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Quality of care of acute ischemic stroke in Germany 2018.
Abstract In this overview the current quality of acute in-hospital care of stroke patients in Germany in 2018 is described based on standardized and evidence-based quality indicators. For this purpose the reports of the regional quality assurance projects for stroke care, which collaborated within the German-speaking Stroke Registers Study Group (ADSR) were analyzed. Overall, more than 280,000 acute admissions of stroke patients were documented in the included quality assurance projects. The results regarding the defined 16 quality indicators comprising diagnostics, acute treatment, rehabilitation and secondary pr...
Source: Der Nervenarzt - April 29, 2020 Category: Neurology Authors: Misselwitz B, Grau A, Berger K, Bruder I, Burmeister C, Hermanek P, Hohnhold R, Koennecke HC, Matthis C, Heuschmann PU Tags: Nervenarzt Source Type: research

Mobile Stroke Units: Current and Future Impact on Stroke Care
Semin Neurol DOI: 10.1055/s-0040-1722724Ischemic stroke is a leading cause of death and major disability that impacts societies across the world. Earlier thrombolysis of blocked arteries with intravenous tissue plasminogen activator (tPA) and/or endovascular clot extraction is associated with better clinical outcomes. Mobile stroke units (MSU) can deliver faster tPA treatment and rapidly transport stroke patients to centers with endovascular capabilities. Initial MSU trials in Germany indicated more rapid tPA treatment times using MSUs compared with standard emergency room treatment, a higher proportion of patients treated...
Source: Seminars in Neurology - January 28, 2021 Category: Neurology Authors: Bowry, Ritvij Grotta, James C. Tags: Review Article Source Type: research

The “Flying Intervention Team”: A Novel Stroke Care Concept for Rural Areas
Background: Endovascular treatment of large vessel occlusion in acute ischemic stroke patients is difficult to establish in remote areas, and time dependency of treatment effect increases the urge to develop health care concepts for this population.Summary: Current strategies include direct transportation of patients to a comprehensive stroke center (CSC) ( “mothership model”) or transportation to the nearest primary stroke center (PSC) and secondary transfer to the CSC (“drip-and-ship model”). Both have disadvantages. We propose the model “flying intervention team.” Patients will be transported to the nearest ...
Source: Cerebrovascular Diseases - April 13, 2021 Category: Neurology Source Type: research

The "Flying Intervention Team": A Novel Stroke Care Concept for Rural Areas
Cerebrovasc Dis. 2021 Apr 13:1-8. doi: 10.1159/000514845. Online ahead of print.ABSTRACTBACKGROUND: Endovascular treatment of large vessel occlusion in acute ischemic stroke patients is difficult to establish in remote areas, and time dependency of treatment effect increases the urge to develop health care concepts for this population.SUMMARY: Current strategies include direct transportation of patients to a comprehensive stroke center (CSC) ("mothership model") or transportation to the nearest primary stroke center (PSC) and secondary transfer to the CSC ("drip-and-ship model"). Both have disadvantages. We propose the mod...
Source: Rural Remote Health - April 13, 2021 Category: Rural Health Authors: Gordian Jan Hubert Frank Kraus Christian Maegerlein Sabine Platen Benjamin Friedrich Hans-Ulrich Kain Thomas Witton-Davies Nikolai Dominik Hubert Claus Zimmer Philip M Bath Heinrich J Audebert Roman L Haberl Source Type: research

Pharyngeal electrical stimulation for early decannulation in tracheotomised patients with neurogenic dysphagia after stroke (PHAST-TRAC): a prospective, single-blinded, randomised trial
Publication date: Available online 28 August 2018Source: The Lancet NeurologyAuthor(s): Rainer Dziewas, Rebecca Stellato, Ingeborg van der Tweel, Ernst Walther, Cornelius J Werner, Tobias Braun, Giuseppe Citerio, Mitja Jandl, Michael Friedrichs, Katja Nötzel, Milan R Vosko, Satish Mistry, Shaheen Hamdy, Susan McGowan, Tobias Warnecke, Paul Zwittag, Philip M Bath, Tobias Braun, Rainer Dziewas, Michael FriedrichsSummaryBackgroundDysphagia after stroke is common, especially in severely affected patients who have had a tracheotomy. In a pilot trial, pharyngeal electrical stimulation (PES) improved swallowing function in this ...
Source: The Lancet Neurology - August 29, 2018 Category: Neurology Source Type: research

Mobile Stroke Units: Bringing Treatment to the Patient
AbstractPurpose of reviewMobile stroke units (MSUs) have revolutionized emergency stroke care by delivering pre-hospital thrombolysis faster than conventional ambulance transport and in-hospital treatment. This review discusses the history of MSUs technological development, current operations and research, cost-effectiveness, and future directions.Recent findingsMultiple prospective and retrospective studies have shown that MSUs deliver acute ischemic stroke treatment with intravenous recombinant tissue plasminogen activator (IV r-tPA) approximately 30  min faster than conventional care. The 90-day modified Rankin Scores ...
Source: Current Treatment Options in Neurology - February 5, 2020 Category: Neurology Source Type: research

