The Bigger the Better? Center Volume Dependent Effects on Procedural and Functional Outcome in Established Endovascular Stroke Centers.
GSR-ET
center volume
endovascular stroke therapy
mechanical thrombectomy
procedural volume
stroke
Journal
Frontiers in neurology
ISSN: 1664-2295
Titre abrégé: Front Neurol
Pays: Switzerland
ID NLM: 101546899
Informations de publication
Date de publication:
2022
2022
Historique:
received:
03
12
2021
accepted:
24
01
2022
entrez:
21
3
2022
pubmed:
22
3
2022
medline:
22
3
2022
Statut:
epublish
Résumé
Mechanical thrombectomy (MT) rates for the treatment of acute ischaemic stroke due to large vessel occlusion are steadily increasing, but are delivered in heterogenic settings. We aim to investigate effects of procedural load in centers with established MT-structures by comparing high- vs. low-volume centers with regard to procedural characteristics and functional outcomes. Data from 5,379 patients enrolled in the German Stroke Registry Endovascular Treatment (GSR-ET) between June 2015 and December 2019 were compared between three groups: high volume: ≥180 MTs/year, 2,342 patients; medium volume: 135-179 MTs/year, 2,202 patients; low volume: <135 MTs/year, 835 patients. Univariate analysis and multiple linear and logistic regression analyses were performed to identify differences between high- and low-volume centers. We identified high- vs. low-volume centers to be an independent predictor of shorter intra-hospital (admission to groin puncture: 60 vs. 82 min, β = -26.458; Differences in efficiency measured by procedural times call for analysis and optimization of in-house procedural workflows at regularly used but comparatively low procedural volume MT centers.
Sections du résumé
Background
UNASSIGNED
Mechanical thrombectomy (MT) rates for the treatment of acute ischaemic stroke due to large vessel occlusion are steadily increasing, but are delivered in heterogenic settings. We aim to investigate effects of procedural load in centers with established MT-structures by comparing high- vs. low-volume centers with regard to procedural characteristics and functional outcomes.
Methods
UNASSIGNED
Data from 5,379 patients enrolled in the German Stroke Registry Endovascular Treatment (GSR-ET) between June 2015 and December 2019 were compared between three groups: high volume: ≥180 MTs/year, 2,342 patients; medium volume: 135-179 MTs/year, 2,202 patients; low volume: <135 MTs/year, 835 patients. Univariate analysis and multiple linear and logistic regression analyses were performed to identify differences between high- and low-volume centers.
Results
UNASSIGNED
We identified high- vs. low-volume centers to be an independent predictor of shorter intra-hospital (admission to groin puncture: 60 vs. 82 min, β = -26.458;
Conclusion
UNASSIGNED
Differences in efficiency measured by procedural times call for analysis and optimization of in-house procedural workflows at regularly used but comparatively low procedural volume MT centers.
Identifiants
pubmed: 35309589
doi: 10.3389/fneur.2022.828528
pmc: PMC8925986
doi:
Types de publication
Journal Article
Langues
eng
Pagination
828528Investigateurs
A Reich
(A)
O Nikoubashman
(O)
J Röther
(J)
B Eckert
(B)
M Braun
(M)
G F Hamann
(GF)
E Siebert
(E)
C H Nolte
(CH)
G Bohner
(G)
R M Eckert
(RM)
J Borggrefe
(J)
P Schellinger
(P)
J Berrouschot
(J)
A Bormann
(A)
C Kraemer
(C)
H Leischner
(H)
M Petersen
(M)
F Stögbauer
(F)
T Boeck-Behrens
(T)
S Wunderlich
(S)
A Ludolph
(A)
K H Henn
(KH)
C Gerloff
(C)
J Fiehler
(J)
G Thomalla
(G)
A Alegiani
(A)
J H Schäfer
(JH)
F Keil
(F)
S Tiedt
(S)
L Kellert
(L)
C Trumm
(C)
U Ernemannn
(U)
S Poli
(S)
J Liman
(J)
M Ernst
(M)
K Gröschel
(K)
T Uphaus
(T)
Informations de copyright
Copyright © 2022 Hahn, Gröschel, Tanyildizi, Brockmann, Gröschel, Uphaus and German Stroke Registry-Endovascular Treatment (GSR-ET) Investigators.
Déclaration de conflit d'intérêts
TU reports personal fees from Merck Serono and Pfizer, grants from Else Kröner-Fresenius Stiftung. KG reports personal fees and/or non-financial support from Bayer, Boehringer Ingelheim, Bristol-Meyers Squibb, Daiichi Sankyo, and Pfizer. MH reports personal fees from Bristol-Meyers Squibb, outside of the submitted work. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
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