The School of Stroke scientific and practical conference in Kazakhstan is a major annual event that brings together experts who are passionate about improving stroke treatment and care. Now in its fifth year, School of Stroke 2024 gathered together scientists from across Kazakhstan and experts from countries such as Italy, Ukraine, Latvia, Germany, and Poland, for a transformative event in the capital, Astana.
It was, said Timur Muratov, chairman of the RSE on REM National Coordination Centre for Emergency Medicine, “an event where domestic specialists summarize their work, while foreign speakers share their experience, and young specialists gain new knowledge”. Dr. Timur Muratov is a seasoned physician and public health expert who became chairman of the board of the National Coordination Centre for Emergency Medicine in 2023. His opening speech at the conference set an inspiring tone. He said, “I hope that the knowledge gained will be beneficial to all participants, particularly young professionals, and that the given recommendations will be implemented in practice”.
The National Coordination Centre for Emergency Medicine was a cohost of the event along with the Public Association “Kazakh League of Stroke”, the Kazakh Association of Neurosurgeons, and the Republican Coordination Center for Stroke Problems.
In the course of the two-day event commencing on 4 July, leading experts in the fields of neurology, neurosurgery, cardiology, and resuscitation discussed the organization of stroke services in Kazakhstan, neuroimaging diagnostics, stroke treatment using thrombolytic therapy, open neurosurgical and endovascular surgical interventions, and secondary prevention. Attendees gained enriching experience by delving into the master class, Interactive Workshop on Acute Stroke Care, organized by Angels Initiative on the second day of the event.
First on the agenda was a comprehensive overview of the state of stroke services in the Republic of Kazakhstan by Republican Coordination Center for Stroke Problems director Dr. Sabina Medukhanova. Her presentation paved the way for discussions about national healthcare strategies aimed at improving stroke care across the country.
Francesca Romana Pezzella, co-chair of the steering committee at the Italian Stroke Association, delivered an engaging speech on the implementation of quality monitoring for acute stroke, in which she emphasized the critical importance of standardized care protocols in enhancing stroke management practices.
Further demonstrating the conference’s objective of advancing stroke care through innovation, collaboration, and the sharing of specialized knowledge, Dr. Yerzhan Adilbekov, chairman of the Kazakh League of Stroke, offered practical guidance on specialized treatments for challenging stroke cases in a presentation titled “External ventricular drainage for non-traumatic intraventricular hemorrhage. Nuances of antihypertensive therapy”.
A positive trend
Kazakhstan’s stroke services have seen significant improvement from 2016 to mid-2024. Thrombolysis rates have steadily increased, from 1.33% in 2016 to 5.40% in the first half of 2024. Similarly, endovascular thrombectomy (EVT) has shown a positive trend, rising from 0.05% in 2016 to 2.10% by mid-2024.
The impact of the COVID-19 pandemic on healthcare services probably contributed to a brief dip in thrombolysis rates to 4.01% in 2020. In 2021 and 2022, more stroke centers started to prioritize endovascular thrombectomy, also impacting thrombolysis percentages. However, following increased training and strategic changes in admission criteria to improve patient outcomes, stroke centers have begun to understand the “bridging” benefit, as thrombectomy does not eliminate the need for thrombolysis.
At the same time, the number of stroke centers has increased from 40 in 2016 to 81 by mid-2024, indicating an improved infrastructure for stroke management and care. Kazakhstan’s 81 stroke centers comprise 30 comprehensive stroke centers and 51 primary stroke centers. Over the past year, the conference organizing committee has been evaluating these centers based on quality-of-care indicators. This rigorous evaluation is designed to identify and recognize centers that provide excellent stroke care and set a benchmark for standards across the country. These developments demonstrate the evolving stroke treatment and healthcare system environment in Kazakhstan, as well as coordinated efforts to improve outcomes.
