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Treatment on stroke unit can prevent death and severe disability
A stroke is an absolute emergency that must be treated as quickly as possible in a specially designed clinic. As a study led by the Neurological University Clinic in Heidelberg shows, however, more than half of those affected reach a so-called “stroke unit” far too late. Almost 20 percent of the patients would also be brought to hospitals without a special ward. This reduces the chances of surviving the stroke alive and without serious consequential damage, the university reports in a current press release. The results of the study were published in the journal “Neurology”.
In the event of a stroke, quick action is vital
Every year, according to information from the German Stroke Society (DSG), 270,000 people in Germany experience a stroke for the first time or repeatedly. It is always an emergency, and it is important not to waste time. Because only if the patient is immediately taken to a clinic with an attached stroke unit can special, life-saving therapy procedures be used within a narrow “therapeutic time window” of a maximum of four and a half hours.
Time window of a maximum of four and a half hours
How important it is to be briefed in such a stroke center obviously cannot be repeated often enough. Because many patients still reach a corresponding clinic far too late. This is shown in a current study by the Baden-Württemberg AG stroke of the Quality Assurance in Hospital (GeQiK) office, which is a cooperation project between the university clinics in Heidelberg, Mannheim and Freiburg. According to this, 60 percent of all stroke patients in Baden-Württemberg would only reach a stroke unit if it was already too late for a so-called "thrombolysis" (short: "lysis").
Rescue services should approach stroke units more consistently
According to the study, 17 percent of the patients would be brought to the clinic in time for thrombolysis, but would end up in a hospital without a stroke unit. Here, however, the special treatment is used much less frequently, which increases the risk of a fatal stroke and severe disabilities. Because lysis is the only approved drug therapy after an acute stroke. By administering medication, the blood clot in the brain is dissolved again, which means that the blood can flow freely again and the brain can be adequately supplied with oxygen. "It would therefore be desirable for emergency services to approach hospitals with a stroke unit more consistently than previously," says study leader Professor Dr. Peter Ringleb, head of the Heidelberg Stroke Unit, according to the announcement.
Older patients often remain underserved
The team headed by Professor Dr. Peter Ringleb and Dr. Christoph Gumbinger from the Neurological University Clinic in Heidelberg had evaluated data from GeQiK for the inpatient treatment of stroke patients in all hospitals in Baden-Württemberg (2008 to 2012) for the study, the university said. It was shown that 40 percent of those affected within 4.5 hours of the first signs of stroke, such as hemiplegia or speech disorders came to the clinic and in time for lysis treatment. This was then carried out immediately in specialized stroke centers in 44 percent of these patients. In hospitals without a stroke unit, on the other hand, only 13 percent of the patients arriving on time received thrombolysis, which means that older patients with pre-existing physical impairments in particular often remained underserved, the university reports. "Especially with these patients, it takes a lot of experience and competence to be able to assess whether the lysis therapy can be carried out," emphasizes Professor Ringleb.
In Germany there is a network of more than 250 stroke units, most of which are affiliated to neurological clinics. The centers have the technical and human resources to provide stroke patients with the necessary medical measures. "It has been proven that treatment on a stroke unit as a whole and beyond lysis therapy helps prevent deaths and severe disabilities after a stroke thanks to a specially trained treatment team and comprehensive diagnostics and therapy around the clock," says Ringleb. (No)