{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T06:03:16Z","timestamp":1789970596702,"version":"4.0.1"},"reference-count":17,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T00:00:00Z","timestamp":1789948800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Stroke"],"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Stroke is a major cause of death and disability worldwide, with low- and middle-income countries bearing the highest burden of this condition. To address regional shortcomings in access to reperfusion therapies-particularly thrombolysis-the Red ACV-Quind\u00edo was established as the first integrated network for stroke management in central Colombia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methodology<\/jats:title>\n                    <jats:p>This pre-post quasi-experimental study evaluated the Red ACV-Quind\u00edo strategy. The study estimated functional outcomes and in-hospital mortality in patients diagnosed with stroke before and after the implementation of the network.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The study included a total of 841 cases. Although year-by-year variations in patient volume were detected, linear tests confirmed a homogeneous population across the study period. Baseline clinical characteristics remained stable throughout: most patients presented with minor stroke (47.1%) and low functional dependency at admission (89.0%). At discharge, overall functional independence reached 55.0% (95% CI: 51.6\u201358.4,\n                      <jats:italic>p<\/jats:italic>\n                      = 0.23) and was associated with favorable safety outcomes. Thrombolyzed patients demonstrated a significantly reduced risk of fatal outcomes (OR = 0.61; 95% CI: 0.38\u20130.96;\n                      <jats:italic>p<\/jats:italic>\n                      = 0.037). Complications were rare, with hemorrhagic transformation occurring in 4.5% of cases and malignant edema in 3.9%. In-hospital mortality showed minor fluctuations but remained under 10% overall (9.9%,\n                      <jats:italic>p<\/jats:italic>\n                      = 0.39).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>These findings suggest that regionally integrated stroke care networks represent an effective public health intervention to mitigate stroke-associated disability and mortality in resource-limited settings.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fstro.2026.1916617","type":"journal-article","created":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T05:37:28Z","timestamp":1789969048000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["The Quind\u00edo stroke network: impact of an integrated care model on mortality and functional outcomes in a middle-income country"],"prefix":"10.3389","volume":"5","author":[{"given":"Laura Sof\u00eda","family":"Garc\u00eda-Espinosa","sequence":"first","affiliation":[{"name":"Department of Neurology, Cl\u00ednica Central del Quind\u00edo","place":["Armenia, Quind\u00edo, Colombia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"\u00c1ngel Basilio","family":"Corredor-Quintero","sequence":"additional","affiliation":[{"name":"Department of Neurology, Cl\u00ednica Central del Quind\u00edo","place":["Armenia, Quind\u00edo, Colombia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ricardo Andr\u00e9s","family":"Lineros-Franco","sequence":"additional","affiliation":[{"name":"Essential Stroke Center, Cl\u00ednica Central del Quind\u00edo","place":["Armenia, Quind\u00edo, Colombia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adriana","family":"Hern\u00e1ndez-Cardona","sequence":"additional","affiliation":[{"name":"Essential Stroke Center, Cl\u00ednica Central del Quind\u00edo","place":["Armenia, Quind\u00edo, Colombia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ivett Natalia","family":"Loaiza-Giraldo","sequence":"additional","affiliation":[{"name":"Department of Neurology, Cl\u00ednica Central del Quind\u00edo","place":["Armenia, Quind\u00edo, Colombia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Felipe","family":"Torres-G\u00f3mez","sequence":"additional","affiliation":[{"name":"Internal Medicine","place":["Cali, Valle del Cauca, Colombia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jorge Luis","family":"Igirio-Gamero","sequence":"additional","affiliation":[{"name":"Department of Neurology, Cl\u00ednica Central del Quind\u00edo","place":["Armenia, Quind\u00edo, Colombia"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,9,21]]},"reference":[{"key":"B1","volume-title":"Tasa de Mortalidad por Enfermedades Cr\u00f3nicas No Transmisibles","year":"2026"},{"key":"B2","doi-asserted-by":"publisher","first-page":"108249","DOI":"10.1016\/j.jstrokecerebrovasdis.2025.108249","article-title":"Quality indicators of stroke care in Colombia based on the RES-Q registry","volume":"34","author":"Bayona","year":"2025","journal-title":"J. Stroke Cerebrovascular Dis"},{"key":"B3","doi-asserted-by":"publisher","first-page":"472","DOI":"10.1161\/CIRCRESAHA.116.308398","article-title":"Stroke risk factors, genetics, and prevention","volume":"120","author":"Boehme","year":"2017","journal-title":"Circ. Res"},{"key":"B4","doi-asserted-by":"publisher","first-page":"1103066","DOI":"10.3389\/fneur.2023.1103066","article-title":"Delivering acute stroke care in a middle-income country. The Mexican model: ResISSSTE Cerebro","volume":"14","author":"Bonifacio-Delgadillo","year":"2023","journal-title":"Front. Neurol"},{"key":"B5","volume-title":"Relaci\u00f3n existente entre capacidad funcional y comorbilidades en pacientes con ACV isqu\u00e9mico agudo mayores de 18 a\u00f1os en la ciudad de Barranquilla en el periodo 2019-2021","author":"Chalela Blanco","year":"2026"},{"key":"B6","volume-title":"Cifras ACV en Colombia","year":"2026"},{"key":"B7","doi-asserted-by":"publisher","first-page":"2280","DOI":"10.1161\/01.STR.30.11.2280","article-title":"Hemorrhagic transformation within 36 hours of a cerebral infarct: relationships with early clinical deterioration and 3-month outcome in the European Cooperative Acute Stroke Study I (ECASS I) cohort","volume":"30","author":"Fiorelli","year":"1999","journal-title":"Stroke"},{"key":"B8","doi-asserted-by":"publisher","first-page":"1783830","DOI":"10.3389\/fstro.2026.1783830","article-title":"Real-world characteristics and outcomes of ischemic stroke: a Peruvian multicenter analysis from the RES-Q registry","volume":"5","author":"Gallo-Guerrero","year":"2026","journal-title":"Front. 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Clin. Transl. Neurol."},{"key":"B15","doi-asserted-by":"publisher","first-page":"108637","DOI":"10.1016\/j.jstrokecerebrovasdis.2026.108637","article-title":"Global inequities and strategies for expanding access to reperfusion therapies in acute ischemic stroke: A focus on low- and middle-income countries","volume":"35","author":"Sikakulya","year":"2026","journal-title":"J. Stroke Cerebrovascular Dis."},{"key":"B16","doi-asserted-by":"publisher","first-page":"275","DOI":"10.1016\/S0140-6736(07)60149-4","article-title":"Thrombolysis with alteplase for acute ischaemic stroke in the Safe Implementation of Thrombolysis in Stroke-Monitoring Study (SITS-MOST): an observational study","volume":"369","author":"Wahlgren","year":"2007","journal-title":"Lancet."},{"key":"B17","volume-title":"Stroke Center Certification","year":"2026"}],"container-title":["Frontiers in Stroke"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fstro.2026.1916617\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T05:37:29Z","timestamp":1789969049000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fstro.2026.1916617\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,21]]},"references-count":17,"alternative-id":["10.3389\/fstro.2026.1916617"],"URL":"https:\/\/doi.org\/10.3389\/fstro.2026.1916617","relation":{},"ISSN":["2813-3056"],"issn-type":[{"value":"2813-3056","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,21]]},"article-number":"1916617"}}