Echocardiography in acute stroke patients: a nationwide analysis in departments with certified stroke units in Germany.

Autor: Rizos T; Department of Neurology, University of Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany. timolaos.rizos@med.uni-heidelberg.de., Jenetzky E; Faculty of Health/School of Medicine, Witten/Herdecke University, Witten, Germany.; Department for Child and Adolescent Psychiatry, Johannes Gutenberg-University, Mainz, Germany., Nabavi DG; Department of Neurology, Vivantes Klinikum Neukölln, Rudower Str 48, 12351, Berlin, Germany., Haeusler KG; Department of Neurology, University of Würzburg, Würzburg, Germany., Wachter R; Department of Cardiology, University Hospital Leipzig, Leipzig, Germany., Ossenbrink M; LGA InterCert GmbH, Nuremberg, Germany., Ringleb PA; Department of Neurology, University of Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany., Busse O; Deutsche Schlaganfall Gesellschaft, Berlin, Germany.
Jazyk: angličtina
Zdroj: Neurological research and practice [Neurol Res Pract] 2023 Jan 19; Vol. 5 (1), pp. 3. Date of Electronic Publication: 2023 Jan 19.
DOI: 10.1186/s42466-022-00229-1
Abstrakt: Background: Echocardiography is highly relevant in patients with ischemic stroke or TIA. Utilization of routine echocardiographic examinations [transthoracic (TTE) or transesophageal (TEE)] on stroke units remains however unknown. To representatively examine echocardiographic rates on stroke units in Germany and to evaluate structural factors that may influence the decision to conduct echocardiography.
Methods: A nationwide analysis was performed by using certification audit data of all primary and comprehensive stroke centers (pSC and cSC) in Germany.
Results: Structural and organizational requirements of 310 departments (cSCs: 42.6%) were extracted. Median TTE rate was 63.3% (IQR 39.3-80.8), median TEE rate 21.3% (IQR 16.4-29.5). A cardiological department on site was present in 74.2%, and they were associated with higher TEE rates. TTE rates decreased with increasing numbers of patients (p = 0.026). Likewise, TEE rates decreased with increasing numbers of patients (p = 0.006), mediated by departments with cSCs (p = 0.008 for cSCs vs p = 0.230 for pSCs). TTE rates were far more inhomogeneously distributed than TEE rates and higher in pSCs (p = 0.011). Overall, 12.9% of centers did not perform any echocardiographic examination in at least 50% of all stroke patients.
Conclusion: More detailed recommendations regarding echocardiography should be included in future guidelines. Moreover, evaluating the impact of echocardiographic examinations on long-term prognosis in stroke patients should be focus of further evaluations.
(© 2023. The Author(s).)
Databáze: MEDLINE
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