Central Retinal Artery Occlusion: Current Practice, Awareness and Prehospital Delays in Switzerland
Background and PurposeCentral retinal artery occlusion (CRAO) often leads to permanent monocular blindness. Hence, early recognition and rapid re-perfusion is of paramount importance. This study aims to describe prehospital pathways in CRAO compared to stroke and study the knowledge about CRAO.Metho...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2022-05-01
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| Series: | Frontiers in Neurology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fneur.2022.888456/full |
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| author | Elena Ardila Jurado Veit Sturm Florian Brugger Krassen Nedeltchev Marcel Arnold Leo H. Bonati Emmanuel Carrera Patrik Michel Carlo W. Cereda Manuel Bolognese Sylvan Albert Friedrich Medlin Christian Berger Ludwig Schelosky Susanne Renaud Julien Niederhauser Christophe Bonvin Marie-Luise Mono Biljana Rodic Alexander A. Tarnutzer Guido Schwegler Stephan Salmen Andreas R. Luft Andreas R. Luft Nils Peters Jochen Vehoff Georg Kägi Georg Kägi The Swiss Stroke Registry Investigators |
| author_facet | Elena Ardila Jurado Veit Sturm Florian Brugger Krassen Nedeltchev Marcel Arnold Leo H. Bonati Emmanuel Carrera Patrik Michel Carlo W. Cereda Manuel Bolognese Sylvan Albert Friedrich Medlin Christian Berger Ludwig Schelosky Susanne Renaud Julien Niederhauser Christophe Bonvin Marie-Luise Mono Biljana Rodic Alexander A. Tarnutzer Guido Schwegler Stephan Salmen Andreas R. Luft Andreas R. Luft Nils Peters Jochen Vehoff Georg Kägi Georg Kägi The Swiss Stroke Registry Investigators |
| author_sort | Elena Ardila Jurado |
| collection | DOAJ |
| description | Background and PurposeCentral retinal artery occlusion (CRAO) often leads to permanent monocular blindness. Hence, early recognition and rapid re-perfusion is of paramount importance. This study aims to describe prehospital pathways in CRAO compared to stroke and study the knowledge about CRAO.Methods(1) Description of baseline characteristics, prehospital pathways/delays, and acute treatment (thrombolysis/thrombectomy vs. standard of care) of patients with CRAO and ischemic stroke registered in the Swiss Stroke Registry. (2) Online survey about CRAO knowledge amongst population, general practitioners (GPs) and ophthalmologists in Eastern Switzerland.ResultsThree hundred and ninety seven CRAO and 32,816 ischemic stroke cases were registered from 2014 until 2019 in 20 Stroke Centers/Units in Switzerland. In CRAO, 25.6% arrived at the hospital within 4 h of symptom onset and had a lower rate of emergency referrals. Hence, the symptom-to-door time was significantly longer in CRAO compared to stroke (852 min. vs. 300 min). The thrombolysis/thrombectomy rate was 13.2% in CRAO and 30.9% in stroke. 28.6% of the surveyed population recognized CRAO-symptoms, 55.4% of which would present directly to the emergency department in contrast to 90.0% with stroke symptoms. Almost 100% of the ophthalmologist and general practitioners recognized CRAO as a medical emergency and 1/3 of them considered IV thrombolysis a potentially beneficial therapy.ConclusionsCRAO awareness of the general population and physician awareness about the treatment options as well as the non-standardized prehospital organization, seems to be the main reason for the prehospital delays and impedes treating CRAO patients. Educational efforts should be undertaken to improve awareness about CRAO. |
| first_indexed | 2024-04-13T23:00:38Z |
| format | Article |
| id | doaj.art-4cc7b23bf33b472985c6bfcfb1f9621f |
| institution | Directory Open Access Journal |
| issn | 1664-2295 |
| language | English |
| last_indexed | 2024-04-13T23:00:38Z |
| publishDate | 2022-05-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Neurology |
| spelling | doaj.art-4cc7b23bf33b472985c6bfcfb1f9621f2022-12-22T02:25:52ZengFrontiers Media S.A.Frontiers in Neurology1664-22952022-05-011310.3389/fneur.2022.888456888456Central Retinal Artery Occlusion: Current Practice, Awareness and Prehospital Delays in SwitzerlandElena Ardila Jurado0Veit Sturm1Florian Brugger2Krassen Nedeltchev3Marcel Arnold4Leo H. Bonati5Emmanuel Carrera6Patrik Michel7Carlo W. Cereda8Manuel Bolognese9Sylvan Albert10Friedrich Medlin11Christian Berger12Ludwig Schelosky13Susanne Renaud14Julien Niederhauser15Christophe Bonvin16Marie-Luise Mono17Biljana Rodic18Alexander A. Tarnutzer19Guido Schwegler20Stephan Salmen21Andreas R. Luft22Andreas R. Luft23Nils Peters24Jochen Vehoff25Georg Kägi26Georg Kägi27The Swiss Stroke Registry InvestigatorsDepartment of Neurology and Stroke Center, Cantonal Hospital St. Gallen, St. Gallen, SwitzerlandDepartment of Ophthalmology, Cantonal Hospital St. Gallen, St. Gallen, SwitzerlandDepartment of Neurology and Stroke Center, Cantonal Hospital St. Gallen, St. Gallen, SwitzerlandDepartment of Neurology, Kantonsspital Aarau, Aarau, SwitzerlandDepartment of Neurology, Inselspital, Bern University Hospital, University of Bern, Bern, SwitzerlandDepartment of Neurology and Stroke Center, University Hospital Basel and University