31333
2022
eng
22
article
1
--
--
--
Experiences of family caregivers 3-months after stroke: results of the prospective trans-regional network for stroke intervention with telemedicine registry (TRANSIT-Stroke)
Background
Long-term support of stroke patients living at home is often delivered by family caregivers (FC). We identified characteristics of stroke patients being associated with receiving care by a FC 3-months (3 M) after stroke, assessed positive and negative experiences and individual burden of FC caring for stroke patients and determined factors associated with caregiving experiences and burden of FC 3 M after stroke.
Methods
Data were collected within TRANSIT-Stroke, a regional telemedical stroke-network comprising 12 hospitals in Germany. Patients with stroke/TIA providing informed consent were followed up 3 M after the index event. The postal patient-questionnaire was accompanied by an anonymous questionnaire for FC comprising information on positive and negative experiences of FC as well as on burden of caregiving operationalized by the Caregiver Reaction Assessment and a self-rated burden-scale, respectively. Multivariable logistic and linear regression analyses were performed.
Results
Between 01/2016 and 06/2019, 3532 patients provided baseline and 3 M-follow-up- data and 1044 FC responded to questionnaires regarding positive and negative caregiving experiences and caregiving burden. 74.4% of FC were older than 55 years, 70.1% were women and 67.5% were spouses. Older age, diabetes and lower Barthel-Index in patients were significantly associated with a higher probability of receiving care by a FC at 3 M. Positive experiences of FC comprised the importance (81.5%) and the privilege (70.0%) of caring for their relative; negative experiences of FC included financial difficulties associated with caregiving (20.4%). Median overall self-rated burden was 30 (IQR: 0–50; range 0–100). Older age of stroke patients was associated with a lower caregiver burden, whereas younger age of FC led to higher burden. More than half of the stroke patients in whom a FC questionnaire was completed did self-report that they are not being cared by a FC. This stroke patient group tended to be younger, more often male with less severe stroke and less comorbidities who lived more often with a partner.
Conclusions
The majority of caregivers wanted to care for their relatives but experienced burden at the same time. Elderly patients, patients with a lower Barthel Index at discharge and diabetes are at higher risk of needing care by a family caregiver.
Trial registration
The study was registered at “German Clinical Trial Register”: DRKS00011696. https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00011696
BMC Geriatrics
10.1186/s12877-022-02919-6
urn:nbn:de:bvb:20-opus-313330
@articleJiruHillmann.2022, author = Jírů-Hillmann, Steffi and Gabriel, Katharina M. A. and Schuler, Michael and Wiedmann, Silke and Mühler, Johannes and Dötter, Klaus and Soda, Hassan and Rascher, Alexandra and Benesch, Sonka and Kraft, Peter and Pfau, Mathias and Stenzel, Joachim and von Nippold, Karin and Benghebrid, Mohamed and Schulte, Kerstin and Meinck, Ralf and Volkmann, Jens and Haeusler, Karl Georg and Heuschmann, Peter U., year = 2022, title = Experiences of family caregivers 3-months after stroke: results of the prospective trans-regional network for stroke intervention with telemedicine registry (TRANSIT-Stroke), pages = 228, volume = 22, number = 1, journal = BMC geriatrics, doi = 10.1186/s12877-022-02919-6,
md5:749c8b2475949059eae942fdccb64f6d
2023-05-03T15:10:55+00:00
/tmp/phpzQOCvD
bibtex
6452797f3a9ea0.54382512
BMC Geriatrics (2022) 22:228. https://doi.org/10.1186/s12877-022-02919-6
false
true
CC BY: Creative-Commons-Lizenz: Namensnennung 4.0 International
Steffi Jírů-Hillmann
Katharina M. A. Gabriel
Michael Schuler
Silke Wiedmann
Johannes Mühler
Klaus Dötter
Hassan Soda
Alexandra Rascher
Sonka Benesch
Peter Kraft
Mathias Pfau
Joachim Stenzel
Karin von Nippold
Mohamed Benghebrid
Kerstin Schulte
Ralf Meinck
Jens Volkmann
Karl Georg Haeusler
Peter U. Heuschmann
eng
uncontrolled
family caregiver
eng
uncontrolled
informal care
eng
uncontrolled
stroke
eng
uncontrolled
stroke care
eng
uncontrolled
telemedicine network
Medizin und Gesundheit
open_access
Neurologische Klinik und Poliklinik
Institut für Klinische Epidemiologie und Biometrie
Förderzeitraum 2022
Universität Würzburg
https://opus.bibliothek.uni-wuerzburg.de/files/31333/s12877-022-02919-6.pdf
30011
2022
eng
1
22
article
1
--
--
--
Cardiac dysfunction and high-sensitive C-reactive protein are associated with troponin T elevation in ischemic stroke: insights from the SICFAIL study
Background
Troponin elevation is common in ischemic stroke (IS) patients. The pathomechanisms involved are incompletely understood and comprise coronary and non-coronary causes, e.g. autonomic dysfunction. We investigated determinants of troponin elevation in acute IS patients including markers of autonomic dysfunction, assessed by heart rate variability (HRV) time domain variables.
