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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