Abstract
BackgroundStroke Unit Care (SUC), intravenous thrombolysis (IVT) and mechanical thrombectomy (MT) are evidence-based treatment options for acute ischemic stroke (AIS). Using nationwide comprehensive administrative data from Germany, we recently reported nationwide development of AIS admissions, SUC rates, IVT rates and MT rates in Germany between 2010 and 2016. In this update paper, we analyze data on the further development of these data to 2019 after publication of time window extensions for recanalization therapies.MethodsWe considered all hospitalized cases with the main diagnosis of the ICD-10-GM code I63 (AIS) for the year 2019. We identified stroke therapies by using the corresponding Operating and Procedure Keys for IVT, MT and SUC out of the DRG statistics. Regional analyses are based on data from the 412 German administrative districts and cities. We compared the results with those from 2016.ResultsNumber of hospitalized AIS patients showed a mild decrease in 2019 (n = 225,531) compared with 2016 (n = 227,687), with significant more AIS patients treated on a stroke unit in 2019 (n = 167,799; 74.4% vs. n = 164,270; 72.1%, p < 0.001). The rate of IVT further increased from 14.9% (n = 33,916) in 2016 to 16.3% (n = 36,745) in 2019 (p < 0.001). Similarly, the MT rate increased from 4.3% (n = 9795) in 2016 to 7.2% (n = 16,135) in 2019 (p < 0.001). There was still a high regional variability for MT (1.4 to 15.2%) according to the place of residence of the AIS patients.ConclusionsIn Germany, the rates of recanalization therapies in patients with AIS continued to increase from 2016 to 2019. Compared to IVT-rates and numbers, the respective data for MT procedures showed an even more pronounced increase.
Highlights
Stroke Unit Care (SUC), intravenous thrombolysis (IVT) and mechanical thrombectomy (MT) are evidence-based treatment options for acute ischemic stroke (AIS)
In 2019, we reported nationwide numbers of all hospitalized patients with acute ischemic stroke (AIS) in Germany for the years 2010 to 2016 and the distribution and evolution of recanalizing treatment strategies such as intravenous thrombolysis (IVT) and mechanical thrombectomy (MT) [2]
Our evaluation represents the most current data before the coronavirus disease 2019 (COVID-19) outbreak and can serve as reference for further analysis regarding the effects of the pandemic on the acute stroke care [24] and for treatment rates among AIS patients with COVID-19 [25]
Summary
Stroke Unit Care (SUC), intravenous thrombolysis (IVT) and mechanical thrombectomy (MT) are evidence-based treatment options for acute ischemic stroke (AIS). Using nationwide comprehensive administrative data from Germany, we recently reported nationwide development of AIS admissions, SUC rates, IVT rates and MT rates in Germany between 2010 and 2016. In this update paper, we analyze data on the further development of these data to 2019 after publication of time window extensions for recanalization therapies. In 2019, we reported nationwide numbers of all hospitalized patients with acute ischemic stroke (AIS) in Germany for the years 2010 to 2016 and the distribution and evolution of recanalizing treatment strategies such as intravenous thrombolysis (IVT) and mechanical thrombectomy (MT) [2]. Our evaluation represents the most current data before the coronavirus disease 2019 (COVID-19) outbreak and can serve as reference for further analysis regarding the effects of the pandemic on the acute stroke care [24] and for treatment rates among AIS patients with COVID-19 [25]
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