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Only a Minority of Thrombectomy Candidates Are Admitted During Night Shift: A Rationale for Diurnal Stroke Care Planning.
Reuter, Björn; Stock, Christian; Ungerer, Matthias; Hyrenbach, Sonja; Bruder, Ingo; Ringleb, Peter A; Kern, Rolf; Gumbinger, Christoph.
Afiliación
  • Reuter B; Department of Neurology and Geriatrics, Helios Klinik Müllheim, Müllheim, Germany.
  • Stock C; Institute of Medical Biometry and Informatics, University of Heidelberg, Heidelberg, Germany.
  • Ungerer M; Department of Neurology, Heidelberg University, Heidelberg, Germany.
  • Hyrenbach S; Office for Quality Assurance in Health Care System Baden-Württemberg LLC (QiG BW GmbH), Stuttgart, Germany.
  • Bruder I; Office for Quality Assurance in Health Care System Baden-Württemberg LLC (QiG BW GmbH), Stuttgart, Germany.
  • Ringleb PA; Department of Neurology, Heidelberg University, Heidelberg, Germany.
  • Kern R; Department of Neurology, Klinikum Kempten, Kempten, Germany.
  • Gumbinger C; Department of Neurology, Heidelberg University, Heidelberg, Germany.
Front Neurol ; 11: 573381, 2020.
Article en En | MEDLINE | ID: mdl-33101182
Background: Widespread quick access to mechanical thrombectomy (MT) for acute ischemic stroke (AIS) is one of the main challenges in stroke care. It is unclear if newly established MT units are required 24 h/7 d. We explored the diurnal admission rate of patients with AIS potentially eligible for MT to provide a basis for discussion of daytime-adapted stroke care concepts. Methods: Data collected from the Baden-Württemberg Stroke Registry in Germany were assessed (2008-2012). We analyzed the admission rate of patients with AIS stratified by the National Institutes of Health Stroke Scale (NIHSS) score at admission in 3-h intervals. An NIHSS score ≥10 was considered a predictor of large vessel occlusion. The average annual admission number of patients with severe AIS were stratified by stroke service level and calculated for a three-shift model and working/non-working hours. Results: Of 91,864, 22,527 (21%) presented with an NIHSS score ≥10. The average admission rates per year for a hospital without Stroke Unit (SU), with a local SU, with a regional SU and a stroke center were 8, 52, 90 and 178, respectively. Approximately 61% were admitted during working hours, 54% in the early shift, 36% in the late shift and 10% in the night shift. Conclusions: A two-shift model, excluding the night shift, would cover 90% of the patients with severe AIS. A model with coverage during working hours would miss ~40% of the patients with severe AIS. To achieve a quick and area-wide MT, it seems preferable for newly implemented MT-units to offer MT in a two-shift model at a minimum.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Tipo de estudio: Prognostic_studies Idioma: En Revista: Front Neurol Año: 2020 Tipo del documento: Article País de afiliación: Alemania Pais de publicación: Suiza

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Tipo de estudio: Prognostic_studies Idioma: En Revista: Front Neurol Año: 2020 Tipo del documento: Article País de afiliación: Alemania Pais de publicación: Suiza