of Basel, Basel, SwitzerlandDepartment of Neurology, Hôpitaux Universitaires de Genève, Geneva, SwitzerlandStroke Center, Neurology Service, Lausanne University Hospital, Lausanne, SwitzerlandStroke Center, Neurocenter of Southern Switzerland, Lugano, SwitzerlandNeurocenter, Cantonal Hospital of Lucerne, Lucerne, Switzerland0Cantonal Hospital Graubuenden, Chur, Switzerland1Stroke Unit, Cantonal Hospital Fribourg, Fribourg, Switzerland2Spital Sarganserland Grabs, Grabs, Switzerland3Division of Neurology, Cantonal Hospital Münsterlingen, Münsterlingen, Switzerland4Division of Neurology, Cantonal Hospital Neuchatel, Neuchâtel, Switzerland5Stroke Unit, Groupement Hospitalier de l'Ouest Lémanique, Nyon, Switzerland6Hôpital du Valais, Sion, Switzerland7Stadtspital Waid und Triemli, Zurich, Switzerland8Cantonal Hospital Winterthur, Winterthur, Switzerland9Cantonal Hospital of Baden, Baden, Switzerland0Division of Neurology, Hospital Limmattal, Schlieren, Switzerland1Spitalzentrum Biel, Biel, Switzerland2Department of Neurology and Clinical Neuroscience Center, University Hospital Zurich and University of Zurich, Zurich, Switzerland3Cereneo Center for Neurology and Rehabilitaiton, Vitznau, Switzerland4Department of Neurology, Hirslanden Clinic, Zurich, SwitzerlandDepartment of Neurology and Stroke Center, Cantonal Hospital St. Gallen, St. Gallen, SwitzerlandDepartment of Neurology and Stroke Center, Cantonal Hospital St. Gallen, St. Gallen, SwitzerlandDepartment of Neurology, Inselspital, Bern University Hospital, University of Bern, Bern, SwitzerlandBackground and PurposeCentral retinal artery occlusion (CRAO) often leads to permanent monocular blindness. Hence, early recognition and rapid re-perfusion is of paramount importance. This study aims to describe prehospital pathways in CRAO compared to stroke and study the knowledge about CRAO.Methods(1) Description of baseline characteristics, prehospital pathways/delays, and acute treatment (thrombolysis/thrombectomy vs. standard of care) of patients with CRAO and ischemic stroke registered in the Swiss Stroke Registry. (2) Online survey about CRAO knowledge amongst population, general practitioners (GPs) and ophthalmologists in Eastern Switzerland.ResultsThree hundred and ninety seven CRAO and 32,816 ischemic stroke cases were registered from 2014 until 2019 in 20 Stroke Centers/Units in Switzerland. In CRAO, 25.6% arrived at the hospital within 4 h of symptom onset and had a lower rate of emergency referrals. Hence, the symptom-to-door time was significantly longer in CRAO compared to stroke (852 min. vs. 300 min). The thrombolysis/thrombectomy rate was 13.2% in CRAO and 30.9% in stroke. 28.6% of the surveyed population recognized CRAO-symptoms, 55.4% of which would present directly to the emergency department in contrast to 90.0% with stroke symptoms. Almost 100% of the ophthalmologist and general practitioners recognized CRAO as a medical emergency and 1/3 of them considered IV thrombolysis a potentially beneficial therapy.ConclusionsCRAO awareness of the general population and physician awareness about the treatment options as well as the non-standardized prehospital organization, seems to be the main reason for the prehospital delays and impedes treating CRAO patients. Educational efforts should be undertaken to improve awareness about CRAO.https://www.frontiersin.org/articles/10.3389/fneur.2022.888456/fullcentral retinal artery occlusion (CRAO)incidenceischemic strokeawarenessprehospital |
| spellingShingle | Elena Ardila Jurado Veit Sturm Florian Brugger Krassen Nedeltchev Marcel Arnold Leo H. Bonati Emmanuel Carrera Patrik Michel Carlo W. Cereda Manuel Bolognese Sylvan Albert Friedrich Medlin Christian Berger Ludwig Schelosky Susanne Renaud Julien Niederhauser Christophe Bonvin Marie-Luise Mono Biljana Rodic Alexander A. Tarnutzer Guido Schwegler Stephan Salmen Andreas R. Luft Andreas R. Luft Nils Peters Jochen Vehoff Georg Kägi Georg Kägi The Swiss Stroke Registry Investigators Central Retinal Artery Occlusion: Current Practice, Awareness and Prehospital Delays in Switzerland Frontiers in Neurology central retinal artery occlusion (CRAO) incidence ischemic stroke awareness prehospital |
| title | Central Retinal Artery Occlusion: Current Practice, Awareness and Prehospital Delays in Switzerland |
| title_full | Central Retinal Artery Occlusion: Current Practice, Awareness and Prehospital Delays in Switzerland |
| title_fullStr | Central Retinal Artery Occlusion: Current Practice, Awareness and Prehospital Delays in Switzerland |
| title_full_unstemmed | Central Retinal Artery Occlusion: Current Practice, Awareness and Prehospital Delays in Switzerland |
| title_short | Central Retinal Artery Occlusion: Current Practice, Awareness and Prehospital Delays in Switzerland |
| title_sort | central retinal artery occlusion current practice awareness and prehospital delays in switzerland |
| topic | central retinal artery occlusion (CRAO) incidence ischemic stroke awareness prehospital |
| url | https://www.frontiersin.org/articles/10.3389/fneur.2022.888456/full |
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