Schlaganfallhäufigkeit und Versorgung von Schlaganfallpatienten in Deutschland

Zusammenfassung

Hintergrund Epidemiologische Daten zum Krankheitsbild Schlaganfall bilden eine wichtige Grundlage zur Planung des zukünftigen Versorgungsbedarfs in der Bevölkerung sowie zur Identifikation möglicher Optimierungspotenziale in der derzeitigen Versorgung. Die folgende Arbeit präsentiert aktuelle Daten zu Schlaganfallhäufigkeit sowie Versorgungssituation von Schlaganfallpatienten in Deutschland. Ergebnisse Basierend auf den derzeit verfügbaren epidemiologischen Daten ereignen sich jährlich in Deutschland ca. 196 000 erstmalige und 66 000 wiederholte Schlaganfälle (Stand 2008). Der Schlaganfall ist die dritthäufigste Todesursache in Deutschland mit ca. 63 000 Todesfällen (Todesursachenstatistik 2008). Im Rahmen der regionalen Schlaganfallregister der Arbeitsgemeinschaft Deutscher Schlaganfall Register (ADSR) werden derzeit jährlich ca. 180 000 Patientenverläufe aus über 600 Kliniken dokumentiert (2008); die Qualität der akutstationären Versorgung wird zwischen den teilnehmenden Kliniken kontinuierlich mittels standardisiert entwickelter Qualitätsindikatoren verglichen. Circa 7–10 % der in den ADSR Registern dokumentierten Patienten mit Diagnose Hirninfarkt erhalten eine intravenöse Thrombolysebehandlung (2008). In Deutschland existieren 163 regionale und überregionale Stroke Units (SU), die nach dem neuen Zertifizierungsverfahren der Deutschen Schlaganfall Gesellschaft sowie der Stiftung Deutschen Schlaganfall-Hilfe zertifiziert sind (Stand Mai 2010). Die Bettenzahl der zertifizierten SU beträgt insgesamt 950 Betten (Mittelwert 5,7; Streubreite 4–14) (Stand Mai 2010). Es wird geschätzt, dass derzeit zwischen 45 und 50 % der Schlaganfallpatienten in Deutschland auf einer SU behandelt werden. Derzeit gibt es allerdings nur wenige Daten zur Qualität der Schlaganfallversorgung nach Entlassung aus dem Akutkrankenhaus, obwohl die Anzahl der Daten zur poststationären Versorgung kontinuierlich zunimmt. Schlussfolgerung In Deutschland gibt es auch im Vergleich zu anderen Ländern relativ gute Daten zu Häufigkeit sowie zur Versorgungssituation von Schlaganfallpatienten, insbesondere während der akutstationären Behandlung. Es fehlen jedoch aktuelle Daten zur zeitlichen Entwicklung der Schlaganfallhäufigkeit sowie zu Schlaganfallrisiko und Prognose bei Hochrisikokollektiven. Zudem werden mehr Daten zur Versorgung von Schlaganfallpatienten nach Entlassung aus der akutstationären Behandlung benötigt.

Abstract

Background Epidemiological data on frequency and treatment of stroke in routine clinical care provide the basis for assessing population needs and identifying potential for improvements. The paper provides an up-to-date overview on stroke frequency and management of patients in Germany. Results Based on epidemiological studies about 196,000 first-ever and 66,000 recurrent strokes occur in Germany each year (2008). Stroke is the third main cause of death with about 63,000 documented deaths in the routine statistics of 2008. Currently about 180,000 patients from over 600 hospitals are documented within the regional audits of the ADSR per year (2008); quality of acute stroke care is compared between participating hospitals using standardised quality indicators. Intravenous thrombolytic treatment is administered in 7–10 % of ischaemic stroke patients documented within the ADSR registers (2008). In Germany about 160 Stroke Units are certified according to criteria of German Stroke Society and German Stroke Foundation (May 2010). The total number of beds within certified SU is about 950 (mean 5.7; range 4 to 14). It is estimated that between 45 and 50 % of eligible stroke patients receive SU care. Currently data are limited on quality of care after discharge although available information on post-acute stroke care is increasing. Conclusions In Germany data on stroke frequency and quality of acute care are collected at a high level. However, limited information is available on time trends in incidence and risk in specific subgroups of the population. More data are needed on treatment and management after discharge from acute care hospitals.

Schlaganfall - Häufigkeit - Versorgung

stroke - frequency - care

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