The Quindío stroke network: impact of an integrated care model on mortality and functional outcomes in a middle-income country

Introduction 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-Quindío was established as the first integrated network for stroke management in central Colombia. Methodology This pre-post quasi-experimental study evaluated the Red ACV-Quindío strategy. The study estimated functional outcomes and in-hospital mortality in patients diagnosed with stroke before and after the implementation of the network. Results 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: 51.6–58.4, p = 0.23) and was associated with favorable safety outcomes. Thrombolyzed patients demonstrated a significantly reduced risk of fatal outcomes (OR = 0.61; 95% CI: 0.38–0.96; p = 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%, p = 0.39). Discussion 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.