Mechanical Thrombectomy Quality Indicators Study in Czech Stroke Centers: Results of the METRICS Study.

Autor: Köcher M; Department of Radiology and Neurology, Palacký University Faculty of Medicine and University Hospital Olomouc, Czech Republic., Šaňák D; Department of Radiology and Neurology, Palacký University Faculty of Medicine and University Hospital Olomouc, Czech Republic. Electronic address: daniel.sanak@centrum.cz., Zapletalová J; Department of Medical Biophysics and Statistics, Palacký University Faculty of Medicine Olomouc, Czech Republic., Cihlář F; Department of Radiology and Neurology, Masaryk's Hospital Faculty of Health Studies, J.E. Purkinje University, KZ a.s., Ústí nad Labem, Czech Republic., Czerny D; Department of Radiology and Neurology, University of Ostrava Faculty of Medicine and University Hospital, Ostrava, Czech Republic., Černík D; Department of Radiology and Neurology, University of Ostrava Faculty of Medicine and University Hospital, Ostrava, Czech Republic., Duras P; Department of Radiology and Neurology, Charles University Faculty of Medicine and University Hospital Plzen, Czech Republic., Fiksa J; Department of Neurology and 2nd Department of Internal Medicine, Charles University 1st Faculty of Medicine and General University Hospital Prague, Czech Republic., Hustý J; Department of Neurology and Radiology, Hospital Na Homolce Prague, Czech Republic., Jurák L; Department of Neurology and Radiology, Hospital Liberec, Czech Republic., Kovář M; Department of Neurology and Radiology, Hospital Na Homolce Prague, Czech Republic., Lacman J; Department of Radiology and Neurology, Central Military University Hospital Prague, Czech Republic., Pádr R; Department of Radiology and Neurology, Charles University 2nd Faculty of Medicine and University Hospital Motol Prague, Czech Republic., Procházka P; Department of Neurology and 2nd Department of Internal Medicine, Charles University 1st Faculty of Medicine and General University Hospital Prague, Czech Republic., Raupach J; Department of Radiology and Neurology, Charles University Faculty of Medicine and University Hospital, Hradec Králové, Czech Republic., Reiser M; Department of Neurology and Radiology, Hospital České Budějovice, Czech Republic., Rohan V; Department of Radiology and Neurology, Masaryk University Faculty of Medicine, University Hospital Brno, Czech Republic., Roubec M; Department of Radiology and Neurology, Charles University Faculty of Medicine and University Hospital Plzen, Czech Republic., Sova J; Department of Neurology and Radiology, Hospital České Budějovice, Czech Republic., Šercl M; Department of Neurology and Radiology, Hospital Liberec, Czech Republic., Škorňa M; Department of Radiology and Neurology, Masaryk University Faculty of Medicine, University Hospital Brno, Czech Republic., Šimůnek L; Department of Radiology and Neurology, Charles University Faculty of Medicine and University Hospital, Hradec Králové, Czech Republic., Šnajdrová A; Department of Neurology and Radiology, Hospital Na Homolce Prague, Czech Republic., Šrámek M; Department of Radiology and Neurology, Central Military University Hospital Prague, Czech Republic., Tomek A; Department of Radiology and Neurology, Charles University 2nd Faculty of Medicine and University Hospital Motol Prague, Czech Republic.
Jazyk: angličtina
Zdroj: Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association [J Stroke Cerebrovasc Dis] 2022 Apr; Vol. 31 (4), pp. 106308. Date of Electronic Publication: 2022 Jan 29.
DOI: 10.1016/j.jstrokecerebrovasdis.2022.106308
Abstrakt: Background and Purpose: Rigorous and regular evaluation of defined quality indicators is crucial for further improvement of both technical and clinical results after mechanical thrombectomy (MT) for acute ischemic stroke (AIS). Following the recent international multi-society consensus quality indicators, we aimed to assess trend in these indicators on national level.
Material and Methods: The prospective multicenter study (METRICS) was conducted in Czech Republic (CR) in year 2019. All participating centers collected technical and clinical data including defined quality indicators and results were subsequently compared with those from year 2016.
Results: In the 2019, 1375 MT were performed in the CR and 1178 (86%) patients (50.3% males, mean age 70.5 ± 13.0 years) were analyzed. Recanalization (TICI 2b-3) was achieved in 83.7% of patients and 46.2% of patients had good 3-month clinical outcome. Following time intervals were shortened in comparison to 2016: "hospital arrival - GP" (77 vs. 53 min; p<0.0001), "hospital arrival - maximal achieved recanalization" (122 vs. 93 min; p<0.0001), and "stroke onset - maximal achieved recanalization" (240 vs. 229 min; p p<0.0001). More patients with tandem occlusion were treated in 2019 (7.8 vs. 16.5%; p<0.0001) and more secondary transports were in 2019 (31.3 vs. 37.8%; p=0.002). No difference was found in 3-month clinical outcome and in the rate of periprocedural complications. Results of the METRICS study met all criteria of multi-society consensus quality indicators.
Conclusion: Nationwide comparison between 2016 and 2019 showed improvement in the key time intervals, but without better overall clinical outcomes after MT.
Competing Interests: Conflict of Interest The authors declare that they have no conflict of interest.
(Copyright © 2022 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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