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

Abstract 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...
Ausführliche Beschreibung

Gespeichert in:

Autor*in:	Timolaos Rizos [verfasserIn] Ekkehart Jenetzky [verfasserIn] Darius Günther Nabavi [verfasserIn] Karl Georg Haeusler [verfasserIn] Rolf Wachter [verfasserIn] Martin Ossenbrink [verfasserIn] Peter Arthur Ringleb [verfasserIn] Otto Busse [verfasserIn]

Format:	E-Artikel
Sprache:	Englisch

Erschienen:	2023

Schlagwörter:	Ischemic stroke TIA Echocardiography Stroke unit Guidelines

Übergeordnetes Werk:	In: Neurological Research and Practice - BMC, 2019, 5(2023), 1, Seite 8
Übergeordnetes Werk:	volume:5 ; year:2023 ; number:1 ; pages:8

Links:	Link aufrufen Link aufrufen Link aufrufen Journal toc

DOI / URN:	10.1186/s42466-022-00229-1

Katalog-ID:	DOAJ081638450

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520			\|a Abstract 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.
650		4	\|a Ischemic stroke
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allfields	10.1186/s42466-022-00229-1 doi (DE-627)DOAJ081638450 (DE-599)DOAJ36a6660fcb95468398706d92e3ed5d5b DE-627 ger DE-627 rakwb eng RC321-571 RC346-429 Timolaos Rizos verfasserin aut Echocardiography in acute stroke patients: a nationwide analysis in departments with certified stroke units in Germany 2023 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Abstract 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. Ischemic stroke TIA Echocardiography Stroke unit Guidelines Neurosciences. Biological psychiatry. Neuropsychiatry Neurology. Diseases of the nervous system Ekkehart Jenetzky verfasserin aut Darius Günther Nabavi verfasserin aut Karl Georg Haeusler verfasserin aut Rolf Wachter verfasserin aut Martin Ossenbrink verfasserin aut Peter Arthur Ringleb verfasserin aut Otto Busse verfasserin aut In Neurological Research and Practice BMC, 2019 5(2023), 1, Seite 8 (DE-627)1038162947 25243489 nnns volume:5 year:2023 number:1 pages:8 https://doi.org/10.1186/s42466-022-00229-1 kostenfrei https://doaj.org/article/36a6660fcb95468398706d92e3ed5d5b kostenfrei https://doi.org/10.1186/s42466-022-00229-1 kostenfrei https://doaj.org/toc/2524-3489 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 5 2023 1 8
spelling	10.1186/s42466-022-00229-1 doi (DE-627)DOAJ081638450 (DE-599)DOAJ36a6660fcb95468398706d92e3ed5d5b DE-627 ger DE-627 rakwb eng RC321-571 RC346-429 Timolaos Rizos verfasserin aut Echocardiography in acute stroke patients: a nationwide analysis in departments with certified stroke units in Germany 2023 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Abstract 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. Ischemic stroke TIA Echocardiography Stroke unit Guidelines Neurosciences. Biological psychiatry. Neuropsychiatry Neurology. Diseases of the nervous system Ekkehart Jenetzky verfasserin aut Darius Günther Nabavi verfasserin aut Karl Georg Haeusler verfasserin aut Rolf Wachter verfasserin aut Martin Ossenbrink verfasserin aut Peter Arthur Ringleb verfasserin aut Otto Busse verfasserin aut In Neurological Research and Practice BMC, 2019 5(2023), 1, Seite 8 (DE-627)1038162947 25243489 nnns volume:5 year:2023 number:1 pages:8 https://doi.org/10.1186/s42466-022-00229-1 kostenfrei https://doaj.org/article/36a6660fcb95468398706d92e3ed5d5b kostenfrei https://doi.org/10.1186/s42466-022-00229-1 kostenfrei https://doaj.org/toc/2524-3489 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 5 2023 1 8
allfields_unstemmed	10.1186/s42466-022-00229-1 doi (DE-627)DOAJ081638450 (DE-599)DOAJ36a6660fcb95468398706d92e3ed5d5b DE-627 ger DE-627 rakwb eng RC321-571 RC346-429 Timolaos Rizos verfasserin aut Echocardiography in acute stroke patients: a nationwide analysis in departments with certified stroke units in Germany 2023 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Abstract 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. Ischemic stroke TIA Echocardiography Stroke unit Guidelines Neurosciences. Biological psychiatry. Neuropsychiatry Neurology. Diseases of the nervous system Ekkehart Jenetzky verfasserin aut Darius Günther Nabavi verfasserin aut Karl Georg Haeusler verfasserin aut Rolf Wachter verfasserin aut Martin Ossenbrink verfasserin aut Peter Arthur Ringleb verfasserin aut Otto Busse verfasserin aut In Neurological Research and Practice BMC, 2019 5(2023), 1, Seite 8 (DE-627)1038162947 25243489 nnns volume:5 year:2023 number:1 pages:8 https://doi.org/10.1186/s42466-022-00229-1 kostenfrei https://doaj.org/article/36a6660fcb95468398706d92e3ed5d5b kostenfrei https://doi.org/10.1186/s42466-022-00229-1 kostenfrei https://doaj.org/toc/2524-3489 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 5 2023 1 8