Methods
Data were collected within the Stroke Induced Cardiac FAILure (SICFAIL) cohort study. IS patients admitted to the Department of Neurology, Würzburg University Hospital, underwent baseline investigation including cardiac history, physical examination, echocardiography, and blood sampling. Four HRV time domain variables were calculated in patients undergoing electrocardiographic Holter monitoring. Multivariable logistic regression with corresponding odds ratios (OR) and 95% confidence intervals (CI) was used to investigate the determinants of high-sensitive troponin T (hs-TnT) levels ≥14 ng/L.
Results
We report results from 543 IS patients recruited between 01/2014–02/2017. Of those, 203 (37%) had hs-TnT ≥14 ng/L, which was independently associated with older age (OR per year 1.05; 95% CI 1.02–1.08), male sex (OR 2.65; 95% CI 1.54–4.58), decreasing estimated glomerular filtration rate (OR per 10 mL/min/1.73 m2 0.71; 95% CI 0.61–0.84), systolic dysfunction (OR 2.79; 95% CI 1.22–6.37), diastolic dysfunction (OR 2.29; 95% CI 1.29–4.02), atrial fibrillation (OR 2.30; 95% CI 1.25–4.23), and increasing levels of C-reactive protein (OR 1.48 per log unit; 95% CI 1.22–1.79). We did not identify an independent association of troponin elevation with the investigated HRV variables.
Conclusion
Cardiac dysfunction and elevated C-reactive protein, but not a reduced HRV as surrogate of autonomic dysfunction, were associated with increased hs-TnT levels in IS patients independent of established cardiovascular risk factors.
BMC Neurology
10.1186/s12883-022-03017-1
urn:nbn:de:bvb:20-opus-300119
@articleMontellano.2022, author = Montellano, Felipe A. and Kluter, Elisabeth J. and Rücker, Viktoria and Ungethüm, Kathrin and Mackenrodt, Daniel and Wiedmann, Silke and Dege, Tassilo and Quilitzsch, Anika and Morbach, Caroline and Frantz, Stefan and Störk, Stefan and Haeusler, Karl Georg and Kleinschnitz, Christoph and Heuschmann, Peter U., year = 2022, title = Cardiac dysfunction and high-sensitive C-reactive protein are associated with troponin T elevation in ischemic stroke: insights from the SICFAIL study, pages = 511, volume = 22, number = 1, journal = BMC neurology, doi = 10.1186/s12883-022-03017-1,
md5:f275f104ad9a12a080bca2d78a1c1bb2
2023-01-19T06:57:20+00:00
/tmp/phpBgsooK
bibtex
63c8e9d0519074.51406195
BMC Neurology 2022, 22(1):511. DOI: 10.1186/s12883-022-03017-1
false
true
Felipe A. Montellano
Elisabeth J. Kluter
Viktoria Rücker
Kathrin Ungethüm
Daniel Mackenrodt
Silke Wiedmann
Tassilo Dege
Anika Quilitzsch
Caroline Morbach
Stefan Frantz
Stefan Störk
Karl Georg Haeusler
Christoph Kleinschnitz
Peter U. Heuschmann
eng
uncontrolled
echocardiography
eng
uncontrolled
ischemic stroke
eng
uncontrolled
troponin
eng
uncontrolled
heart failure
eng
uncontrolled
biomarkers
Medizin und Gesundheit
open_access
Neurologische Klinik und Poliklinik
Medizinische Klinik und Poliklinik I
Institut für Klinische Epidemiologie und Biometrie
Deutsches Zentrum für Herzinsuffizienz (DZHI)
Förderzeitraum 2022
Universität Würzburg
https://opus.bibliothek.uni-wuerzburg.de/files/30011/BMC_Neurology_Montellano.pdf
19650
2015
eng
24-29
1
44
article
1
--
2015-01-31
--
Time Trends in Incidence of Pathological and Etiological Stroke Subtypes during 16 Years: The Erlangen Stroke Project
