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- Appelros, Peter, et al.
(author)
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Riks-Stroke och hur fallgropar vid tolkning av resultaten undviks : [Riks-Stroke and how to prevent pitfalls interpreting the results]
- 2008
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In: Läkartidningen. - 0023-7205 .- 1652-7518. ; 105:8, s. 529-533
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Journal article (other academic/artistic)abstract
- Riks-Stroke, the Swedish quality register for stroke care, has been in service for twelve years. The register gives a unique opportunity to compare treatment, care, and rehabilitation of stroke patients. The protocol has now been launched in its eighth version. The most important changes include that the register now also includes cases that are treated as outpatients. Also, a more robust measure of stroke severity, the National Institutes of Health Stroke Scale (NIHSS) has been included. All quality registers are sensitive for selection bias. Therefore, it is important to aim at as complete case ascertainment as possible, both at baseline and at the 3-month follow-up. To analyze the comparability of quality parameters between different time points, or between different hospitals, we suggest the use of certain “base factors”, for example age, stroke severity, and number of patients included at baseline and at follow-up.From 2007, with a more robust measure of stroke severity, we are offered an instrument that facilitates comparisons. By registering outpatients, selection bias from this cause is avoided. We will also learn if outpatients have a worse long time outcome. A possible future direction is that the quality of medical follow-up is evaluated within the frames of Riks-Stroke, for example life style factors and treatment of hypertension.
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- Eriksson, Marie, et al.
(author)
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Trombolys som akutbehandling vid ischemisk stroke sprids över landet : Men regionala variationer är ännu stora, visar Riks-Stroke-analys
- 2011
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In: Läkartidningen. - 0023-7205 .- 1652-7518. ; 108:1-2, s. 21-25
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Journal article (peer-reviewed)abstract
- Spridningen av trombolys som akutbehandling vid ischemisk stroke har analyserats hos patienter registrerade i Riks-Stroke under 2003–2009. Implementeringen har varit långsam, även om den varit snabbare än i många andra länder. De regionala variationerna i införandet av trombolys är stora. Trombolys har införts med 2–3 års fördröjning vid icke-universitetssjukhus jämfört med universitetssjukhus. Andra oberoende prediktorer för trombolysbehandling har varit bl a låg ålder, sammanboende, intagning på strokeenhet och intagning på neurologklinik i stället för medicinklinik. Andelen trombolyslarm i målgruppen har nära samband med behandlingsfrekvensen. Spridningen till mindre sjukhus har kunnat genomföras med bevarad patientsäkerhet.
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- Hårdemark, Hans-Göran, et al.
(author)
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Snabb trombolytisk behandling indicerad vid hotande hjärninfarkt : Studie av 60 patienter behandlade vid Akademiska sjukhuset i Uppsala
- 2002
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In: Läkartidningen. - 0023-7205 .- 1652-7518. ; 99:44, s. 4350-4355
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Journal article (other academic/artistic)abstract
- Results of the routine use of tissue plasminogen activator (tPA) within 3 hours of an acute ischemic stroke have been reported from the United States, Canada and Germany. Published reports from other countries and from centers using tPA within a wider timeframe are limited. 60 patients in a Swedish University Hospital were treated with i.v. tPA within 6 hours of onset of acute ischemic stroke symptoms. Two patients suffered more extensive parenchymal intracerebral hemorrhages, of which one required surgery and one died. At 3 months, 47% were independent, 35% dependent and 18% deceased. Due to the relatively low number of patients in this series, data should be cautiously interpreted, but the results are comparable to those of large randomized controlled trials and published phase 4 studies. The risk of tPA treatment after 3-6 hours does not seem to be significantly increased as compared to treatment within 3 hours.
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