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Variations in the use of diagnostic procedures after acute stroke in Europe: results from the BIOMED II study of stroke care
Author(s) -
Heidrich J.,
Heuschmann P. U.,
KolominskyRabas P.,
Rudd A. G.,
Wolfe C. D. A.
Publication year - 2007
Publication title -
european journal of neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.881
H-Index - 124
eISSN - 1468-1331
pISSN - 1351-5101
DOI - 10.1111/j.1468-1331.2006.01573.x
Subject(s) - medicine , stroke (engine) , acute stroke , etiology , logistic regression , gold standard (test) , multivariate analysis , pediatrics , emergency medicine , mechanical engineering , tissue plasminogen activator , engineering
Valid classification of stroke is essential to initiate effective acute management and early secondary prevention strategies. To accurately evaluate stroke subtype a number of diagnostic procedures have to be performed. This study sought to investigate variations in use of diagnostic procedures across selected European hospitals. First‐ever stroke patients were sampled over a 1‐year period through 11 hospital‐based registers across 10 European countries. We defined a diagnostic standard for valid aetiological classification of ischemic stroke including brain imaging, vascular imaging and echocardiography. The impact of socio‐demographic, clinical and structural characteristics on performance of the diagnostic standard was assessed using multivariate logistic regression analyses. A total of 1721 patients were included in the study. 83.1% received brain imaging, ranging from 32.8% to 100%. The diagnostic standard was performed in 40.4% of stroke patients, ranging from 0% to 77.2%. Patients with increasing age ( P < 0.001) and with more severe strokes ( P = 0.001) were less probably to receive the diagnostic standard. Patients treated in stroke units and neurological departments were more frequently investigated with the diagnostic standard ( P < 0.001). Less than half of hospitalized stroke patients across Europe underwent diagnostic procedures to allow for aetiological classification of stroke, which may hamper the initiation of effective early management and secondary prevention.