Stroke in the Dominican Republic: Exploring Clinical and Treatment Trends in a Tertiary Hospital
María Cedeño1, Sabrina Lora1, Marian Javier1, Marcos Brea Montes de Oca1, Francisco Méndez2, Edwina Luna Rodríguez3, Stephanie Castro Turbi3
1Knowledge Management and Epidemiology Department, 2Emergency Department, 3Neurology Department, Diagnostic Centers and Advanced Medicine and Telemedicine and Medical Conference (CEDIMAT)
Objective:
To describe the clinical profile and analyze trends in the management of acute ischemic stroke (AIS) patients at a Dominican tertiary hospital.
Background:
Ischemic stroke is the second leading cause of death and the primary cause of disability in middle-income countries. Despite improvements in acute care, barriers remain in implementing standardized protocols to ensure timely diagnosis and treatment, compounded by the limited availability of local data.
Design/Methods:
Retrospective, descriptive, cross-sectional study using hospital records and the RES-Q database for patients with AIS from March 2022 to June 2025. Clinical characteristics and workflow metrics, including annual revascularization rates were analyzed with STATA 19.0.
Results:
Of 563 AIS patients, 58.6% (n=330) were male, most were between 60–85 years, while only 15.6% (n=88) were younger than 50 years. Median NIHSS at admission was 4 points. According to the TOAST classification, large-artery atherosclerosis was the most frequent etiology (38.0%, n=171), followed by cryptogenic stroke (31.3%, n=141) and cardioembolism (18.0%, n=81). Median onset-to-door and door-to-imaging time were 159.5 minutes (IQR 219) and 18 minutes (IQR 25), respectively. Intravenous thrombolysis was performed in 11.2% (n=63), with a median door-to-needle time of 49 minutes (IQR 36). Mechanical thrombectomy was performed in 7.5% (n=42), with a median door-to-groin time of 251 minutes (IQR 179.5). Consistent increments were identified in the annual revascularization rates. Median mRS at discharge was 4 (IQR 4), with 43.3% achieving mRS <3; mortality was 16.7%.
Conclusions:
The majority of patients were older adults, with a predominance of large-artery atherosclerotic etiology. Access to reperfusion therapies and workflow times improved between 2022 and 2024. However, major challenges remain to optimize therapeutic coverage and strengthen performance indicators in acute stroke care.
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