دورية أكاديمية
Extent of routine diagnostic cardiac work-up at certified German stroke units participating in the prospective MonDAFIS study.
| العنوان: | Extent of routine diagnostic cardiac work-up at certified German stroke units participating in the prospective MonDAFIS study. |
|---|---|
| المؤلفون: | Olma, Manuel C, Tütüncü, Serdar, Nabavi, Darius G, Heuschmann, Peter U, Endres, Matthias, Haeusler, Karl Georg, Grittner, Ulrike, Kunze, Claudia, Jawad-Ul-Qamar, Muhammad, Kirchhof, Paulus, Röther, Joachim, Thomalla, Götz, Veltkamp, Roland, Laufs, Ulrich |
| المصدر: | Neurological research and practice 5(1), 21 (2023). doi:10.1186/s42466-023-00246-8 |
| بيانات النشر: | BioMed Central |
| سنة النشر: | 2023 |
| مصطلحات موضوعية: | info:eu-repo/classification/ddc/610, Ischaemic stroke, Stroke-unit monitoring, echocardiography, Holter-ECG, Transient ischaemic attack, atrial fibrillation |
| جغرافية الموضوع: | DE |
| الوصف: | About 25% of all ischaemic strokes are related to cardio-embolism, most often due to atrial fibrillation (AF). Little is known about the extent and standardization of routine cardiac diagnostic work-up at certified stroke-units in Germany.The MonDAFIS study included non-AF patients with acute ischaemic stroke or transient ischaemic attack (TIA) at 38 certified stroke-units in Germany. Here, we analysed routine diagnostic work-up and disregarded study-related Holter-ECG monitoring. We compared duration of stroke-unit stay, number of 24-h Holter-ECGs, and echocardiography performed between university-based comprehensive stroke centres (UCSC, 12 hospitals, 1606 patients), non university-based comprehensive stroke centres (nUCSC, 14 hospitals, 892 patients), and primary stroke centres at non-university hospitals (PCS, 12 hospitals, 933 patients) using multivariable mixed regression analyses. Detection of a first AF episode in-hospital was also compared between hospitals of different stroke-unit levels.In 3431 study patients (mean age 66.2 years, 39.5% female, median NIHSS = 2 on admission), median duration of the stroke-unit stay was 72 h (IQR 42-86). Stroke-unit stay was longer (categorised ≤ 24/ > 24- ≤ 72/ > 72 h) for patients with severe stroke (NIHSS score ≥ 5/ < 5: OR = 1.6, 95%CI 1.3-2.0) and for patients with ischaemic stroke vs. TIA (OR = 1.7, 95%CI 1.4-2.1). Overall, 2149/3396 (63.3%) patients underwent at least one additional 24-h Holter-ECG (median 1 [IQR 0-1], range 0-7). Holter-ECG rate was 47% in UCSC, 71% in nUCSC, and 84% in PCS. Compared to PCS, AF was less often detected in-hospital in UCSC (OR = 0.65, 95%CI 0.45-0.93) and nUCSC (OR = 0.69, 95%CI 0.46-1.04). Transoesophageal echocardiography (TEE) only was performed in 513/3391 (15.1%) study patients, transthoracic echocardiography (TTE) only in 1228/3391 (36.2%), and TEE combined with TTE in 1020/3391 (30.1%) patients. Patients younger than 60 years (vs. ≥ 60 years) underwent TEE more often than those older than 60 years (OR = 3.44, ... |
| نوع الوثيقة: | article in journal/newspaper |
| اللغة: | English |
| العلاقة: | info:eu-repo/semantics/altIdentifier/pmid/pmid:37259147; info:eu-repo/semantics/altIdentifier/issn/2524-3489; https://pub.dzne.de/record/258250Test; https://pub.dzne.de/search?p=id:%22DZNE-2023-00596%22Test |
| الإتاحة: | https://doi.org/10.1186/s42466-023-00246-8Test https://pub.dzne.de/record/258250Test https://pub.dzne.de/search?p=id:%22DZNE-2023-00596%22Test |
| حقوق: | info:eu-repo/semantics/openAccess |
| رقم الانضمام: | edsbas.FFF3FC68 |
| قاعدة البيانات: | BASE |
| الوصف غير متاح. |