Detailed Information on Publication Record
2022
Between-Center Variation in Outcome After Endovascular Treatment of Acute Stroke: Analysis of Two Nationwide Registries
JANSSEN, Paula M, Katrine van OVERHAGEN, Jan VINKLÁREK, Bob ROOZENBEEK, H Bart VAN DER WORP et. al.Basic information
Original name
Between-Center Variation in Outcome After Endovascular Treatment of Acute Stroke: Analysis of Two Nationwide Registries
Authors
JANSSEN, Paula M (guarantor), Katrine van OVERHAGEN, Jan VINKLÁREK (203 Czech Republic, belonging to the institution), Bob ROOZENBEEK, H Bart VAN DER WORP, Charles B. MAJOIE, Michal BAR, David ČERNÍK, Roman HERZIG, Lubomir JURÁK, Svatopluk OSTRÝ, Robert MIKULÍK (203 Czech Republic, belonging to the institution), Hester F LINGSMA and Diederik W J DIPPEL
Edition
Circulation: Cardiovascular Quality and Outcomes logo, PHILADELPHIA, LIPPINCOTT WILLIAMS & WILKINS, 2022, 1941-7705
Other information
Language
English
Type of outcome
Článek v odborném periodiku
Field of Study
30201 Cardiac and Cardiovascular systems
Country of publisher
United States of America
Confidentiality degree
není předmětem státního či obchodního tajemství
References:
Impact factor
Impact factor: 6.900
RIV identification code
RIV/00216224:14110/22:00126930
Organization unit
Faculty of Medicine
UT WoS
000767469300005
Keywords in English
icenter study; thrombectomy; stroke; hospitals; quality improvement
Tags
International impact, Reviewed
Změněno: 5/4/2023 13:49, Mgr. Tereza Miškechová
Abstract
V originále
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.
Links
| 90128, large research infrastructures |
|