Health AI Central
Peer-Reviewed Publication
Cureus2026;18(9):e116643.September 1, 2026Journal Article

Beyond the Hospital: Spatial Inequality and Structural Divergence in Stroke Mortality Across the United States (2020-2024).

Carlos Acosta-Batista1, Sirley Sibello Deustua2, Marisleydis Perez Santiago1, Josselin Bryan3, Andrew López Sánchez4, Nathali Gonzalez Reyes5, Raisa C Brana Miranda6, Antoinette Contino Rivero1, Francisco J Santana Mercedes1, Laura Diaz Perez7, Elizabeth Blanco Espinosa8,9
1Clinical Research, Primary Care - Research Initiative (PCRI), Miami Lakes, USA.
2Ophthalmology, Center for Excellence in Eye Care, Miami, USA.
3Neurology, Pontificia Universidad Javeriana, Cali, COL.
4Internal Medicine, Asociación Española, Montevideo, URY.
5Clinical Research, Primary - Research Initiative (PCRI), Miami Lakes, USA.
6Internal Medicine, Hospital Menonita Ponce, Ponce, USA.
7Family Medicine, Included Health, Lewiston, USA.
8General Practice, CEDA Orthopedic Group, Miami, USA.
9General Surgery, Hospital Arnaldo Milian, Santa Clara, CUB.
PubMed PMC DOI PDF

Abstract

BACKGROUND: Stroke is a time-critical cerebrovascular emergency where survival depends heavily on rapid prehospital recognition and transport. While in-hospital acute stroke care has advanced significantly, the structural distribution of where stroke deaths occur, particularly out-of-hospital, remains a critical blind spot. The COVID-19 pandemic severely disrupted emergency medical services (EMS)…

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