Background: Population-based data, which continuously monitors time trends in stroke epidemiology are limited. We investigated the incidence of pathological and etiological stroke subtypes over a 16 year time period. Methods: Data were collected within the Erlangen Stroke Project (ESPro), a prospective, population-based stroke register in Germany covering a total study population of 105,164 inhabitants (2010). Etiology of ischemic stroke was classified according to the Trial of Org 10172 in Acute Stroke Treatment (TOAST) criteria. Results: Between January 1995 and December 2010, 3,243 patients with first-ever stroke were documented. The median age was 75 and 55% were females. The total stroke incidence decreased over the 16 year study period in men (Incidence Rate Ratio 1995-1996 vs. 2009-2010 (IRR) 0.78; 95% CI 0.58-0.90) but not in women. Among stroke subtypes, a decrease in ischemic stroke incidence (IRR 0.73; 95% CI 0.57-0.93) and of large artery atherosclerotic stroke (IRR 0.27; 95% CI 0.12-0.59) was found in men and an increase of stroke due to small artery occlusion in women (IRR 2.33; 95% CI 1.39-3.90). Conclusions: Variations in time trends of pathological and etiological stroke subtypes were found between men and women that might be linked to gender differences in the development of major vascular risk factors in the study population.
Neuroepidemiology
0251-5350
1423-0208
10.1159/000371353
25659352
urn:nbn:de:bvb:20-opus-196503
This publication is with permission of the rights owner freely accessible due to an Alliance licence and a national licence (funded by the DFG, German Research Foundation) respectively.
swordwue
2020-01-14T14:18:09+00:00
attachment; filename=deposit.zip
60fb0aa6a58a4bfec5086937f2d6069c
Neuroepidemiology 2015;44(1):24–29. DOI: 10.1159/000371353
false
true
Deutsches Urheberrecht
Peter L. Kolominsky-Rabas
Silke Wiedmann
Michael Weingärtner
Thomas G. Liman
Matthias Endres
Stefan Schwab
Michael Buchfelder
Peter U. Heuschmann
eng
uncontrolled
stroke
eng
uncontrolled
epidemiology
eng
uncontrolled
incidence
eng
uncontrolled
time trends
eng
uncontrolled
register
Medizin und Gesundheit
open_access
Institut für Klinische Epidemiologie und Biometrie
Import
Universität Würzburg
https://opus.bibliothek.uni-wuerzburg.de/files/19650/NED371353.pdf
17734
2018
eng
e0204285
9
13
article
1
2019-02-26
--
--
Outcome after stroke attributable to baseline factors—the PROSpective Cohort with Incident Stroke (PROSCIS)
Background
The impact of risk factors on poor outcome after ischemic stroke is well known, but estimating the amount of poor outcome attributable to single factors is challenging in presence of multimorbidity. We aim to compare population attributable risk estimates obtained from different statistical approaches regarding their consistency. We use a real-life data set from the PROSCIS study to identify predictors for mortality and functional impairment one year after first-ever ischemic stroke and quantify their contribution to poor outcome using population attributable risks.
Methods
The PROSpective Cohort with Incident Stroke (PROSCIS) is a prospective observational hospital-based cohort study of patients after first-ever stroke conducted independently in Berlin (PROSCIS-B) and Munich (PROSCIS-M). The association of baseline factors with poor outcome one year after stroke in PROSCIS-B was analysed using multiple logistic regression analysis and population attributable risks were calculated, which were estimated using sequential population attributable risk based on a multiple generalized additive regression model, doubly robust estimation, as well as using average sequential population attributable risk. Findings were reproduced in an independent validation sample from PROSCIS-M.