allfieldsGer	10.1186/s42466-022-00229-1 doi (DE-627)DOAJ081638450 (DE-599)DOAJ36a6660fcb95468398706d92e3ed5d5b DE-627 ger DE-627 rakwb eng RC321-571 RC346-429 Timolaos Rizos verfasserin aut Echocardiography in acute stroke patients: a nationwide analysis in departments with certified stroke units in Germany 2023 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Abstract 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. Ischemic stroke TIA Echocardiography Stroke unit Guidelines Neurosciences. Biological psychiatry. Neuropsychiatry Neurology. Diseases of the nervous system Ekkehart Jenetzky verfasserin aut Darius Günther Nabavi verfasserin aut Karl Georg Haeusler verfasserin aut Rolf Wachter verfasserin aut Martin Ossenbrink verfasserin aut Peter Arthur Ringleb verfasserin aut Otto Busse verfasserin aut In Neurological Research and Practice BMC, 2019 5(2023), 1, Seite 8 (DE-627)1038162947 25243489 nnns volume:5 year:2023 number:1 pages:8 https://doi.org/10.1186/s42466-022-00229-1 kostenfrei https://doaj.org/article/36a6660fcb95468398706d92e3ed5d5b kostenfrei https://doi.org/10.1186/s42466-022-00229-1 kostenfrei https://doaj.org/toc/2524-3489 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 5 2023 1 8
allfieldsSound	10.1186/s42466-022-00229-1 doi (DE-627)DOAJ081638450 (DE-599)DOAJ36a6660fcb95468398706d92e3ed5d5b DE-627 ger DE-627 rakwb eng RC321-571 RC346-429 Timolaos Rizos verfasserin aut Echocardiography in acute stroke patients: a nationwide analysis in departments with certified stroke units in Germany 2023 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Abstract 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. Ischemic stroke TIA Echocardiography Stroke unit Guidelines Neurosciences. Biological psychiatry. Neuropsychiatry Neurology. Diseases of the nervous system Ekkehart Jenetzky verfasserin aut Darius Günther Nabavi verfasserin aut Karl Georg Haeusler verfasserin aut Rolf Wachter verfasserin aut Martin Ossenbrink verfasserin aut Peter Arthur Ringleb verfasserin aut Otto Busse verfasserin aut In Neurological Research and Practice BMC, 2019 5(2023), 1, Seite 8 (DE-627)1038162947 25243489 nnns volume:5 year:2023 number:1 pages:8 https://doi.org/10.1186/s42466-022-00229-1 kostenfrei https://doaj.org/article/36a6660fcb95468398706d92e3ed5d5b kostenfrei https://doi.org/10.1186/s42466-022-00229-1 kostenfrei https://doaj.org/toc/2524-3489 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 5 2023 1 8
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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. 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author	Timolaos Rizos
spellingShingle	Timolaos Rizos misc RC321-571 misc RC346-429 misc Ischemic stroke misc TIA misc Echocardiography misc Stroke unit misc Guidelines misc Neurosciences. Biological psychiatry. Neuropsychiatry misc Neurology. Diseases of the nervous system Echocardiography in acute stroke patients: a nationwide analysis in departments with certified stroke units in Germany
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topic_title	RC321-571 RC346-429 Echocardiography in acute stroke patients: a nationwide analysis in departments with certified stroke units in Germany Ischemic stroke TIA Echocardiography Stroke unit Guidelines
topic	misc RC321-571 misc RC346-429 misc Ischemic stroke misc TIA misc Echocardiography misc Stroke unit misc Guidelines misc Neurosciences. Biological psychiatry. Neuropsychiatry misc Neurology. Diseases of the nervous system
topic_unstemmed	misc RC321-571 misc RC346-429 misc Ischemic stroke misc TIA misc Echocardiography misc Stroke unit misc Guidelines misc Neurosciences. Biological psychiatry. Neuropsychiatry misc Neurology. Diseases of the nervous system
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title	Echocardiography in acute stroke patients: a nationwide analysis in departments with certified stroke units in Germany
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title_full	Echocardiography in acute stroke patients: a nationwide analysis in departments with certified stroke units in Germany
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title_sort	echocardiography in acute stroke patients: a nationwide analysis in departments with certified stroke units in germany
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title_auth	Echocardiography in acute stroke patients: a nationwide analysis in departments with certified stroke units in Germany
abstract	Abstract 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.
abstractGer	Abstract 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.
abstract_unstemmed	Abstract 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.
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title_short	Echocardiography in acute stroke patients: a nationwide analysis in departments with certified stroke units in Germany
url	https://doi.org/10.1186/s42466-022-00229-1 https://doaj.org/article/36a6660fcb95468398706d92e3ed5d5b https://doaj.org/toc/2524-3489
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author2	Ekkehart Jenetzky Darius Günther Nabavi Karl Georg Haeusler Rolf Wachter Martin Ossenbrink Peter Arthur Ringleb Otto Busse
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up_date	2024-07-03T21:03:37.932Z
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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. 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Echocardiography in acute stroke patients: a nationwide analysis in departments with certified stroke units in Germany

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