TY  - JOUR
A1  - Wiedmann, Silke
A1  - Heuschmann, Peter U.
A1  - Hillmann, Steffi
A1  - Busse, Otto
A1  - Wiethoelter, Horst
A1  - Walter, Georg M.
A1  - Seidel, Guenter
A1  - Misselwitz, Bjoern
A1  - Janssen, Alfred
A1  - Berger, Klaus
A1  - Burmeister, Christoph
A1  - Matthias, Christine
A1  - Kolominsky-Rabas, Peter
A1  - Hermanek, Peter
T1  - The Quality of Acute Stroke Care-an Analysis of Evidence-Based Indicators in 260 000 Patients
JF  - Deutsches Ärzteblatt International
N2  - 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.
KW  - Hesse
KW  - study-group ADSR
KW  - ischemic-stroke
KW  - Germany
KW  - implementation
KW  - rehabilitation
Y1  - 2014
U6  - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-114747
SN  - 1866-0452
VL  - 111
IS  - 45
ER  - 
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  -