Results
Out of 507 patients with available outcome information after 12 months in PROSCIS-B, 20.5% suffered from poor outcome. Factors associated with poor outcome were age, pre-stroke physical disability, stroke severity (NIHSS), education, and diabetes mellitus. The order of risk factors ranked by magnitudes of population attributable risk was almost similar for all methods, but population attributable risk estimates varied markedly between the methods. In PROSCIS-M, incidence of poor outcome and distribution of baseline parameters were comparable. The multiple logistic regression model could be reproduced for all predictors, except pre-stroke physical disability. Similar to PROSCIS-B, the order of risk factors ranked by magnitudes of population attributable risk was almost similar for all methods, but magnitudes of population attributable risk differed markedly between the methods.
Conclusions
Ranking of risk factors by population impact is not affected by the different statistical approaches. Thus, for a rational decision on which risk factor to target in disease interventions, population attributable risk is a supportive tool. However, population attributable risk estimates are difficult to interpret and are not comparable when they origin from studies applying different methodology. The predictors for poor outcome identified in PROSCIS-B have a relevant impact on mortality and functional impairment one year after first-ever ischemic stroke.
PLoS ONE
10.1371/journal.pone.0204285
urn:nbn:de:bvb:20-opus-177342
PLoS ONE 13(9):e0204285 (2018). DOI: 10.1371/journal.pone.0204285
false
true
CC BY: Creative-Commons-Lizenz: Namensnennung 4.0 International
Carolin Malsch
Thomas Liman
Silke Wiedmann
Bob Siegerink
Marios K. Georgakis
Steffen Tiedt
Matthias Endres
Peter U. Heuschmann
eng
uncontrolled
ischemic stroke
eng
uncontrolled
stroke
eng
uncontrolled
physical activity
eng
uncontrolled
diabetes mellitus
eng
uncontrolled
regression analysis
eng
uncontrolled
hemorrhagic stroke
eng
uncontrolled
atrial fibrillation
eng
uncontrolled
hypertension
Medizin und Gesundheit
open_access
Institut für Klinische Epidemiologie und Biometrie
Förderzeitraum 2018
Universität Würzburg
https://opus.bibliothek.uni-wuerzburg.de/files/17734/Malsch_PLoS_ONE.pdf
14866
2015
eng
288
112
article
1
2017-05-17
--
--
In reply: The quality of acute stroke treatment-an analysis of evidence-based indicators in 260 000 patients
No abstract available.
Deutsches Aerzteblatt International
10.3238/arztebl.2015.0288b
urn:nbn:de:bvb:20-opus-148666
Deutsches Aerzteblatt International 2015, 112, 288. DOI: 10.3238/arztebl.2015.0288b
false
true
Deutsches Urheberrecht
Silke Wiedmann
Peter U. Heuschmann
Peter Hermanek
eng
uncontrolled
acute stroke
eng
uncontrolled
treatment
Medizin und Gesundheit
open_access
Institut für Klinische Epidemiologie und Biometrie
Universität Würzburg
14905
2015
eng
432497
2015
article
1
2017-05-22
--
--
Temporal changes in the quality of acute stroke care in five national audits across Europe
Background. Data on potential variations in delivery of appropriate stroke care over time are scarce. We investigated temporal changes in the quality of acute hospital stroke care across five national audits in Europe over a period of six years. Methods. Data were derived from national stroke audits in Germany, Poland, Scotland, Sweden, and England/Wales/Northern Ireland participating within the European Implementation Score (EIS) collaboration. Temporal changes in predefined quality indicators with comparable information between the audits were investigated. Multivariable logistic regression analyses were performed to estimate adherence to quality indicators over time. Results. Between 2004 and 2009, individual data from 542,112 patients treated in 538 centers participating continuously over the study period were included. In most audits, the proportions of patients who were treated on a SU, were screened for dysphagia, and received thrombolytic treatment increased over time and ranged from 2-fold to almost 4-fold increase in patients receiving thrombolytic therapy in 2009 compared to 2004. Conclusions. A general trend towards a better quality of stroke care defined by standardized quality indicators was observed over time. The association between introducing a specific measure and higher adherence over time might indicate that monitoring of stroke care performance contributes to improving quality of care.
