Management of stroke patients and stroke registry in

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Management of stroke patients and stroke registry in Austria Milan R. Vosko, MD, Ph.

Management of stroke patients and stroke registry in Austria Milan R. Vosko, MD, Ph. D Head of the Stroke Unit AKH Linz, Austria

Austria - facts n Inhabitants n Strokes n 2003 ca 6 Mio 20. 000/y

Austria - facts n Inhabitants n Strokes n 2003 ca 6 Mio 20. 000/y – Stroke units establishment

Austrian Stroke Unit Register Organisation Gesundheit Österreich Gmb. H ÖGSF - Austrian Society of

Austrian Stroke Unit Register Organisation Gesundheit Österreich Gmb. H ÖGSF - Austrian Society of Stroke Research BIQG Dr. Christine Hofer Vienna Prim. Univ. Prof. Dr. Wilfried Lang Wien Univ-Prof. Prim. Dr. Michael Brainin Gugging Administration by ÖBIG/ÖGSF Expert committee (interim analyses, discussion of data, decisions, …)

Austrian Stroke Unit Register Planned Stroke Units 2003 38 Established Stroke Units per 5/2007

Austrian Stroke Unit Register Planned Stroke Units 2003 38 Established Stroke Units per 5/2007 32 Participating in the registry: 25

Austrian Stroke Unit Register Data from 2003 -2007, 17. 790 Datasets of stroke patients

Austrian Stroke Unit Register Data from 2003 -2007, 17. 790 Datasets of stroke patients n 16. 300 Datasets of stroke patients with valid discharge date n n n n AKH Linz BKH Kufstein Christian-Doppler-Klinik Salzburg KH Barmherzige Brüder Linz KH Barmherzige Brüder Wien KH Göttlicher Heiland Wien KH Hietzing Wien KH Oberwart KH Rudolfstiftung Wien KH Wiener Neustadt LK Donauregion Gugging LK Mostviertel Amstetten LK Waldviertel Horn LK Weinviertel Mistelbach n n n LKH Vöcklabruck LKH Klagenfurt LNK Sigmund Freud Graz LNK Wagner-Jauregg Linz Med. Universität Innsbruck Neurol. Zentrum Rosenhügel Wien II. Otto Wagner Spital Wien Universitätsklinikum Graz Wilhelminenspital Gesundheit Österreich Gmb. H/Geschäftsbereich BIQG Expertengremium an der GÖG/BIQG

Overview of dataset ADMISSION DISCHARGE FOLLOW UP admission data NIHSS, BI, m. RS Syndrome

Overview of dataset ADMISSION DISCHARGE FOLLOW UP admission data NIHSS, BI, m. RS Syndrome dg and monitoring risk factors therapy NIH, BI, m. RS additional dg. complications preliminary classif. sec. prevention patient status social situation BI, m. RS sec. prevention

Registry - benchmarking n Functions for participitaing centres – – Full view of patient

Registry - benchmarking n Functions for participitaing centres – – Full view of patient data Follow up reminder Data collection of the centre Statistics – benchmarking, austrian wide standard analysis Duration of hospitalisation in days - SU Thrombolysis rate in %

NIHSS at admission for patients with stroke (numbers in %) Year Nr. of cases

NIHSS at admission for patients with stroke (numbers in %) Year Nr. of cases included 2003 1472 2004 3306 2005 3889 2006 5422 2007 2155

Age of patients with stroke (numbers in %) Year Nr. of cases included 2003

Age of patients with stroke (numbers in %) Year Nr. of cases included 2003 1475 2004 3310 2005 3890 2006 5001 2007 2072

Time – event to hospital Patients with stroke with known event time (numbers in

Time – event to hospital Patients with stroke with known event time (numbers in %) Year Nr. of cases included 2003 978 2004 2055 2005 2345 2006 3247 2007 1351

Time – admission to imaging Stroke patients with imaging after hospital admission CCT, MRI

Time – admission to imaging Stroke patients with imaging after hospital admission CCT, MRI (numbers in %) Year Nr. of cases included 2003 1196 2004 2852 2005 3560 2006 4921 2007 1934

Rate of thrombolysis IV, IA Left: without lysis, Right: with lysis % Year Nr.

Rate of thrombolysis IV, IA Left: without lysis, Right: with lysis % Year Nr. of cases included 2003 1350 2004 2961 2005 3473 2006 4887 2007 1932

Stroke program AKH Linz n Dept of Neurology 108 beds n NICU (8), SU

Stroke program AKH Linz n Dept of Neurology 108 beds n NICU (8), SU (4) n Ideal cooperation with radiology 85 85 2006 2007 – 87% acute strokes get MRI n Frequency of tx-treatment: 44 11 2004 2005

Stroke program AKH Linz total strokes (isch, ich, tia) ischem. strokes thrombolysis (nr. of

Stroke program AKH Linz total strokes (isch, ich, tia) ischem. strokes thrombolysis (nr. of pts) lysis rate (isch. stroke) 2006 2007 570 381 85 22% 590 428 85 20%

n WELCOME TO EURO 2008

n WELCOME TO EURO 2008

ANZOD Registry ANZOD Registry ANZOD Registry ANZOD RegistryANZOD Registry ANZOD Registry ANZOD Registry ANZOD Registry
ANZDATA Registry ANZDATA Registry ANZDATA Registry ANZDATA RegistryANZDATA Registry ANZDATA Registry ANZDATA Registry ANZDATA Registry
Management of stroke patients and stroke registry inManagement of stroke patients and stroke registry in
TARS Registry 1 Registry 2 Registry N WebTARS Registry 1 Registry 2 Registry N Web
MANAGEMENT OF STROKE Stroke Definition Stroke is clinicallyMANAGEMENT OF STROKE Stroke Definition Stroke is clinically
Stroke Stroke is a Brain Attack Stroke isStroke Stroke is a Brain Attack Stroke is
Stroke subtype STROKE 15 85 Ischemic Stroke 20Stroke subtype STROKE 15 85 Ischemic Stroke 20
Stroke Cerebro Vascualar Accident CVA Stroke A strokeStroke Cerebro Vascualar Accident CVA Stroke A stroke
Patients and families Patients in mind Patients inPatients and families Patients in mind Patients in
Publications Office Metadata Registry MDR INSPIRE Registry andPublications Office Metadata Registry MDR INSPIRE Registry and
ESAVO Registry and Curation Utility Aurlien Stb RegistryESAVO Registry and Curation Utility Aurlien Stb Registry
ESAVO Registry and Curation Utility Aurlien Stb RegistryESAVO Registry and Curation Utility Aurlien Stb Registry
Prevention of Stroke or Recurrent Stroke Including ManagementPrevention of Stroke or Recurrent Stroke Including Management
MANAGEMENT OF STROKE STROKE ACUTE CARE PATHWAY DEFINITIONSMANAGEMENT OF STROKE STROKE ACUTE CARE PATHWAY DEFINITIONS
MANAGEMENT OF STROKE STROKE ACUTE CARE PATHWAY DEFINITIONSMANAGEMENT OF STROKE STROKE ACUTE CARE PATHWAY DEFINITIONS