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Abstract

Critical Gaps in Stroke Care: A Call for Urgent Reform in Laboratory Protocols and Diagnostic Access in Brazil †

by
Matheus G. Castro
,
Juliana M. A. Seixas
,
Antonio A. F. Soares
,
Alexandre P. Batista
,
Calliandra M. S. Silva
,
Cristina L. B. Furia
and
Izabel C. R. Silva
*
Faculty of Health Sciences and Technology, University of Brasília (UnB), Brasília 72220-275, Brazil
*
Author to whom correspondence should be addressed.
†
Presented at the 6th International Congress on Health Innovation—INOVATEC 2025, Hybrid, 21–23 November 2025.
Proceedings 2026, 137(1), 32; https://doi.org/10.3390/proceedings2026137032
Published: 25 February 2026
(This article belongs to the Proceedings of The 6th International Congress on Health Innovation—INOVATEC 2025)
Versions Notes

Introduction: Stroke remains a leading cause of morbidity and mortality in Brazil, requiring rapid and effective responses from the initial point of care. This study evaluated adherence to national laboratory guidelines for etiological investigation in stroke cases, highlighting systemic failures that compromise patient outcomes. Methodology: A pilot observational, cross-sectional, and analytical study included patients diagnosed with primary ischemic or hemorrhagic stroke, admitted to a tertiary public hospital specializing in stroke care (CEP/CONEP protocol 6.561.329). Clinical data were collected through electronic medical records between July 2024 and July 2025. Descriptive and inferential statistical analyses were performed using SPSS v.29.0 (α = 5%). Results: Among 49 patients (36 ischemic, 13 hemorrhagic), none received the full panel of 25 essential laboratory tests recommended by the Ministry of Health. While sodium (95.9%), potassium (85.7%), and creatinine/urea (81.6%) were commonly requested, critical tests such as TTPA (38.8%), cholesterol (12.2%), TSH (20.4%), and functional C-reactive protein (4.1%) were severely underutilized. Inflammatory markers, antibodies, and urinalysis were also frequently omitted. Conclusions: The fragmented implementation of laboratory protocols reveals alarming deficiencies in stroke care, particularly in diagnostic precision and therapeutic safety. These findings underscore the urgent need for structural reorganization, improved clinical workflows, and continuous professional education to prevent avoidable disabilities and deaths.

Author Contributions

Conceptualization, M.G.C.; methodology, M.G.C. and I.C.R.S.; software, M.G.C., I.C.R.S. and A.A.F.S.; validation, M.G.C. and I.C.R.S.; formal analysis, M.G.C.; investigation, M.G.C.; re-sources, M.G.C. and I.C.R.S.; data curation, M.G.C. and I.C.R.S.; writing—original draft preparation, M.G.C.; writing—review and editing, M.G.C., C.M.S.S. and I.C.R.S.; visualization, M.G.C. and A.P.B.; supervision, M.G.C. and I.C.R.S.; project administration, M.G.C. and I.C.R.S.; funding acquisition, I.C.R.S., C.L.B.F. and J.M.A.S. All authors have read and agreed to the published version of the manuscript.

Funding

This research was supported by CAPES (Finance Code: 001); SEI nº 00193-25000002187/2023-24 under Notice 09/2023—Spontaneous Demand FAPDF; Notice nº 25106/2024—FAPDF LEARNING PROGRAM—Strategic Development Program in the macro areas of research lines: AGRO Learning, BIO Learning, GOV Learning, TECH Learning (00193-00000110/2024-09); the National Council for Scientific and Technological Development (CNPq) with the Ministry of Health/Department of Science and Technology (MS/Decit, Finance Code: 444755/2023-3); and UnB-DPG-DPI—0022022., FAPDF, DPI/UnB.

Institutional Review Board Statement

The study was conducted in accordance with the Declaration of Helsinki, and approved by the Ethics and Research Committee—CEP of the institutions participating in the study, Faculty of Health Sciences and Technologies—FCTS and Hospital de Base of the Federal District; opinions No. 6.561.329; CAAE: 52896121.5.0000.8093—Notice 12/2023 and No. 6.648.436; CAAE: 52896121.5.3001.8153—Notice 02/2024.

Informed Consent Statement

Informed consent was obtained from all subjects involved in the study.

Data Availability Statement

The datasets generated and/or analyzed during the current study are not publicly available due to privacy restrictions but are available from the corresponding author on reasonable request.

Conflicts of Interest

The authors declare no conflict of interest.
Disclaimer/Publisher’s Note: The statements, opinions and data contained in all publications are solely those of the individual author(s) and contributor(s) and not of MDPI and/or the editor(s). MDPI and/or the editor(s) disclaim responsibility for any injury to people or property resulting from any ideas, methods, instructions or products referred to in the content.

Share and Cite

MDPI and ACS Style

Castro, M.G.; Seixas, J.M.A.; Soares, A.A.F.; Batista, A.P.; Silva, C.M.S.; Furia, C.L.B.; Silva, I.C.R. Critical Gaps in Stroke Care: A Call for Urgent Reform in Laboratory Protocols and Diagnostic Access in Brazil. Proceedings 2026, 137, 32. https://doi.org/10.3390/proceedings2026137032

AMA Style

Castro MG, Seixas JMA, Soares AAF, Batista AP, Silva CMS, Furia CLB, Silva ICR. Critical Gaps in Stroke Care: A Call for Urgent Reform in Laboratory Protocols and Diagnostic Access in Brazil. Proceedings. 2026; 137(1):32. https://doi.org/10.3390/proceedings2026137032

Chicago/Turabian Style

Castro, Matheus G., Juliana M. A. Seixas, Antonio A. F. Soares, Alexandre P. Batista, Calliandra M. S. Silva, Cristina L. B. Furia, and Izabel C. R. Silva. 2026. "Critical Gaps in Stroke Care: A Call for Urgent Reform in Laboratory Protocols and Diagnostic Access in Brazil" Proceedings 137, no. 1: 32. https://doi.org/10.3390/proceedings2026137032

APA Style

Castro, M. G., Seixas, J. M. A., Soares, A. A. F., Batista, A. P., Silva, C. M. S., Furia, C. L. B., & Silva, I. C. R. (2026). Critical Gaps in Stroke Care: A Call for Urgent Reform in Laboratory Protocols and Diagnostic Access in Brazil. Proceedings, 137(1), 32. https://doi.org/10.3390/proceedings2026137032

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