Stroke is a leading cause of death, accounting for 6% of all deaths across OECD countries in 2023 (see sections on “Main causes of mortality” and “Mortality from circulatory diseases” in Chapter 3). A stroke occurs when the blood supply to a part of the brain is interrupted, leading to necrosis (cell death) of the affected part. Of the two types of stroke, about 85% are ischaemic (caused by clotting) and 15% are haemorrhagic (caused by bleeding). Timely diagnosis is essential for time‑sensitive treatment such as intravenous thrombolysis to remove or disperse blood clots and thrombectomy to remove a blood clot from a blood vessel.
Figure 6.27 shows the case fatality rates within 30 days of hospital admission for ischaemic stroke where death occurred in the same hospital as the initial admission (unlinked data). Figure 6.28 shows the case fatality rate where deaths are recorded regardless of where they occurred, including in another hospital or outside the hospital where the stroke was first recorded (linked data). The indicator using linked data is more comprehensive and comparable, but it requires a unique patient identifier and the capacity to link data – which are not available in all countries. The results from this indicator are higher than for the same‑hospital indicator, as deaths are recorded regardless of where they occurred after hospital admission.
Across OECD countries, 7.7% of patients died within 30 days of hospital admission for ischaemic stroke in 2023, based on unlinked data (Figure 6.27). The case fatality rates were highest in Latvia, Mexico, Slovenia and Lithuania – all with mortality rates over 11%. Rates were lower than 4% in Japan, Korea and Norway. Low rates in Japan are due in part to efforts dedicated to improving the treatment of stroke patients, through systematic blood pressure monitoring, major material investment in hospitals and establishment of specialised stroke units so that almost all of the population have access to a primary stroke centre within 60 minutes by emergency motor vehicle (OECD, 2015[1]). In Norway, mobile stroke ambulances with on-board computed tomography scanners that can diagnose and treat acute ischaemic stroke are available; in 2023, 95% of stroke patients receive care at specialised stroke units (OECD, 2025[2]). On the other hand, in Latvia with a relatively high case fatality rate, only about half of stroke patients were treated in specialised stroke units in 2023.
Across 24 OECD countries that reported linked data, 12.1% of patients on average died within 30 days of being admitted to hospital for ischaemic stroke in 2023 (Figure 6.28). The mortality rate was highest (over 15%) in Latvia, Türkiye, Lithuania, Chile and Estonia, and lowest (under 8%) in Korea, Israel and Norway. Korea has attained low mortality rates through improvements in acute ischaemic stroke management, including an increased number of comprehensive stroke centres supporting high-quality care and thrombectomy, and expansions in health insurance coverage in relation to mechanical thrombectomy (Park et al., 2022[3]).
Treatment for ischaemic stroke has advanced dramatically over recent decades, with systems and processes now in place in many OECD countries to identify suspected ischaemic stroke patients and to deliver acute reperfusion therapy quickly. Improvement was notable before the pandemic between 2013 and 2019, when case fatality rates for ischaemic stroke decreased across OECD countries: on average, from 9.3% to 7.9% for unlinked data rates and from 13.4% to 12.1% for linked data rates (Figure 6.27 and Figure 6.28). However, as with AMI (see section on “Mortality following acute myocardial infarction (AMI)”), there has been little improvement in recent years, and mortality rates remained stable between 2019 and 2023.
Countries can improve the quality of stroke care further through timely transportation of patients, timely diagnosis, evidence‑based medical interventions and access to high-quality specialised facilities such as stroke units. Advances in technology are leading to new models of care to deliver reperfusion therapy even more quickly and efficiently, whether through pre‑hospital triage by telephone or administering the treatment in the ambulance (OECD, 2025[2]).
