TY  - JOUR
A1  - Hillmann, Steffi
A1  - Wiedmann, Silke
A1  - Fraser, Alec
A1  - Baeza, Juan
A1  - Rudd, Anthony
A1  - Norrving, Bo
A1  - Asplund, Kjell
A1  - Niewada, Maciej
A1  - Dennis, Martin
A1  - Hermanek, Peter
A1  - Wolfe, Charles D. A.
A1  - Heuschmann, Peter U.
T1  - Temporal changes in the quality of acute stroke care in five national audits across Europe
JF  - BioMed Research International
N2  - 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.
KW  - ischemic stroke
KW  - indicators
KW  - thrombolysis
KW  - registries
KW  - outcomes
KW  - mortality
KW  - implementation
KW  - German Stroke Registers Study Group
Y1  - 2015
U6  - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-149059
VL  - 2015
IS  - 432497
ER  - 
TY  - JOUR
A1  - Kraft, Peter
A1  - Drechsler, Christiane
A1  - Schuhmann, Michael K.
A1  - Gunreben, Ignaz
A1  - Kleinschnitz, Christoph
T1  - Characterization of Peripheral Immune Cell Subsets in Patients with Acute and Chronic Cerebrovascular Disease: A Case-Control Study
JF  - International Journal of Molecular Science
N2  - Immune cells (IC) play a crucial role in murine stroke pathophysiology. However, data are limited on the role of these cells in ischemic stroke in humans. We therefore aimed to characterize and compare peripheral IC subsets in patients with acute ischemic stroke/transient ischemic attack (AIS/TIA), chronic cerebrovascular disease (CCD) and healthy volunteers (HV). We conducted a case-control study of patients with AIS/TIA (n = 116) or CCD (n = 117), and HV (n = 104) who were enrolled at the University Hospital Würzburg from 2010 to 2013. We determined the expression and quantity of IC subsets in the three study groups and performed correlation analyses with demographic and clinical parameters. The quantity of several IC subsets differed between the AIS/TIA, CCD, and HV groups. Several clinical and demographic variables independently predicted the quantity of IC subsets in patients with AIS/TIA. No significant changes in the quantity of IC subsets occurred within the first three days after AIS/TIA. Overall, these findings strengthen the evidence for a pathophysiologic role of IC in human ischemic stroke and the potential use of IC-based biomarkers for the prediction of stroke risk. A comprehensive description of IC kinetics is crucial to enable the design of targeted treatment strategies.
KW  - chronic cerebrovascular disease
KW  - lymphocytes
KW  - leukocytes
KW  - immune cells
KW  - biomarker
KW  - monocytes
KW  - regulatory T cells
KW  - ischemic stroke
KW  - thromboinflammation
Y1  - 2015
U6  - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-126319
VL  - 16
IS  - 10
ER  -