Podrobný výpis o publikaci

JANSSEN, Paula M, Katrine van OVERHAGEN, Jan VINKLÁREK, Bob ROOZENBEEK, H Bart VAN DER WORP, Charles B. MAJOIE, Michal BAR, David ČERNÍK, Roman HERZIG, Lubomir JURÁK, Svatopluk OSTRÝ, Robert MIKULÍK, Hester F LINGSMA a Diederik W J DIPPEL. Between-Center Variation in Outcome After Endovascular Treatment of Acute Stroke: Analysis of Two Nationwide Registries. Circulation: Cardiovascular Quality and Outcomes logo. PHILADELPHIA: LIPPINCOTT WILLIAMS & WILKINS, 2022, roč. 15, č. 3, s. 1-10. ISSN 1941-7705. Dostupné z: https://dx.doi.org/10.1161/CIRCOUTCOMES.121.008180.

Další formáty: BibTeX LaTeX RIS

TY  - JOUR
ID  - 2225477
AU  - Janssen, Paula M - Overhagen, Katrine van - Vinklárek, Jan - Roozenbeek, Bob - van der Worp, H Bart - Majoie, Charles B. - Bar, Michal - Černík, David - Herzig, Roman - Jurák, Lubomir - Ostrý, Svatopluk - Mikulík, Robert - Lingsma, Hester F - Dippel, Diederik W J
PY  - 2022
TI  - Between-Center Variation in Outcome After Endovascular Treatment of Acute Stroke: Analysis of Two Nationwide Registries
JF  - Circulation: Cardiovascular Quality and Outcomes logo
VL  - 15
IS  - 3
SP  - 1-10
EP  - 1-10
PB  - LIPPINCOTT WILLIAMS & WILKINS
SN  - 19417705
KW  - icenter study
KW  - thrombectomy
KW  - stroke
KW  - hospitals
KW  - quality improvement
UR  - https://www.ahajournals.org/doi/10.1161/CIRCOUTCOMES.121.008180
N2  - Background: Insight in differences in patient outcomes between endovascular thrombectomy (EVT) centers can help to improve stroke care. We assessed between-center variation in functional outcome of patients with acute ischemic stroke who were treated with EVT. We analyzed to what extent this variation may be explained by modifiable center characteristics. Methods: We used nationwide registry data of patients with stroke treated with EVT in the Netherlands and in the Czech Republic. Primary outcome was modified Rankin Scale score at 90 days as an indicator of disability. We used multilevel ordinal logistic regression to quantify the between-center variation in outcomes and the impact of patient and center characteristics. Between-center variation was expressed as the relative difference in odds of a more favorable modified Rankin Scale score between a relatively better performing center (75th percentile) and a relatively worse performing center (25th percentile). Results: We included a total of 4518 patients treated in 33 centers. Adjusted for patient characteristics, the odds of a more favorable outcome in a center at the 75th percentile of the outcome distribution were 1.46 times higher (95% CI, 1.31-1.70) than the odds in a center at the 25th percentile. Adjustment for center characteristics, including the median time between stroke onset and reperfusion per center, decreased this relative difference in odds to 1.30 (95% CI, 1.18-1.50, P=0.01). This translates into an absolute difference in likelihood of good functional outcome of 8% after adjustment for patient characteristics and to 5% after further adjustment for modifiable center characteristics. Conclusions: The considerable between-center variation in patient outcomes after EVT for acute ischemic stroke could be largely explained by center-specific characteristics, such as time to reperfusion. Improvement of these parameters may likely result in a decrease in center-specific differences, and an overall improvement in outcome of patients with acute ischemic stroke.
ER  -

Základní údaje
Originální název	Between-Center Variation in Outcome After Endovascular Treatment of Acute Stroke: Analysis of Two Nationwide Registries
Autoři	JANSSEN, Paula M (garant), Katrine van OVERHAGEN, Jan VINKLÁREK (203 Česká republika, domácí), Bob ROOZENBEEK, H Bart VAN DER WORP, Charles B. MAJOIE, Michal BAR, David ČERNÍK, Roman HERZIG, Lubomir JURÁK, Svatopluk OSTRÝ, Robert MIKULÍK (203 Česká republika, domácí), Hester F LINGSMA a Diederik W J DIPPEL.
Vydání	Circulation: Cardiovascular Quality and Outcomes logo, PHILADELPHIA, LIPPINCOTT WILLIAMS & WILKINS, 2022, 1941-7705.

