Haverkamp C, Ganslandt T, Horki P, Boeker M, Dörfler A, Schwab S, Berkefeld J, Pfeilschifter W, Niesen WD, Egger K, Kaps M, Brockmann MA, Neumaier-Probst E, Szabo K, Skalej M, Bien S, Best C, Prokosch HU, Urbach H (2018)
Publication Type: Journal article
Publication year: 2018
DOI: 10.1007/s00062-017-0656-y
Mechanical thrombectomy, in addition to intravenous (i.v.) thrombolysis is recommended for treatment of acute stroke in patients with large vessel occlusions (LVO) in the anterior circulation up to 6 h after symptom onset. We compared thrombectomy rates of eight university hospitals of the MIRACUM consortium to analyze the implementation of this guideline in clinical routine.Anonymized billing data in a standardized format were loaded into a local i2b2 data warehouse by applying already existing extract, transform and load (ETL) routines. A locally executed uniform SQL (structured query language) query delivered aggregated site data for all inpatients with a discharge diagnosis of ischemic stroke (ICD-10 I63) containing counts for type of acute treatment, type of admission and age groups, which were centrally analyzed with R.From 2014 to 2016, the thrombectomy rate almost doubled from a mean of 4.7% to 9.6%, although significant differences between centers exist (range in 2016: 5.8-17%). The number of drip-and-ship procedures increased in 3 out of 8 centers. There was no evidence for a decrease in thrombectomy rates during weekends/holiday or among patients older than 80 years, but this age group is more likely to receive i.v. recombinant tissue plasminogen activator (rtPA).The observed increase of thrombectomy rates and drip-and-ship procedures without a significant difference between weekdays and weekends or patients of different ages is substantiating a rapid implementation of stroke guidelines within the analyzed neurovascular centers. The prototype of the MIRACUM Data Integration Center already contributes to health services research in Germany.
APA:
Haverkamp, C., Ganslandt, T., Horki, P., Boeker, M., Dörfler, A., Schwab, S.,... Urbach, H. (2018). Regional Differences in Thrombectomy Rates : Secondary use of Billing Codes in the MIRACUM (Medical Informatics for Research and Care in University Medicine) Consortium. Clinical Neuroradiology. https://doi.org/10.1007/s00062-017-0656-y
MLA:
Haverkamp, Christian, et al. "Regional Differences in Thrombectomy Rates : Secondary use of Billing Codes in the MIRACUM (Medical Informatics for Research and Care in University Medicine) Consortium." Clinical Neuroradiology (2018).
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