Outcome of endovascular stroke therapy in a large mandatory stroke-registry
Abstract Background Endovascular stroke treatment (EST) has become the standard treatment for patients with stroke due to large vessel occlusion, especially in earlier time windows. Only few data from population-based registries on effectiveness of EST have been published. Methods Baden–Wuerttemberg...
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| Format: | Article |
| Language: | English |
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BMC
2023-12-01
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| Series: | Neurological Research and Practice |
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| Online Access: | https://doi.org/10.1186/s42466-023-00287-z |
| _version_ | 1797376735857082368 |
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| author | Sonja Hyrenbach Susanne Rode Martin Schabet Michael Daffertshofer Karin Schoser Stephan Neumaier Peter A. Ringleb |
| author_facet | Sonja Hyrenbach Susanne Rode Martin Schabet Michael Daffertshofer Karin Schoser Stephan Neumaier Peter A. Ringleb |
| author_sort | Sonja Hyrenbach |
| collection | DOAJ |
| description | Abstract Background Endovascular stroke treatment (EST) has become the standard treatment for patients with stroke due to large vessel occlusion, especially in earlier time windows. Only few data from population-based registries on effectiveness of EST have been published. Methods Baden–Wuerttemberg is the third largest state in Germany in terms of area and population and has a structured stroke concept since 1998 which includes mandatory collection of quality assurance data. In 2018 and 2019, 3820 of 39,168 ischemic stroke patients (9.8%) were treated by EST (age median 78 y, NIHSS median 14). We analyzed the clinical outcome of these patients determined with the modified Rankin Scale (mRS) at discharge from the hospital or with the initiation of palliative therapy using logistic regression analysis with adjustment for the mRS at admission, additive IVT, age, and NIHSS. Results The probability of an excellent clinical outcome (mRS 0 or 1 at discharge) and for a good clinical outcome (mRS 0–2) were significantly higher in EST-patients (odds-ratio (OR) 1.27; 95% confidence interval (95% CI) 1.13–1.43, and OR of 1.15 (95% CI 1.04–1.28). Also, the regression model showed an advantage for EST-patients with less frequent ‘decision for palliative care’ (OR 0.87; 95% CI 0.78–0.98). Sensitivity analysis adjusting for intracranial vessel occlusion as further factor showed similar results. Conclusion Our data suggest that EST can be of benefit also for an area-wide unselected stroke population, in a large German federal state with sometimes long distance to the next thrombectomy center. |
| first_indexed | 2024-03-08T19:43:01Z |
| format | Article |
| id | doaj.art-ed10f9cd58c14d2a820ea3b2c4974a2e |
| institution | Directory Open Access Journal |
| issn | 2524-3489 |
| language | English |
| last_indexed | 2024-03-08T19:43:01Z |
| publishDate | 2023-12-01 |
| publisher | BMC |
| record_format | Article |
| series | Neurological Research and Practice |
| spelling | doaj.art-ed10f9cd58c14d2a820ea3b2c4974a2e2023-12-24T12:32:40ZengBMCNeurological Research and Practice2524-34892023-12-01511710.1186/s42466-023-00287-zOutcome of endovascular stroke therapy in a large mandatory stroke-registrySonja Hyrenbach0Susanne Rode1Martin Schabet2Michael Daffertshofer3Karin Schoser4Stephan Neumaier5Peter A. Ringleb6Stroke Working Group, Office for Quality Assurance in Hospitals (QiG BW)Stroke Working Group, Office for Quality Assurance in Hospitals (QiG BW)Stroke Working Group, Office for Quality Assurance in Hospitals (QiG BW)Stroke Working Group, Office for Quality Assurance in Hospitals (QiG BW)Stroke Working Group, Office for Quality Assurance in Hospitals (QiG BW)Stroke Working Group, Office for Quality Assurance in Hospitals (QiG BW)Stroke Working Group, Office for Quality Assurance in Hospitals (QiG BW)Abstract Background Endovascular stroke treatment (EST) has become the standard treatment for patients with stroke due to large vessel occlusion, especially in earlier time windows. Only few data from population-based registries on effectiveness of EST have been published. Methods Baden–Wuerttemberg is the third largest state in Germany in terms of area and population and has a structured stroke concept since 1998 which includes mandatory collection of quality assurance data. In 2018 and 2019, 3820 of 39,168 ischemic stroke patients (9.8%) were treated by EST (age median 78 y, NIHSS median 14). We analyzed the clinical outcome of these patients determined with the modified Rankin Scale (mRS) at discharge from the hospital or with the initiation of palliative therapy using logistic regression analysis with adjustment for the mRS at admission, additive IVT, age, and NIHSS. Results The probability of an excellent clinical outcome (mRS 0 or 1 at discharge) and for a good clinical outcome (mRS 0–2) were significantly higher in EST-patients (odds-ratio (OR) 1.27; 95% confidence interval (95% CI) 1.13–1.43, and OR of 1.15 (95% CI 1.04–1.28). Also, the regression model showed an advantage for EST-patients with less frequent ‘decision for palliative care’ (OR 0.87; 95% CI 0.78–0.98). Sensitivity analysis adjusting for intracranial vessel occlusion as further factor showed similar results. Conclusion Our data suggest that EST can be of benefit also for an area-wide unselected stroke population, in a large German federal state with sometimes long distance to the next thrombectomy center.https://doi.org/10.1186/s42466-023-00287-zStrokeThrombectomyThrombolysisHealth care research |
| spellingShingle | Sonja Hyrenbach Susanne Rode Martin Schabet Michael Daffertshofer Karin Schoser Stephan Neumaier Peter A. Ringleb Outcome of endovascular stroke therapy in a large mandatory stroke-registry Neurological Research and Practice Stroke Thrombectomy Thrombolysis Health care research |
| title | Outcome of endovascular stroke therapy in a large mandatory stroke-registry |
| title_full | Outcome of endovascular stroke therapy in a large mandatory stroke-registry |
| title_fullStr | Outcome of endovascular stroke therapy in a large mandatory stroke-registry |
| title_full_unstemmed | Outcome of endovascular stroke therapy in a large mandatory stroke-registry |
| title_short | Outcome of endovascular stroke therapy in a large mandatory stroke-registry |
| title_sort | outcome of endovascular stroke therapy in a large mandatory stroke registry |
| topic | Stroke Thrombectomy Thrombolysis Health care research |
| url | https://doi.org/10.1186/s42466-023-00287-z |
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