Nabavi D G, Busse O
Klinik für Neurologie mit Stroke Unit, Vivantes Klinikum Neukölln, Rudower Str. 48, 12351, Berlin, Deutschland.
Deutsche Schlaganfallgesellschaft, Berlin, Deutschland.
Nervenarzt. 2020 Oct;91(10):891-901. doi: 10.1007/s00115-020-00978-x.
In this cross-sectional study data from 299 certified stroke units (SU) in Germany were analyzed from January 2016 to December 2018 and included comprehensive stroke centers (CSC 34%), local SU (62%), and telemedical SU (4%). In a total of 2487 SU monitor beds, 251,539 cases of stroke treatment were documented. The number of monitor beds (10.8 vs. 7.2) and stroke cases per year (1143 vs. 708) were significantly higher in CSC than in local SU. A total of 9251 endovascular recanalization (ER) procedures were performed annually by 475 interventionalists. The overall rate of ER was 3.7% of all stroke cases, including intracerebral hemorrhage (ICH) and transient ischemic attacks (TIA). A total of 124 of the SUs (41.5%) had a 24/7 ER structure in which 55% of all stroke treatments and 96% of all ERs were carried out. In the vast majority of CSC the ER structure was robust (≥4 interventionalists, 52%) or acceptable (3 interventionalists, 27%). In contrast, the majority of local SU (88%) had to transfer patients for ER over average distances of 40 km (range 1-160 km). Overall, the ER structures in Germany between 2016 and 2018 could be described as good to very good.
在这项横断面研究中，对2016年1月至2018年12月期间德国299个认证卒中单元（SU）的数据进行了分析，这些卒中单元包括综合卒中中心（CSC，占34%）、当地卒中单元（占62%）和远程医疗卒中单元（占4%）。在总共2487张卒中单元监测床位上，记录了251539例卒中治疗病例。CSC的监测床位数（10.8张对7.2张）和每年的卒中病例数（1143例对708例）显著高于当地卒中单元。475名介入医生每年共进行9251例血管内再通（ER）手术。ER的总体发生率为所有卒中病例的3.7%，包括脑出血（ICH）和短暂性脑缺血发作（TIA）。共有124个卒中单元（41.5%）具备全天候ER结构，其中55%的卒中治疗和96%的ER手术在此结构下进行。在绝大多数CSC中，ER结构强大（≥4名介入医生，占52%）或可以接受（3名介入医生，占27%）。相比之下，大多数当地卒中单元（88%）不得不将患者转送至平均距离为40公里（范围为1 - 160公里）的地方进行ER手术。总体而言，2016年至2018年德国的ER结构可描述为良好至非常良好。
