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- Asplund, Kjell, et al.
(författare)
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Hemikraniektomi är livräddande, visar Riks-Stroke : erfarenheter av ingreppet vid malign hjärninfarkt och intracerebral blödning
- 2014
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Ingår i: Läkartidningen. - : Sveriges läkarförbund. - 0023-7205 .- 1652-7518. ; 111:3-4
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Tidskriftsartikel (refereegranskat)abstract
- From 2009 to mid-2013, 229 hemicraniectomies were reported in Riks-Stroke, of which 43 were performed in patients with intracerebral hemorrhage. In patients with brain infarction, it was performed in 0.19% (all ages) and 1.07% (below 60 years), higher than reported from the US. Of the hemicraniectomies, 45% were performed in patients above 60 years. Survival was 83% at 3 months and 81% at 12 months, similar to survival reported in the literature. Three months after hemicraniectomy, 69% of survivors responded to a follow-up questionnaire. Of these, 31% were independent in personal ADL and 46% were living at home. Case fatality was higher but functional outcome in survivors was similar in patients above 60 years compared to below 60. In conclusion, outcomes are similar in Sweden to those reported in randomized trials and international observational studies. With proper patient selection, it seems that hemicraniectomy may also benefit patients above 60 years.
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| 2. |
- Bergqvist, D, et al.
(författare)
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Haverikommission granskade karotiskirurgins komplikationer. Hälften kunde förklaras med misstag eller tveksamma indikationer
- 2000
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Ingår i: Läkartidningen. - 0023-7205. ; 97:14, s. 1673-1676
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Tidskriftsartikel (refereegranskat)abstract
- As carotid endarterectomy is a prophylactic procedure, it would seem particularly important to analyze complications with an aim to avoiding them. All carotid endarterectomies in Sweden are registered, and all serious complications (death and permanent neurological deficit) are analyzed in detail, classified and discussed within the profession. During the period 1994-1996 the frequency was 4.3 percent (technical causes in 17 percent, contraindications in 8 percent and dubious indications in 21 percent, but correct indication and surgery in 54 percent). Thus, even when conditions are optimal there is a certain price to pay for the prevention of ischemic stroke.
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| 3. |
- Eriksson, Marie, et al.
(författare)
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Kvalitetsregistret Riksstroke visar på ojämlik strokevård : omedveten diskriminering kanske förklarar en del av skillnaderna
- 2015
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Ingår i: Läkartidningen. - : Läkartidningen Förlag AB. - 0023-7205 .- 1652-7518. ; 112
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Tidskriftsartikel (refereegranskat)abstract
- In this article, results from a series of studies on the relationships between socioeconomic factors and stroke processes (stroke unit care, acute reperfusion treatment, secondary prevention with oral anticoagulants and statins) and outcomes (long-term survival, return to work and risk of suicide and suicide attempts) are summarized. The overall pattern is that acute and secondary prevention interventions and prognosis are better in patients with a high compared with a low level of education, better in people with high than low income, better in people who are cohabitant than single. As to country of birth, a more complex pattern has emerged. Unmeasured confounding may possibly explain part of the difference, but the socioeconomic gradients remain after adjustment for multiple potential confounders, leaving the possibility that there is an element of unconscious discrimination in stroke care.
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| 4. |
- Eriksson, Marie, et al.
(författare)
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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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Ingår i: Läkartidningen. - 0023-7205 .- 1652-7518. ; 108:1-2, s. 21-25
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Tidskriftsartikel (refereegranskat)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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| 9. |
- Murray, Veronica, et al.
(författare)
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Trombolys vid akut ischemisk stroke. Kritisk analys av aktuell kunskapsfront
- 2004
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Ingår i: Läkartidningen. - 0023-7205. ; 101:8, s. 662-673
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Tidskriftsartikel (refereegranskat)abstract
- Thrombolysis is a highly promising treatment in acute ischaemic stroke. There is evidence of positive effects at least up to three hours and most probably up to six. The risk of intracranial haemorrhage is increased fourfold with thrombolysis; risk factors other than the treatment as such have not been identified for certain; the risk is not related to giving thrombolysis during the 0-3 as opposed to the 3-6 hour time window. There is a non-significant excess of deaths, ranging from a small reduction to a substantial excess. There is not enough evidence to answer several questions regarding the influence of patient- and stroke characteristics on effectsize; death; and risk of intracranial haemorrhage. Giving priority to new large randomized controlled trials is essential to achieve this knowledge.
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