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Management of stroke Management of stroke patients and stroke patients and stroke registry in Austriaregistry in Austria
Milan R. VoskoMilan R. Vosko, MD, PhD, MD, PhD
Head of the Head of the Stroke Unit Stroke Unit
AKH Linz, AustriaAKH Linz, Austria
Austria - factsAustria - facts
InhabitantsInhabitants ca 6 Mioca 6 Mio StrokesStrokes 20.000/y20.000/y
2003 – Stroke units2003 – Stroke units establishment establishment
Austrian Stroke Unit Austrian Stroke Unit RegisterRegisterOrganisationOrganisation
ÖGSF - Austrian Society of ÖGSF - Austrian Society of Stroke ResearchStroke Research
Prim. Univ. Prof. Dr. Wilfried LangWien
Univ-Prof. Prim. Dr. Michael BraininGugging
Administration by ÖBIG/ÖGSFExpert committee (interim analyses, discussion of data, decisions,…)
Gesundheit Österreich GmbHGesundheit Österreich GmbH
BIQGDr. Christine HoferVienna
Austrian Stroke Unit Austrian Stroke Unit RegisterRegister
Established Stroke Units per 5/2007Planned Stroke Units 2003
3238
Participating in the registry: 25
Austrian Stroke Unit Austrian Stroke Unit RegisterRegister
Data from 2003-2007, Data from 2003-2007, 17.790 Datasets of stroke patients 17.790 Datasets of stroke patients 16.300 Datasets of stroke patients with valid discharge date 16.300 Datasets of stroke patients with valid discharge date
AKH LinzAKH Linz BKH KufsteinBKH Kufstein Christian-Doppler-Klinik SalzburgChristian-Doppler-Klinik Salzburg KH Barmherzige Brüder LinzKH Barmherzige Brüder Linz KH Barmherzige Brüder WienKH Barmherzige Brüder Wien KH Göttlicher Heiland WienKH Göttlicher Heiland Wien KH Hietzing WienKH Hietzing Wien KH OberwartKH Oberwart KH Rudolfstiftung WienKH Rudolfstiftung Wien KH Wiener NeustadtKH Wiener Neustadt LK Donauregion GuggingLK Donauregion Gugging LK Mostviertel AmstettenLK Mostviertel Amstetten LK Waldviertel HornLK Waldviertel Horn LK Weinviertel MistelbachLK Weinviertel Mistelbach
LKH VöcklabruckLKH Vöcklabruck LKH KlagenfurtLKH Klagenfurt LNK Sigmund Freud GrazLNK Sigmund Freud Graz LNK Wagner-Jauregg LinzLNK Wagner-Jauregg Linz Med. Universität InnsbruckMed. Universität Innsbruck Neurol. Zentrum Rosenhügel Wien I.Neurol. Zentrum Rosenhügel Wien I. Neurol. Zentrum Rosenhügel Wien II.Neurol. Zentrum Rosenhügel Wien II. Otto Wagner Spital WienOtto Wagner Spital Wien Universitätsklinikum GrazUniversitätsklinikum Graz WilhelminenspitalWilhelminenspital Gesundheit Österreich Gesundheit Österreich
GmbH/Geschäftsbereich BIQGGmbH/Geschäftsbereich BIQG Expertengremium an der GÖG/BIQGExpertengremium an der GÖG/BIQG
Overview of datasetOverview of dataset
ADMISSIONADMISSION DISCHARGEDISCHARGE FOLLOW UPFOLLOW UPadmission dataadmission data risk factorsrisk factors patient statuspatient status
NIHNIHSS,SS, B BI,I, mRS mRS therapytherapy social situationsocial situation
SyndromeSyndrome NIH, BI, mRSNIH, BI, mRS BI, mRSBI, mRS
dg and monitoringdg and monitoring additional dg.additional dg. sec. sec. preventionprevention
complicationscomplications
preliminary classif.preliminary classif.
sec. preventionsec. prevention
Registry - benchmarkingRegistry - benchmarking
Functions for participitaing centresFunctions for participitaing centres– Full view of patient dataFull view of patient data– Follow up reminder Follow up reminder – Data collection of the centreData collection of the centre– Statistics – benchmarking, austrian wide standard analysisStatistics – benchmarking, austrian wide standard analysis
Duration of hospitalisation in days - SUDuration of hospitalisation in days - SU Thrombolysis rate in %Thrombolysis rate in %
NIHSS at admissionNIHSS at admissionNIHSS at admission for patients with stroke NIHSS at admission for patients with stroke
(numbers in %)(numbers in %)
Year Nr. of cases included
2003
1472
2004
3306
2005
3889
2006
5422
2007
2155
AgeAgeAge of patients with strokeAge of patients with stroke (numbers in %) (numbers in %)
Year Nr. of cases included
2003
1475
2004
3310
2005
3890
2006
5001
2007
2072
Time – event to hospitalTime – event to hospitalPatients with stroke with known event time Patients with stroke with known event time
(numbers in %)(numbers in %)
Year Nr. of cases included
2003
978
2004
2055
2005
2345
2006
3247
2007
1351
Time – admission to imagingTime – admission to imagingStroke patients with imaging after hospital Stroke patients with imaging after hospital
admission CCT, MRI (numbers in %)admission CCT, MRI (numbers in %)
Year Nr. of cases included
2003
1196
2004
2852
2005
3560
2006
4921
2007
1934
Year Nr. of cases included
2003
1350
2004
2961
2005
3473
2006
4887
2007
1932
Rate of thrombolysis IV, IARate of thrombolysis IV, IALeft:without lysis, Right: with lysis %Left:without lysis, Right: with lysis %
Stroke Stroke pprogram AKH Linzrogram AKH Linz
Dept of Neurology 108 bedsDept of Neurology 108 beds NICU (8), SU (4)NICU (8), SU (4) Ideal cooperation with radiologyIdeal cooperation with radiology
– 87% acute strokes get MRI 87% acute strokes get MRI Frequency of tx-treatment:Frequency of tx-treatment:
20062004 2005
11
44
85
2007
85
Stroke program AKH LinzStroke program AKH Linz
2006 2006 20072007
total strokes (isch, ich, tia)total strokes (isch, ich, tia) 570570590590
ischem. strokesischem. strokes 381381 428428
thrombolysis (nr. of pts)thrombolysis (nr. of pts) 8585 8585
lysis rate (isch. stroke) lysis rate (isch. stroke) 22%22% 20%20%
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