Summary

Since 2003 a growing number of Austrian stroke units have documented stroke relevant data in a national register. The register is serviced by the BIQG, a business unit of Gesundheit Österreich GmbH (GÖG) and was founded in cooperation with the Austrian Society of Stroke Research (ÖGSF).

Meanwhile (2007) 23 Austrian stroke units participate actively in the Austrian Stroke Unit Register and we aim at including all Austrian stroke units.

Data entry is online, anonymous and password secured. The register contains epidemiological, clinical, diagnostic and therapeutic data, as well as scores necessary for the compliance with the structure criteria. Follow up data are evaluated after three months. The participating centres have the possibility to dispose of their own data. Scientific analyses of the entire register require an application and the approval of an expert committee.

Information and data analyses 2003 to 2007
(Last up date May 2007)

Content (documents are availabe in German only!)
1. General information about the register
2. Participating stroke units
3. Geographical dispersal of stroke units in Austria
4. Austrian wide analyses
5. Benchmarking-analyses

Information
Austrian Stroke Unit-Register

If you have any questions concerning the Austrian Stroke Unit Register or if you want to participate please contact:

Gesundheit Österreich GmbH
Geschäftsbereich BIQG
Dr. Christine Hofer, E-Mail: , Extension number 295
Stubenring 6, 1010 Wien
Tel. 00431/51561

www.oebig.org www.goeg.at

ÖGSF - Austrian Society of Stroke Research
Prim. Univ. Prof. Dr. Wilfried Lang
Neurologische Abteilung
KH Barmherzige Brüder
Große Mohrengasse 9, A-1020 Wien
Tel: 01-21121-3241
Fax: 01-21121-3245
E-Mail:

Univ-Prof. Prim. Dr. Michael Brainin
Neurologische Abteilung
Landesklinikum Donauregion Gugging
Hauptstraße 2, A-3400 Gugging
Tel.: 0043 (0) 2243/90555-371
Fax.: 0043 (0) 2243/90555-338
E-Mail:

Organisation

• Administration by GÖG/BIQS
• Expert committee (discussion of data, decisions, medical content supervision and analyses)

Decentralized data entry

• Password secured online data entry mask
• Anonymous patient data
• 24 data entry centres from 2003 - 2007, 23 centres (2007)

Functions for participating centres

• Full view of patient data
• Follow-up reminder
• Data collection of the centre
• Statistic tools (benchmarking, Austrian wide standard analyses)
• Data pool for scientific analyses

Online data entry mask

Overview of a dataset

The following data are recorded for patients with stroke:

Participants in the Austrian Stroke Unit-Register

(Data from 2003 - 2007)

AKH Linz, BKH Kufstein, Christian-Doppler-Klinik Salzburg, KH Barmherzige Brüder Linz, KH Barmherzige Brüder Wien, KH Göttlicher Heiland Wien, KH Hietzing Wien, KH Oberwart, KH Rudolfstiftung Wien, KH Wiener Neustadt, LK Donauregion Gugging, LK Mostviertel Amstetten, LK Waldviertel Horn, LK Weinviertel Mistelbach, LKH Vöcklabruck, LKH Klagenfurt, LNK Sigmund Freud Graz, LNK Wagner-Jauregg Linz, Medizinische Universität Innsbruck, Neurologisches Zentrum Rosenhügel Wien - I. Neurolog. Abt., Neurologisches Zentrum RosenhügelWien - II. Neurolog. Abt., Otto Wagner Spital Wien, Universitätsklinikum Graz, Wilhelminenspital, Gesundheit Österreich GmbH/Geschäftsbereich BIQG, Expertengremium an der GÖG/BIQG

Planned Stroke Units according to. ÖKAP/GGP 2003

Established Stroke Units per 5/2007

Databasics for the following analyses

Dataset per May 2007

• Data from 2003 - 2007 of 24 participating centre
• 17.790 Datasets of stroke patients
• 16.300 Datasets of stroke patients with valid discharge date
• Database for other analysis
  (Attention different number of cases, notice the filter!)