BioMed Research International
10.1155/2015/432497
urn:nbn:de:bvb:20-opus-149059
BioMed Research International Volume 2015, Article ID 432497. DOI: 10.1155/2015/432497
223153
CC BY: Creative-Commons-Lizenz: Namensnennung 4.0 International
Steffi Hillmann
Silke Wiedmann
Alec Fraser
Juan Baeza
Anthony Rudd
Bo Norrving
Kjell Asplund
Maciej Niewada
Martin Dennis
Peter Hermanek
Charles D. A. Wolfe
Peter U. Heuschmann
eng
uncontrolled
ischemic stroke
eng
uncontrolled
indicators
eng
uncontrolled
thrombolysis
eng
uncontrolled
registries
eng
uncontrolled
outcomes
eng
uncontrolled
mortality
eng
uncontrolled
implementation
eng
uncontrolled
German Stroke Registers Study Group
Medizin und Gesundheit
open_access
Institut für Klinische Epidemiologie und Biometrie
OpenAIRE
Universität Würzburg
https://opus.bibliothek.uni-wuerzburg.de/files/14905/057_Hillmann_BioMed_Research_International.pdf
15944
2017
eng
49
17
article
German Stroke Register Study Group (ADSR)
1
2018-03-21
--
--
Stroke unit care in Germany: the German stroke registers study group (ADSR)
Background:
Factors influencing access to stroke unit (SU) care and data on quality of SU care in Germany are scarce. We investigated characteristics of patients directly admitted to a SU as well as patient-related and structural factors influencing adherence to predefined indicators of quality of acute stroke care across hospitals providing SU care.
Methods:
Data were derived from the German Stroke Registers Study Group (ADSR), a voluntary network of 9 regional registers for monitoring quality of acute stroke care in Germany. Multivariable logistic regression analyses were performed to investigate characteristics influencing direct admission to SU. Generalized Linear Mixed Models (GLMM) were used to estimate the influence of structural hospital characteristics (percentage of patients admitted to SU, year of SU-certification, and number of stroke and TIA patients treated per year) on adherence to predefined quality indicators.
Results:
In 2012 180,887 patients were treated in 255 hospitals providing certified SU care participating within the ADSR were included in the analysis; of those 82.4% were directly admitted to a SU. Ischemic stroke patients without disturbances of consciousness (p < .0001), an interval onset to admission time ≤3 h (p < .0001), and weekend admission (p < .0001) were more likely to be directly admitted to a SU. A higher proportion of quality indicators within predefined target ranges were achieved in hospitals with a higher proportion of SU admission (p = 0.0002). Quality of stroke care could be maintained even if certification was several years ago.
Conclusions:
Differences in demographical and clinical characteristics regarding the probability of SU admission were observed. The influence of structural characteristics on adherence to evidence-based quality indicators was low.
BMC Neurology
10.1186/s12883-017-0819-0
urn:nbn:de:bvb:20-opus-159447
BMC Neurology (2017) 17:49. DOI: 10.1186/s12883-017-0819-0
223153
CC BY: Creative-Commons-Lizenz: Namensnennung 4.0 International
Steffi Hillmann
Silke Wiedmann
Viktoria Rücker
Klaus Berger
Darius Nabavi
Ingo Bruder
Hans-Christian Koennecke
Günter Seidel
Björn Misselwitz
Alfred Janssen
Christoph Burmeister
Christine Matthis
Otto Busse
Peter Hermanek
Peter Ulrich Heuschmann
eng
uncontrolled
stroke register
eng
uncontrolled
stroke unit care
eng
uncontrolled
quality of health care
eng
uncontrolled
quality indicators
Krankheiten
open_access
Institut für Klinische Epidemiologie und Biometrie
OpenAIRE
Förderzeitraum 2017
Universität Würzburg
https://opus.bibliothek.uni-wuerzburg.de/files/15944/Hillmann_BMC_Neurology.pdf
15808
2017
eng
159
17
article
1
2018-02-26
--
--
Feasibility and diagnostic accuracy of point-of-care handheld echocardiography in acute ischemic stroke patients - a pilot study
Background:
Standard echocardiography (SE) is an essential part of the routine diagnostic work-up after ischemic stroke (IS) and also serves for research purposes. However, access to SE is often limited. We aimed to assess feasibility and accuracy of point-of-care (POC) echocardiography in a stroke unit (SU) setting.
