Availability of mechanical thrombectomy for acute stroke. Analysis of the health care reality in Germany

被引：0

作者：

Krogias, C. ^{[1
,11
,12
]}

Bartig, D. ^{[2
,12
]}

Kitzrow, M. ^{[3
,11
,12
]}

Brassel, F. ^{[4
,11
]}

Busch, E. W. ^{[5
,11
]}

Nolden-Koch, M. ^{[6
,11
,12
]}

Reimann, G. ^{[7
,11
,12
]}

Weimar, C. ^{[8
,11
,12
]}

Weber, R. ^{[9
,11
,12
]}

Eyding, J. ^{[10
,11
,12
]}

机构：

[1] Ruhr Univ Bochum, Univ Klinikum, St Josef Hosp, Neurol Klin, Gudrunstr 56, D-44791 Bochum, Germany

[2] Drg Market Osnabruck, Osnabruck, Germany

[3] Ruhr Univ Bochum, Berufsgenossenschaftliches Univ Klinikum Bergmann, Neurol Klin, Bochum, Germany

[4] Sana Kliniken Duisburg, Klin Radiol & Neuroradiol, Duisburg, Germany

[5] St Josef Krankenhaus Moers, Neurol Klin, Moers, Germany

[6] Sana Kliniken Duisburg, Neurol Klin, Duisburg, Germany

[7] Klinikum Dortmund gGmbH, Neurol Klin, Dortmund, Germany

[8] Univ Klinikum Essen, Neurol Klin, Essen, Germany

[9] Alfried Krupp Krankenhaus Essen, Neurol Klin, Essen, Germany

[10] Ruhr Univ Bochum, Univ Klinikum Knappschaftskrankenhaus, Neurol Klin, Bochum, Germany

[11] Neurovaskulares Netz Ruhr, Ruhrgebiet, Germany

[12] Arbeitsgemeinschaft Nordwestdeutscher Stroke Zirk, Bochum, Germany

来源：

NERVENARZT | 2017年 / 88卷 / 10期

关键词：

Federal states; Districts; Independent city; Thrombolysis; Network; ACUTE ISCHEMIC-STROKE; MANAGEMENT; GUIDELINE; THERAPY;

D O I：

10.1007/s00115-017-0324-0

中图分类号：

R74 [神经病学与精神病学];

学科分类号：

摘要：

Mechanical thrombectomy (MT) has become an evidence-based therapy for stroke patients with proximal vessel occlusion of the anterior cerebral circulation. Nationwide availability of MT for all eligible patients within the shortest possible time window is a major challenge. Nationwide analysis of the rates of systemic thrombolysis (STL) and MT in Germany according to region and hospital-based evaluation. The evaluation involved data analysis of the diagnosis-related groups (DRG) statistics and structured quality reports of hospitals for 2010 and 2014. The rates and changes of STL and MT were evaluated in the 413 German districts with reference to the corresponding case number of patients with acute ischemic stroke. Nationwide recanalization treatment rates increased from 2010 to 2014 both for STL (from 8.0% to 11.6%) and MT (from 0.7% to 2.3%). High variations were observed depending on the patient's place of residence (STL = 3.4-36.7%, MT = 0-7.4%). In 2014 a total of 5526 MT were coded in a total of 244,757 ischemic strokes. A total of 134 hospitals with more than 2 MT per year were identified; however, 21% of the nationwide MTs were performed in only 7 hospitals with more than 100 MT/year. In 308 (75%) of the 413 districts, not a single MT was performed. Due to a narrow net of certified stroke units with nationwide availability of STL, excellent structural conditions for treatment of acute stroke patients are already established in Germany. With regard to the nationwide availability of MT, there is still a need for optimization. Despite the increasing number of hospitals providing MT as an emergency procedure, a trend toward large intervention centers with supraregional catchment areas can be observed.

引用

页码：1177 / 1185

页数：9

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