Standard data analyses
2003 to 2007

• Number of admission (entered datasets)
• General information (age, sex, NIH at admission, syndrome)
• Interface Ambulance - Stroke Unit (Time event - hospital admission, transport variables)
• Time chain of medical examination (time hospital admission - first imaging, time hospital admission - first examination of brain leading vessels)
• Therapy (rate of thrombolysis)
• Quality of outcome (success rates depending on the NIH at admission)

NIH-Score at admission

NIH-score at admission for patients with stroke (numbers in %)

Sex

Sex of patients with stroke (numbers in %)
Left: male, right: female

Age

Age of patients with stroke (numbers in %)

Transport mode

Different transport variants to the hospital of patients with stroke (numbers in %).
Transport mode from left to right: ambulance with emergency physician, ambulance without emergency physician, helicopter, private, other.

Approximately 14% of the patients are transferred from another hospital, others are admitted directly.

Ambulance with emergency physician declines.

Time from event to hospital admission

Patients with stroke with known event time (numbers in %)

40% of the patients arrive within 90 min at the hospital

Time from hospital admission to first imaging (CCT, MRI)

Stroke patients with imaging after hospital admission. (numbers in %)

First imaging within 30 / 60 min: 53% / 74%

Time from hospital admission to first examination of brain leading vessels (Doppler, Duplex, MRA, other)

Patients with ischemic stroke (numbers in %)

First examination within 2 hours: 45%

Rate of thrombolysis (i.v. or i.a.)

Patients with ischemic stroke
(left: patients without thrombolysis, right: patients with thrombolysis)

Percent

Absolute Data

Average rate of thrombolysis: 8 %

Thrombolysis rate (i.v. or i.a.) for selected patients

Patients with ischemic stroke, age < 80, NIH at admission > 3, hospital admission within 2 hours after the event.
(left: patients without thrombolysis, right: patients with thrombolysis)

Percent

Absolute Data

Average thrombolysis rate up to date: 41%

Outcome - "mild" strokes

Percentage of patients with "mild" stroke (NIH-score at admission > 0 and < 6), achieving either a Rankin score of 0 (left) or >0 (right) at the time of discharge

On average 24 % of patients with "mild" stroke achieve a Rankin score of 0 at the time of discharge

Outcome - "moderate" strokes

Percentage of patients with "moderate" stroke (NIH-score at admission between 6 and 13) achieving a Rankin score of 0 or 1 (left) and those with a score >1 (right) at the time of discharge.

On average 16 % of patients with a "moderate" stroke achieve a Rankin score <= 1 at the time of discharge

Outcome - "severe" strokes

Percentage of patients with "severe" strokes (NIH-score at admission> 13) achieving a Rankin score of 0, 1 or 2 (left) and those with a Rankin score >2 (right) at the time of discharge.

On average 5 % of patients with "severe" stroke achieved a Rankin score <= 2 at discharge

Benchmarking
a service for participating centres

• Number of admitted patients (number entered data)
• General information (age, NIH, Barthel, Rankin at admission, syndrome)
• Interface ambulance - stroke unit (time event - hospital admission)
• Time chain of medical examination (time hospital admission - first imaging, time hospital admission - first examination brain leading vessels)
• Therapy, secondary prevention (thrombolysis rate, clinical examination, secondary prevention)
• Progress (length of stay at the stroke unit, complication rate, patient's state)
• Follow up (Follow up rate, secondary prevention, mortality, Rankin outcome)

Example for benchmarking

Hospital admission < 3 hours after the event
Percentage of patients with stroke admitted at the hospital within 3 hours of the event.
Each column represents one stroke unit for the year 2007.
yellow = own centre; hatched = less than 30 cases
red line = minimum value, green line = target value, pink line = Austrian average

Hospital admission < 3 hours for 65 % of the patients with stroke. The target value is achieved by all centres.