There are already successes to celebrate. During the conference it was announced that the East Kazakhstan Regional Hospital in Ust-Kamenogorsk had been awarded platinum status in the ESO Angels Awards program. These awards recognize outstanding performance in stroke care by hospitals in ESO member countries that capture their stroke patient data in approved quality improvement registries such as SITS-QR and RES-Q. To be eligible for an award, hospitals must meet criteria that are aligned with actions proven to improve outcomes after stroke. Central to the awards concept is that the awards criteria should not only serve as an instrument for recognizing and rewarding excellence. They also function as a checklist for stroke centers and stroke-ready hospitals committed to improving outcomes for their patients and as a tool for targeting opportunities for improvement.
The Multidisciplinary Regional Hospital in Petropavl was also honored with a gold award. These significant achievements will be formally recognized at the next annual ESO Conference, ESOC, highlighting their key contributions to improving stroke care practices in the ESO community and beyond.
Knowledge exchange and collaboration
A highlight of the conference was the parallel afternoon sessions for neurosurgeons and neurologists. These sessions facilitated focused discussion and knowledge exchange between experts in stroke care and neurosurgery.
At the neurosurgeons’ session, Dr. Yerzhan Adilbekov delivered insightful reports on two crucial topics – “The feasibility of prescribing empagliflozin to patients with chronic heart failure with acute stroke” and “Difficult patient in the practice of a neurosurgeon. Coming out of a coma”. These presentations highlighted advances and challenges in the management of complex medical conditions and attracted keen interest from attendees focused on improving patient care and outcomes in Kazakhstan.
The conference featured a number of distinguished international speakers including Gianluca De Rubeis, an interventional neuroradiologist at San Camillo Forlanini Hospital in Italy. In his speech on organization and quality of care monitoring of the angiography lab, Dr. De Rubeis offered valuable insights into enhancing operational efficiency and patient safety in neurosurgical interventions. Presentations such as these served to demonstrate the conference’s commitment to fostering collaboration and sharing expertise to advance stroke care and neurosurgery practices globally.
The neurologists’ session concluded with an insightful presentation by Lev Prystupiuk, who introduced the audience to the Angels Initiative, a global intervention to increase the number of patients treated in stroke-ready hospitals and to optimize the quality of treatment in all existing stroke centers. His presentation highlighted innovative approaches and best practices aimed at optimizing stroke care protocols, attracting considerable interest from healthcare professionals seeking to improve patient outcomes.
The Angels Initiative and Dr. Francesca Romana Pezzella were among the recipients of medals awarded during the conference by the Kazakh League of Stroke in recognition of their contribution to the development of stroke services in Kazakhstan.
Interactive workshop
On day two of the conference the Angels Initiative hosted a rotating interactive workshop on acute care lead by Assoc. Prof. Aleksandras Vilionskis from the Institute of Clinical Medicine, Vilnius University in Lithuania, and Lev Prystupiuk and Maria Sheverdina, Angels consultants from Ukraine. Drs. Pezzella and De Rubeis from Italy and Dr. Sabina Medukhanova also facilitated dynamic discussions and practical demonstrations during which participants eagerly absorbed insights into the latest advances in stroke care protocols aimed at improving patient outcomes. Attendees rotated through sessions on quality monitoring using the RES-Q registry, NIHSS training, decision-making with Body Interact simulation, and the clinical application of the ASPECT score by stroke physicians.
The School of Stroke 2024 provided compelling evidence of a strong commitment to improving stroke care through collaboration, sharing of expertise, and adoption of best practices. The conference provided a unique opportunity for a diverse group of healthcare professionals and researchers to engage in collaborative learning and innovation, fostering a productive environment for the advancement of knowledge in emergency medicine and neurological sciences.
Reflecting on the outcomes of this conference, it is clear that the progress made here will provide significant advances in stroke treatment and management in Kazakhstan. The participants’ commitment to implementing evidence-based approaches promises a bright future for improving patient outcomes and quality of care in Kazakhstan and internationally.
