- •We analyzed administrative data of a total of 458,753 stroke patients in Germany.
- •The overall rate of intravenous thrombolysis increased from 5.6% to 10.2%.
- •Every 46th stroke patient <80 years was treated interventionally in 2012.
- •Rate of specialized stroke unit care is still lower in women than in men.
- •A “Yentl-syndrome” cannot be excluded in cases of minor stroke symptoms.
Promising advances in stroke medicine have been reported recently regarding specialized stroke unit (SU) care, expansion of the time window of iv thrombolysis (IVT), mechanical thrombectomy (MT), and decompressive hemicraniectomy (DHC) for malignant brain infarction. It remains unclear to what extent new evidence of therapeutic procedures is transferred to the “real-world” of everyday hospital care.
We analyzed epidemiologic and procedural therapeutic trends of hospitalized acute stroke patients in Germany by the comparison of administrative hospital data of the years 2008 (n = 219,359) and 2012 (n = 239,394).
Proportion of specialized SU care rose from 43.4% to 56.9%. Even in age-matched analysis women were less likely to obtain this procedure. Rate of IVT increased from 5.6% to 10.2%. 32% of IVT therapies in 2012 were performed in patients over 80 years. Number of MT increased exponentially from 298 to 3906 procedures. Number of DHC did not increase significantly (2008 = 636; 2011 = 796).
A strong momentum in transferring scientific insights to the “real-world” stroke care in Germany was documented. Increase of IVT therapy is largely due to the increase of off-label treatment. Almost every 46th patient <80 years was treated by MT in 2012. Despite proven benefits in selected patients, utilization of DHC remained almost stable.
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Published online: July 29, 2014
Accepted: July 21, 2014
Received in revised form: July 2, 2014
Received: June 4, 2014
☆In the name of the Working group of the Northwest-German Stroke Circle.
© 2014 Elsevier B.V. Published by Elsevier Inc. All rights reserved.