TY - JOUR A1 - Kolominsky-Rabas, Peter L. A1 - Wiedmann, Silke A1 - Weingärtner, Michael A1 - Liman, Thomas G. A1 - Endres, Matthias A1 - Schwab, Stefan A1 - Buchfelder, Michael A1 - Heuschmann, Peter U. T1 - Time Trends in Incidence of Pathological and Etiological Stroke Subtypes during 16 Years: The Erlangen Stroke Project JF - Neuroepidemiology N2 - 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. KW - stroke KW - epidemiology KW - incidence KW - time trends KW - register Y1 - 2015 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-196503 SN - 0251-5350 SN - 1423-0208 N1 - 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. VL - 44 IS - 1 ER - 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 - Wiedmann, Silke A1 - Heuschmann, Peter U. A1 - Hermanek, Peter T1 - In reply: The quality of acute stroke treatment-an analysis of evidence-based indicators in 260 000 patients JF - Deutsches Aerzteblatt International N2 - No abstract available. KW - acute stroke KW - treatment Y1 - 2015 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-148666 VL - 112 ER - TY - JOUR A1 - Magg, Barbara A1 - Riegler, Christoph A1 - Wiedmann, Silke A1 - Heuschmann, Peter A1 - Sommer, Claudia A1 - Üçeyler, Nurcan T1 - Self-administered version of the Fabry-associated pain questionnaire for adult patients JF - Orphanet Journal of Rare Diseases N2 - 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. KW - Fabry disease KW - Fabry-associated pain KW - pain questionnaire Y1 - 2015 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-145294 VL - 10 IS - 113 ER -