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The Quality of Acute Stroke Care-an Analysis of Evidence-Based Indicators in 260 000 Patients

Please always quote using this URN: urn:nbn:de:bvb:20-opus-114747
  • 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 transientBackground: 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.show moreshow less

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Metadaten
Author: 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
URN:urn:nbn:de:bvb:20-opus-114747
Document Type:Journal article
Faculties:Medizinische Fakultät / Institut für Klinische Epidemiologie und Biometrie
Language:English
Parent Title (English):Deutsches Ärzteblatt International
ISSN:1866-0452
Year of Completion:2014
Volume:111
Issue:45
Pagenumber:759-765
Source:Deutsches Ärzteblatt International 2014; 111: 759–65. DOI: 10.3238/arztebl.2014.0759
DOI:https://doi.org/10.3238/arztebl.2014.0759
Pubmed Id:http://www.ncbi.nlm.nih.gov/pubmed?term=25467052
Sonstige beteiligte Institutionen:Comprehensive Heart Failure Center, Universität Würzburg
Sonstige beteiligte Institutionen:Clinical Trial Center, Universität Würzburg
Dewey Decimal Classification:6 Technik, Medizin, angewandte Wissenschaften / 61 Medizin und Gesundheit / 610 Medizin und Gesundheit
Tag:Germany; Hesse; implementation; ischemic-stroke; rehabilitation; study-group ADSR
Release Date:2015/07/10
EU-Project number / Contract (GA) number:223153
OpenAIRE:OpenAIRE
Licence (German):License LogoDeutsches Urheberrecht