Eyding J, Misselwitz B, Weber R, Neumann-Haefelin T, Bartig D, Krogias Ch
Neurologische Klinik, Gemeinschaftskrankenhaus Herdecke, Gerhard-Kienle-Weg 4, 58313, Herdecke, Deutschland.
Medizinische Fakultät, Ruhr Universität Bochum, Bochum, Deutschland.
Nervenarzt. 2020 Oct;91(10):877-890. doi: 10.1007/s00115-020-00989-8.
This article reviews different methodological approaches for determining treatment reality of ischemic stroke patients in acute care hospitals. Considering specific advantages and disadvantages of two different epidemiologic approaches, a specific comparison was carried out of cases from a structured analysis of the nationwide German diagnosis-related groups (DRG) statistics and data from the acute stroke treatment in Hesse (SA_HE) for 2018 collated by the office for quality management. According to the DRG statistics and the SA_HE data, 16,267 and 15,643 acute ischemic stroke patients (ICD code I63) were treated in Hesse in 2018, with 53.7% and 54.5% males, respectively. The overall age distribution did not show significant differences between the two data sources; however, stroke patients over the age of 70 years were registered significantly more often in the DRG statistics. The rates of systemic thrombolysis were 16.5% in both data sources and the rates of mechanical thrombectomy were 5.6% and 5.9%, respectively. The analysis shows that after a rational limitation of the included cases and based on the place of treatment, there were no statistically significant differences concerning the number of hospitalized patients with ischemic stroke, distribution of gender and age as well as the documented rates of systemic thrombolysis and mechanical thrombectomy. It can therefore be concluded that the well-controlled stroke quality register examined is able to capture a sufficient number of hospitalized acute ischemic stroke cases and treatment rates. Therefore, it appears to be recommendable to adopt the strict Hessian guidelines for data acquisition and control nationwide. In this way a nationwide combined analysis of data from the working group of German stroke registers and the DRG statistics would be possible.
本文综述了在急症医院确定缺血性中风患者治疗实际情况的不同方法。考虑到两种不同流行病学方法的具体优缺点，对德国全国诊断相关组（DRG）统计数据的结构化分析中的病例与质量管理办公室整理的2018年黑森州急性中风治疗（SA_HE）数据进行了具体比较。根据DRG统计数据和SA_HE数据，2018年黑森州分别有16267例和15643例急性缺血性中风患者（国际疾病分类代码I63）接受治疗，男性患者分别占53.7%和54.5%。两个数据源的总体年龄分布没有显著差异；然而，70岁以上的中风患者在DRG统计数据中的登记频率明显更高。两个数据源的全身溶栓率均为16.5%，机械取栓率分别为5.6%和5.9%。分析表明，在对纳入病例进行合理限制并基于治疗地点后，缺血性中风住院患者数量、性别和年龄分布以及记录的全身溶栓和机械取栓率方面没有统计学显著差异。因此可以得出结论，所检查的中风质量登记系统能够充分记录住院急性缺血性中风病例和治疗率。因此，似乎建议在全国范围内采用严格的黑森州数据采集和控制指南。这样就有可能对德国中风登记工作组的数据和DRG统计数据进行全国范围的综合分析。
