PMID- 19629563
OWN - NLM
STAT- MEDLINE
DCOM- 20100309
LR  - 20211020
IS  - 1432-1459 (Electronic)
IS  - 0340-5354 (Linking)
VI  - 257
IP  - 1
DP  - 2010 Jan
TI  - A nationwide study on topography and efficacy of the stroke treatment network in 
      the Czech republic.
PG  - 31-7
LID - 10.1007/s00415-009-5259-3 [doi]
AB  - The SITS (Safe Implementation of Thrombolysis in Stroke)-EAST project was 
      launched in 2007 to support evidence-based stroke treatments, including 
      thrombolytic treatments (TLTs), in Central and Eastern Europe. The aim of this 
      study was to detail the topography, efficacy, and specific characteristics of 
      stroke centers in the Czech Republic (CZ), the country with the highest rate of 
      TLT. The nationwide study was performed between September and November 2007 
      through a questionnaire sent to all centers registered in SITS. The questionnaire 
      contained 25 questions addressing how centers met recommendations for primary and 
      comprehensive stroke centers in 2006. Center characteristics predicting the 
      number of TLTs were identified by multiple regression analysis. Altogether, data 
      were obtained from 42 centers (88% response rate) with the following 
      characteristics [median (min-max)]: catchment area population 150,000 
      (90,000-750,000); number of strokes/year 420 (150-1,589); number of TLTs 7.5 
      (2-45); number of physicians specialized in stroke 3 (1-7). Centers treated 4.3% 
      of the patients with ischemic strokes with tissue plasminogen activator. A stroke 
      unit was present in 32 (78%) departments. Rescue interventional therapies were 
      performed in 11 (26%). Financial problems restricted TLT in 14 (35%) centers. 
      Fourteen factors were associated with the number of TLTs in univariate regression 
      analysis, but in multiple regression analysis, only the catchment area population 
      (p < 0.001), >3 physicians specialized in stroke (p < 0.001), and the presence of 
      an acute interventional program (p < 0.006) remained significant. This study 
      provides the fundamental stroke treatment network data that are essential for 
      certification and further SITS-EAST TLT expansion.
FAU - Mikulik, Robert
AU  - Mikulik R
AD  - Department of Neurology, St. Anne's University Hospital, Masaryk University, 
      Brno, Czech Republic. mikulik@hotmail.com
FAU - Vaclavik, Daniel
AU  - Vaclavik D
FAU - Sanak, Daniel
AU  - Sanak D
FAU - Bar, Michal
AU  - Bar M
FAU - Sevcik, Pavel
AU  - Sevcik P
FAU - Kalita, Zbynek
AU  - Kalita Z
FAU - Wahlgren, Nils
AU  - Wahlgren N
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20090723
PL  - Germany
TA  - J Neurol
JT  - Journal of neurology
JID - 0423161
RN  - EC 3.4.21.68 (Tissue Plasminogen Activator)
SB  - IM
MH  - Brain Ischemia/economics/therapy
MH  - Czech Republic
MH  - *Hospital Units/economics/statistics & numerical data
MH  - Humans
MH  - Linear Models
MH  - Medicine/statistics & numerical data
MH  - Multivariate Analysis
MH  - Physicians/statistics & numerical data
MH  - Population
MH  - Regression Analysis
MH  - Stroke/economics/*therapy
MH  - Surveys and Questionnaires
MH  - *Thrombolytic Therapy
MH  - Time Factors
MH  - Tissue Plasminogen Activator/therapeutic use
MH  - Tomography Scanners, X-Ray Computed/statistics & numerical data
EDAT- 2009/07/25 09:00
MHDA- 2010/03/10 06:00
CRDT- 2009/07/25 09:00
PHST- 2009/04/23 00:00 [received]
PHST- 2009/07/08 00:00 [accepted]
PHST- 2009/07/08 00:00 [revised]
PHST- 2009/07/25 09:00 [entrez]
PHST- 2009/07/25 09:00 [pubmed]
PHST- 2010/03/10 06:00 [medline]
AID - 10.1007/s00415-009-5259-3 [doi]
PST - ppublish
SO  - J Neurol. 2010 Jan;257(1):31-7. doi: 10.1007/s00415-009-5259-3. Epub 2009 Jul 23.