Další údaje
Originální jazyk	angličtina
Typ výsledku	Článek v odborném periodiku
Obor	30201 Cardiac and Cardiovascular systems
Stát vydavatele	Spojené státy
Utajení	není předmětem státního či obchodního tajemství
WWW	URL
Impakt faktor	Impact factor: 6.900
Kód RIV	RIV/00216224:14110/22:00126930
Organizační jednotka	Lékařská fakulta
Doi	http://dx.doi.org/10.1161/CIRCOUTCOMES.121.008180
UT WoS	000767469300005
Klíčová slova anglicky	icenter study; thrombectomy; stroke; hospitals; quality improvement
Štítky	14110127, rivok
Příznaky	Mezinárodní význam, Recenzováno
Změnil	Změnila: Mgr. Tereza Miškechová, učo 341652. Změněno: 5. 4. 2023 13:49.

Anotace
Background: Insight in differences in patient outcomes between endovascular thrombectomy (EVT) centers can help to improve stroke care. We assessed between-center variation in functional outcome of patients with acute ischemic stroke who were treated with EVT. We analyzed to what extent this variation may be explained by modifiable center characteristics. Methods: We used nationwide registry data of patients with stroke treated with EVT in the Netherlands and in the Czech Republic. Primary outcome was modified Rankin Scale score at 90 days as an indicator of disability. We used multilevel ordinal logistic regression to quantify the between-center variation in outcomes and the impact of patient and center characteristics. Between-center variation was expressed as the relative difference in odds of a more favorable modified Rankin Scale score between a relatively better performing center (75th percentile) and a relatively worse performing center (25th percentile). Results: We included a total of 4518 patients treated in 33 centers. Adjusted for patient characteristics, the odds of a more favorable outcome in a center at the 75th percentile of the outcome distribution were 1.46 times higher (95% CI, 1.31-1.70) than the odds in a center at the 25th percentile. Adjustment for center characteristics, including the median time between stroke onset and reperfusion per center, decreased this relative difference in odds to 1.30 (95% CI, 1.18-1.50, P=0.01). This translates into an absolute difference in likelihood of good functional outcome of 8% after adjustment for patient characteristics and to 5% after further adjustment for modifiable center characteristics. Conclusions: The considerable between-center variation in patient outcomes after EVT for acute ischemic stroke could be largely explained by center-specific characteristics, such as time to reperfusion. Improvement of these parameters may likely result in a decrease in center-specific differences, and an overall improvement in outcome of patients with acute ischemic stroke.

Anotace

Background: Insight in differences in patient outcomes between endovascular thrombectomy (EVT) centers can help to improve stroke care. We assessed between-center variation in functional outcome of patients with acute ischemic stroke who were treated with EVT. We analyzed to what extent this variation may be explained by modifiable center characteristics. Methods: We used nationwide registry data of patients with stroke treated with EVT in the Netherlands and in the Czech Republic. Primary outcome was modified Rankin Scale score at 90 days as an indicator of disability. We used multilevel ordinal logistic regression to quantify the between-center variation in outcomes and the impact of patient and center characteristics. Between-center variation was expressed as the relative difference in odds of a more favorable modified Rankin Scale score between a relatively better performing center (75th percentile) and a relatively worse performing center (25th percentile). Results: We included a total of 4518 patients treated in 33 centers. Adjusted for patient characteristics, the odds of a more favorable outcome in a center at the 75th percentile of the outcome distribution were 1.46 times higher (95% CI, 1.31-1.70) than the odds in a center at the 25th percentile. Adjustment for center characteristics, including the median time between stroke onset and reperfusion per center, decreased this relative difference in odds to 1.30 (95% CI, 1.18-1.50, P=0.01). This translates into an absolute difference in likelihood of good functional outcome of 8% after adjustment for patient characteristics and to 5% after further adjustment for modifiable center characteristics. Conclusions: The considerable between-center variation in patient outcomes after EVT for acute ischemic stroke could be largely explained by center-specific characteristics, such as time to reperfusion. Improvement of these parameters may likely result in a decrease in center-specific differences, and an overall improvement in outcome of patients with acute ischemic stroke.

Návaznosti
90128, velká výzkumná infrastruktura	Název: CZECRIN III