Impact of Stroke Code Activation on Functional Outcomes and the Role of Nursing in Neurorehabilitation: A Systematic Review.

Abstract

<b>Introduction:</b> Stroke is one of the leading causes of death and disability worldwide. In this context, early activation of the Stroke Code and a structured neurorehabilitation approach are key determinants of patients' functional outcomes. <b>Objectives:</b> We aimed to evaluate the impact of Stroke Code activation on the functional prognosis of patients who have suffered an ischemic stroke, analyzing the time-dependent relationship and the effectiveness of reperfusion therapies. Additionally, we sought to examine the role of nursing in inpatient neurorehabilitation. <b>Methods:</b> A systematic review was conducted following the PRISMA 2020 guidelines. Scientific studies published between 2020 and 2025 were reviewed across five databases: PubMed; Cochrane Library; Dialnet; Web of Science; and Scopus. Eligibility criteria were applied, and validated tools were used to assess methodological quality and risk of bias. <b>Results:</b> Thirteen studies were included, involving a total sample of 80,555 patients. Age; lesion volume; and time to treatment were found to be key prognostic factors. Early implementation of reperfusion therapies (thrombolysis and/or thrombectomy), combined with nursing-led neurorehabilitation interventions, significantly improved neurological status, functional independence, and quality of life. <b>Conclusions:</b> Stroke Code activation has a significant positive influence on functional prognosis. Reducing treatment delays and optimizing reperfusion therapies are critical. Furthermore, the role of nursing in hospital-based neurorehabilitation is essential to support patient recovery and functionality.