapy, Mortality in Thailand from 2009 to 2021

Abstract

BACKGROUND: Thrombolytic treatment is the main treatment of acute ischemic stroke. Thailand started thrombolytic treatment in 2008 only at university hospitals in Bangkok and gradually increased services in large provincial hospitals until widespread in 2014. However, no studies regard the services in stroke management in Thailand.
 AIM: This study aims to present data: incidence, rate of thrombolytic treatment, mortality rate of acute stroke in Thailand for 13 years
 METHODS: A study from the National Health Security Office's database between 2009 and 2021 was reported using percentage statistics, and the number of patients per 100,000 population.
 RESULTS: The overall incidence of acute stroke patients aged 15 years and over was 172.33- 328.00 per 100,000 population. The incidence of acute ischemic stroke patients aged 15 years and over was 90.37-222.73 per 100,000 population. The incidence of non-traumatic intracerebral hemorrhage patients aged 15 years and over was 55.77-87.63 per 100,000 population. Rate of acute ischemic stroke patients who treated with thrombolytic treatment was 0.18-8.04%. Mortality rate of acute stroke patients was 10.24-14.77%. Mortality rate of acute ischemic stroke patients who treated with thrombolytic treatment was 3.97-10.53%.
 CONCLUSIONS: Stroke incidence tends to increase over 13 years. Acute ischemic stroke patients receiving thrombolytic treatment tends to increase in number. The mortality rate in patients with acute stroke tends to decline. Especially in patients with acute ischemic stroke, the mortality rate was greatly reduced.

Availability of stroke services and hospital facilities at different hospital levels in Thailand: a cross-sectional survey study

“…It should be noted that there could be regional differences which ranging from 5 to 22%. These results are supported by a Thai study using national stroke data [ 23 ] which showed that the percentage of acute ischemic stroke patients who were treated with thrombolysis varied widely across the country.…”

“…It seems possible that stroke service delivery was improved due to the improvement of stroke fast track and thrombolytic treatment in mid-level and standard-level referral hospitals. Thrombolysis treatment can be provided at mid-level referral hospitals by non-neurologist, such as internists or emergency physicians, under the supervision of a neurologist from advanced-level or standard-level referral hospitals [ 23 ]. It should be noted that there could be regional differences which ranging from 5 to 22%.…”

Stroke thrombolysis in a middle-income country: A case study exploring the determinants of its implementation

“…A survey across 44 European countries reported an average of 7.3% of thrombolysis between 2016 and 2017 whereas country-specific rates in Europe were higher in Czech Republic (23.5% in 2018) and the Netherlands (21.7% in 2016) ( Table 3 ) ( 3 ). The reported rates however, were noticeably lower in low and middle-income countries such as Thailand (7.8% in 2019) ( 19 ), Vietnam (5.6–8.5% in 2020) ( 20 ) and China (5.6% between 2019 and 2020) ( 21 ). Direct country comparison of the rates however, was not feasible owing to differences in study methods and reporting years.…”

Stroke systems of care in South-East Asia Region (SEAR): commonalities and diversities

“…Since 2002 when Thailand endorsed Universal Health Coverage (UHC), stroke has been covered under public health, but the rate of thrombolysis use (0.18–8.04%) remains limited. 27 Bhutan also provides UHC for its citizens. However, most other countries in the SEAR do not have UHC, and therefore, despite the availability of advanced medical technology, poor affordability limits its equitable usage.…”