Methods:
IS patients were recruited on the SU of the University Hospital Würzburg, Germany. Two SU team members were trained in POC echocardiography for a three-month period to assess a set of predefined cardiac parameters including left ventricular ejection fraction (LVEF). Diagnostic agreement was assessed by comparing POC with SE executed by an expert sonographer, and intraclass correlation coefficient (ICC) or kappa (κ) with 95% confidence intervals (95% CI) were calculated.
Results:
In the 78 patients receiving both POC and SE agreement for cardiac parameters was good, with ICC varying from 0.82 (95% CI 0.71–0.89) to 0.93 (95% CI 0.87–0.96), and κ from 0.39 (−95% CI 0.14–0.92) to 0.79 (95% CI 0.67–0.91). Detection of systolic dysfunction with POC echocardiography compared to SE was very good, with an area under the curve of 0.99 (0.96–1.00). Interrater agreement for LVEF measured by POC echocardiography was good with κ 0.63 (95% CI 0.40–0.85).
Conclusions:
POC echocardiography in a SU setting is feasible enabling reliable quantification of LVEF and preliminary assessment of selected cardiac parameters that might be used for research purposes. Its potential clinical utility in triaging stroke patients who should undergo or do not necessarily require SE needs to be investigated in larger prospective diagnostic studies.
BMC Neurology
10.1186/s12883-017-0937-8
urn:nbn:de:bvb:20-opus-158081
BMC Neurology (2017) 17:159. DOI: 10.1186/s12883-017-0937-8
CC BY: Creative-Commons-Lizenz: Namensnennung 4.0 International
Peter Kraft
Anna Fleischer
Silke Wiedmann
Viktoria Rücker
Daniel Mackenrodt
Caroline Morbach
Uwe Malzahn
Christoph Kleinschnitz
Stefan Störk
Peter U. Heuschmann
eng
uncontrolled
ischemic stroke
eng
uncontrolled
systolic dysfunction
eng
uncontrolled
point-of-care echocardiography
eng
uncontrolled
ejection fraction
eng
uncontrolled
stroke unit
eng
uncontrolled
feasibility
eng
uncontrolled
accuracy
Krankheiten
open_access
Neurologische Klinik und Poliklinik
Abteilung für Molekulare Innere Medizin (in der Medizinischen Klinik und Poliklinik II)
Institut für Klinische Epidemiologie und Biometrie
Förderzeitraum 2017
Universität Würzburg
https://opus.bibliothek.uni-wuerzburg.de/files/15808/Kraft_BMC_Neurology.pdf
14529
2015
eng
113
10
article
1
2017-03-03
--
--
Self-administered version of the Fabry-associated pain questionnaire for adult patients
Background
Fabry-associated pain may be the first symptom of Fabry disease (FD) and presents with a unique phenotype including mostly acral burning triggerable pain attacks, evoked pain, pain crises, and permanent pain. We recently developed and validated the first Fabry Pain Questionnaire (FPQ) for adult patients. Here we report on the validation of the self-administered version of the FPQ that no longer requires a face-to-face interview but can be filled in by the patients themselves allowing more flexible data collection.
Methods
At our Würzburg Fabry Center for Interdisciplinary Treatment, Germany, we have developed the self-administered version of the FPQ by adapting the questionnaire to a self-report version. To do this, consecutive Fabry patients with current or past pain history (n = 56) were first interviewed face-to-face. Two weeks later patients’ self-reported questionnaire results were collected by mail (n = 55). We validated the self-administered version of the FPQ by assessing the inter-rater reliability agreement of scores obtained by supervised administration and self-administration of the FPQ.