Interdisciplinary networking for optimal treatment decision-making : Fast decision-making in acute ischemic stroke management
This article presents a concept for supraregional stroke care by means of networking all involved actors in the prehospital as well as in the in-hospital area. Further needs analyses should ensure the implementation as well as the generalizability to different regions.PMID:34232343 | DOI:10.1007/s00117-021-00876-6
Source: Der Radiologe - July 7, 2021 Category: Radiology Authors: Karl Egger Ingmar Gergel Hannah Syrek Source Type: research

Patient Pathways During Acute in-Hospital Stroke Treatment: A Qualitative Multi-Method Study
Discussion:Our results show that most direct staff-patient interactions are focussed within one phase, with a smaller number of interactions extending to other phases, and no professional (group) with direct patient interactions cover more than two phases of the acute stroke pathway. Future research should investigate how the pathways described here are experienced from the patient perspective, including how the organisation of visible care processes may influence patient satisfaction. Findings can be translated to accessible patient information resources as well as input for digitalisation efforts, provider orientation an...
Source: International Journal of Integrated Care - February 21, 2022 Category: Nursing Source Type: research

Post-stroke Rehabilitation of Severe Upper Limb Paresis in Germany – Toward Long-Term Treatment With Brain-Computer Interfaces
Severe upper limb paresis can represent an immense burden for stroke survivors. Given the rising prevalence of stroke, restoration of severe upper limb motor impairment remains a major challenge for rehabilitation medicine because effective treatment strategies are lacking. Commonly applied interventions in Germany, such as mirror therapy and impairment-oriented training, are limited in efficacy, demanding for new strategies to be found. By translating brain signals into control commands of external devices, brain-computer interfaces (BCIs) and brain-machine interfaces (BMIs) represent promising, neurotechnology-based alte...
Source: Frontiers in Neurology - November 18, 2021 Category: Neurology Source Type: research

Is MRI a necessary addition to CT for stroke patients?
Is it necessary for patients with acute ischemic stroke to undergo both CT an...Read more on AuntMinnie.comRelated Reading: Rapid MRI for ED stroke evaluation cuts costs, hospital length of stay German radiologists take to sky to reach stroke patients Disparities remain in neuroimaging utilization for stroke Using AI with head CT helps clinicians localize hemorrhage Do all ED patients presenting with TIA get complete imaging workup?
Source: AuntMinnie.com Headlines - July 21, 2022 Category: Radiology Source Type: news

Bringing Emergency Neurology to Ambulances: Mobile Stroke Unit
Semin Respir Crit Care Med 2017; 38: 713-717 DOI: 10.1055/s-0037-1607994Ischemic stroke results from blocked arteries in the brain, with earlier thrombolysis with intravenous tissue plasminogen activator (tPA) and/or mechanical thrombectomy resulting in improved clinical outcomes. Mobile Stroke Unit (MSU) can speed up the treatment with tPA and facilitate faster triage for patients to hospitals for mechanical thrombectomy. The first registry-based MSU study in Germany demonstrated faster treatment times with tPA using a MSU, a higher proportion of patients being treated within the first “golden hour,” and a suggestion ...
Source: Seminars in Respiratory and Critical Care Medicine - December 20, 2017 Category: Respiratory Medicine Authors: Bowry, Ritvij Grotta, James C. Tags: Review Article Source Type: research

Smartphone video algorithm analyzes stroke risk factors
Motion analysis of smartphone-recorded video can detect narrowed neck arteries...Read more on AuntMinnie.comRelated Reading: Is MRI a necessary addition to CT for stroke patients? Do ED patients with psychiatric symptoms need head CT? Rapid MRI for ED stroke evaluation cuts costs, hospital length of stay MRI shows that brain health is linked to cardiovascular health German radiologists take to sky to reach stroke patients
Source: AuntMinnie.com Headlines - August 19, 2022 Category: Radiology Source Type: news

Health economic evaluation of the 'Flying Intervention Team as a novel stroke care concept for rural areas: study protocol of the TEMPiS-GÖA study
The objective of the present paper is to describe the methods for the economic evaluation (TEMPiS-Gesundheitsökonomische Analyse (TEMPiS-GÖA)) alongside the TEMPiS-FIT study to determine whether the new form of care is cost-effective compared with standard care. Methods and analysis The within-trial cost-effectiveness analysis (CEA) and cost–utility analysis (CUA) will be performed from a statutory health insurance perspective as well as from a societal perspective over the time horizon of 12 months after the patients’ hospital discharge. Direct costs from outpatient and inpatient care are coll...
Source: BMJ Open - September 20, 2022 Category: General Medicine Authors: Coors, M., Flemming, R., Schüttig, W., Hubert, G. J., Hubert, N. D., Sundmacher, L. Tags: Open access, Health economics Source Type: research

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