Wassélius Johan, Hall Emma, Szolics Alex, Arnberg Fabian, Radhi Hozan, von Euler Mia, Wester Per, Ullberg Teresa, Cronberg Tobias, Ennab Vogel Nicklas, Esbjörnsson Magnus, Jonsson Fredrik, Andersson Tommy, Norrving Bo, Hansen Björn M
Department of Radiology, Skåne University Hospital, Lund, Sweden.
Stroke Imaging Research Group, Department of Clinical Sciences Lund, Lund University, Lund, Sweden.
Eur Stroke J. 2025 Jun 16:23969873251347098. doi: 10.1177/23969873251347098.
Endovascular thrombectomy (EVT) is a significant improvement in the care of acute ischemic stroke (AIS) patients, but only a small portion of patients receive treatment. Our aim was to analyze EVT implementation in Sweden according to a set of key performance indicators (KPIs) for and .
A nationwide prospective registry-based observational study using data from 2018, 2020, and 2022 from the Swedish quality registries for stroke care (Riksstroke and EVAS) and official population statistics. Effectiveness was analyzed using a set of predefined KPIs. To describe procedural and implementation effectiveness in a single comprehensible measure population success rate was derived by multiplying the EVT rate with successful recanalization.
Between 2018 and 2022 EVTs in Sweden increased from 874 to 1474 procedures per year. Correspondingly, the EVT rate (EVT/AIS) increased from 4.1% to 7.3%. Implementation was heterogenous with a six-fold difference between the highest and lowest regions. EVT rates were generally highest in regions with comprehensive stroke centers (CSCs). Procedural effectiveness were similar between all CSCs. The population success-rate increased from 3.4% to 6.4% during the period with large differences between CSCs (range 3.4%-12.4%, in 2022).
By including KPIs for procedural and implementational effectiveness, it is possible to evaluate EVT implementation for the entire stroke population, which is the ultimate objective for healthcare. The population success-rate is capturing procedural implementation effectiveness in a single measure comprehensible for all stake holders and facilitate comparisons over time and between regions, even between regions with different stroke incidence.
血管内血栓切除术（EVT）是急性缺血性卒中（AIS）患者治疗方面的一项重大进展，但只有一小部分患者接受了该治疗。我们的目的是根据一组针对[具体内容缺失]和[具体内容缺失]的关键绩效指标（KPI）来分析瑞典的EVT实施情况。
一项基于全国前瞻性注册的观察性研究，使用了来自瑞典卒中护理质量注册库（Riksstroke和EVAS）2018年、2020年和2022年的数据以及官方人口统计数据。使用一组预定义的KPI分析有效性。为了用一个可理解的单一指标描述手术和实施有效性，通过将EVT率与成功再通率相乘得出总体成功率。
2018年至2022年期间，瑞典每年的EVT手术例数从874例增加到1474例。相应地，EVT率（EVT/AIS）从4.1%提高到7.3%。实施情况存在异质性，最高和最低地区之间相差6倍。在设有综合卒中中心（CSC）的地区，EVT率通常最高。所有CSC之间的手术有效性相似。在此期间，总体成功率从3.4%提高到6.4%，各CSC之间差异较大（2022年范围为3.4%-12.4%）。
通过纳入手术和实施有效性的KPI，可以评估整个卒中人群的EVT实施情况，这是医疗保健的最终目标。总体成功率以一种所有利益相关者都能理解的单一指标体现了手术实施有效性，便于进行时间和地区间的比较，即使是在卒中发病率不同的地区之间。