Results
The FPQ contains 15 questions on the different pain phenotypes, on pain development during life with and without therapy, and on impairment due to pain. Statistical analysis showed that the majority of questions were answered in high agreement in both sessions with a mean AC1-statistic of 0.857 for 55 nominal-scaled items and a mean ICC of 0.587 for 9 scores.
Conclusions
This self-administered version of the first pain questionnaire for adult Fabry patients is a useful tool to assess Fabry-associated pain without a time-consuming face-to-face interview but via a self-reporting survey allowing more flexible usage.
Orphanet Journal of Rare Diseases
10.1186/s13023-015-0325-7
urn:nbn:de:bvb:20-opus-145294
Orphanet Journal of Rare Diseases (2015) 10:113 DOI 10.1186/s13023-015-0325-7
602133
Barbara Magg
Christoph Riegler
Silke Wiedmann
Peter Heuschmann
Claudia Sommer
Nurcan Üçeyler
eng
uncontrolled
Fabry disease
eng
uncontrolled
Fabry-associated pain
eng
uncontrolled
pain questionnaire
Krankheiten
open_access
Neurologische Klinik und Poliklinik
Institut für Klinische Epidemiologie und Biometrie
OpenAIRE
Förderzeitraum 2015
Universität Würzburg
https://opus.bibliothek.uni-wuerzburg.de/files/14529/Magg_10.1186_s13023-015-0325-7.pdf
11474
2014
eng
759-765
45
111
article
1
2015-06-22
--
--
The Quality of Acute Stroke Care-an Analysis of Evidence-Based Indicators in 260 000 Patients
Background: Stroke patients should be cared for in accordance with evidence-based guidelines. The extent of implementation of guidelines for the acute care of stroke patients in Germany has been unclear to date. Methods: The regional quality assurance projects that cooperate in the framework of the German Stroke Registers Study Group (Arbeitsgemeinschaft Deutscher Schlaganfall-Register, ADSR) collected data on the care of stroke patients in 627 hospitals in 2012. The quality of the acute hospital care of patients with stroke or transient ischemic attack (TIA) was assessed on the basis of 15 standardized, evidence-based quality indicators and compared across the nine participating regional quality assurance projects. Results: Data were obtained on more than 260 000 patients nationwide. Intravenous thrombolysis was performed in 59.7% of eligible ischemic stroke patients patients (range among participating projects, 49.7-63.6%). Dysphagia screening was documented in 86.2% (range, 74.8-93.1%). For the following indicators, the defined targets were not reached for all of Germany: antiaggregation within 48 hours, 93.4% (range, 86.6-96.4%); anticoagulation for atrial fibrillation, 77.6% (range, 72.4-80.1%); standardized dysphagia screening, 86.2% (range, 74.8-93.1%); oral and written information of the patients or their relatives, 86.1% (range, 75.4-91.5%). The rate of patients examined or treated by a speech therapist was in the target range. Conclusion: The defined targets were reached for most of the quality indicators. Some indicators, however, varied widely across regional quality assurance projects. This implies that the standardization of care for stroke patients in Germany has not yet been fully achieved.
Deutsches Ärzteblatt International
10.3238/arztebl.2014.0759
1866-0452
25467052
urn:nbn:de:bvb:20-opus-114747
Deutsches Ärzteblatt International 2014; 111: 759–65. DOI: 10.3238/arztebl.2014.0759
Clinical Trial Center (CTC) / Zentrale für Klinische Studien Würzburg (ZKSW)
223153
Deutsches Urheberrecht
Silke Wiedmann
Peter U. Heuschmann
Steffi Hillmann
Otto Busse
Horst Wiethoelter
Georg M. Walter
Guenter Seidel
Bjoern Misselwitz
Alfred Janssen
Klaus Berger
Christoph Burmeister
Christine Matthias
Peter Kolominsky-Rabas
Peter Hermanek
eng
uncontrolled
Hesse
eng
uncontrolled
study-group ADSR
eng
uncontrolled
ischemic-stroke
eng
uncontrolled
Germany
eng
uncontrolled
implementation
eng
uncontrolled
rehabilitation
Medizin und Gesundheit
open_access
Institut für Klinische Epidemiologie und Biometrie
OpenAIRE
Deutsches Zentrum für Herzinsuffizienz (DZHI)
Universität Würzburg