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Diagnostics, treatment and secondary prevention of ischemic stroke in the Silesian Province, Poland between 2009 and 2015
Affiliations- Department of Basic Medical Sciences, Faculty of Public Health, Medical University of Silesia, Katowice, Poland
- Department of Neurology in Zabrze, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia, Katowice, Poland
- Department of Neurology, School of Health Sciences, Medical University of Silesia, Medical Centre of Upper Silesia, Katowice, Poland
- 3rd Department of Cardiology, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia, Katowice, Silesian Centre for Heart Disease in Zabrze, Marii Curie-Sklodowskiej 9, 41-800 Zabrze, Poland
- Department of Biostatistics, Faculty of Public Health, Medical University of Silesia, Katowice, Poland
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Abstract
The available data on diagnostics and treatment of ischemic stroke (IS) in Poland come mainly from non-representative cohorts or are outdated.
ObjectiveTherefore, the current study was done to access the most recent data on IS in the industrial region that covers 12% of the country's population.
Materials & methodsAnalysis of the data from stroke questionnaires, obligatory for all patients hospitalized due to acute stroke and administered by the National Health Fund (the only public health insurer in Poland) between 2009 and 2015 (n=81,193).
ResultsThe number of hospitalizations due to IS in the Silesian Province was 69,403 and constituted 85.5% of all stroke cases reported to the NHF between 2009 and 2015. Neuroimaging of the brain (CT/MRI) was performed in 68,696 (99%) subjects, while ultrasonography of extra- and/or intracranial arteries in 57,886 (83.4%). The rtPA therapy was applied in 3282 patients (4.7% of all IS subjects). The rate of patients treated with rtPA gradually increased (1.2% in 2009, 9.3% in 2015). Among all patients with IS, 57,636 (83.1%) subjects were administered antiplatelet drugs, 16,199 (23.3%) – oral anticoagulants, and 55,971 (80.7%) – antihypertensive drugs. Also, 2260 (3.3%) patients were referred for vascular intervention. In subjects with cardioembolic stroke etiology, 37.8% were treated with anticoagulants.
ConclusionsThere has been observed a significant improvement in the quality of diagnosis and treatment of acute ischemic stroke during recent years. However, further actions are required both in terms of reperfusion treatment (thrombolysis and/or thrombectomy) and secondary prevention of stroke.
Abstract
The available data on diagnostics and treatment of ischemic stroke (IS) in Poland come mainly from non-representative cohorts or are outdated.
ObjectiveTherefore, the current study was done to access the most recent data on IS in the industrial region that covers 12% of the country's population.
Materials & methodsAnalysis of the data from stroke questionnaires, obligatory for all patients hospitalized due to acute stroke and administered by the National Health Fund (the only public health insurer in Poland) between 2009 and 2015 (n=81,193).
ResultsThe number of hospitalizations due to IS in the Silesian Province was 69,403 and constituted 85.5% of all stroke cases reported to the NHF between 2009 and 2015. Neuroimaging of the brain (CT/MRI) was performed in 68,696 (99%) subjects, while ultrasonography of extra- and/or intracranial arteries in 57,886 (83.4%). The rtPA therapy was applied in 3282 patients (4.7% of all IS subjects). The rate of patients treated with rtPA gradually increased (1.2% in 2009, 9.3% in 2015). Among all patients with IS, 57,636 (83.1%) subjects were administered antiplatelet drugs, 16,199 (23.3%) – oral anticoagulants, and 55,971 (80.7%) – antihypertensive drugs. Also, 2260 (3.3%) patients were referred for vascular intervention. In subjects with cardioembolic stroke etiology, 37.8% were treated with anticoagulants.
ConclusionsThere has been observed a significant improvement in the quality of diagnosis and treatment of acute ischemic stroke during recent years. However, further actions are required both in terms of reperfusion treatment (thrombolysis and/or thrombectomy) and secondary prevention of stroke.
Keywords
Ischemic stroke, Treatment, Diagnostics, Recombinant tissue plasminogen activator therapy, Secondary stroke prevention, Recombinant, Tissue plasminogen activator
About this articleTitle
Diagnostics, treatment and secondary prevention of ischemic stroke in the Silesian Province, Poland between 2009 and 2015
Journal
Neurologia i Neurochirurgia Polska
Issue
Pages
235-242
Published online
2017-11-14
Page views
261
Article views/downloads
370
DOI
10.1016/j.pjnns.2017.11.003
Bibliographic record
Neurol Neurochir Pol 2018;52(2):235-242.
Keywords
Ischemic stroke
Treatment
Diagnostics
Recombinant tissue plasminogen activator therapy
Secondary stroke prevention
Recombinant
Tissue plasminogen activator
Authors
Beata Łabuz-Roszak
Anna Starostka-Tatar
Anetta Lasek-Bal
Marek Gierlotka
Mariusz Gąsior
Michał Skrzypek
