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. 2021 Jun 7;3(1):32.
doi: 10.1186/s42466-021-00131-2.

Letter to the Editor: Analysis of stroke patient migration for mechanical thrombectomy and changes in neurointerventional center size in Germany

Ralph Weber  1   2   3 , Dirk Bartig  4   5 , Christos Krogias  6   4   7 , Daniel Richter  7 , Werner Hacke  8 , Jens Eyding  6   4   9
Affiliations

Letter to the Editor: Analysis of stroke patient migration for mechanical thrombectomy and changes in neurointerventional center size in Germany

Ralph Weber et al. Neurol Res Pract. .

Abstract

Aim and methods: To analyse nationwide changes in neurointerventional center size of all German hospitals performing mechanical thrombectomy (MT) in stroke patients from 2016 to 2019. Furthermore, we assessed cross-district patient migration for MT for the first time using hospitals' structured quality reports and German Diagnosis-Related Groups data in 2019.

Findings: Number of hospitals performing more than 100 MT procedures/year doubled in Germany from 2016 (n = 36) to 2019 (n = 71), and these neurointerventional centers performed 71% of all MT procedures in 2019. The overall increase in MT procedures was largely driven by these high-volume neurointerventional centers with ability to perform MT 24/7 (121% increase as compared with 8% increase in hospitals performing less than 100 MT procedures/year). The highest cross-district patient mobility/transfer of stroke patients for MT was observed in districts adjacent to these high-volume neurointerventional centers with existing neurovascular networks.

Conclusion: The substantial increase in MT procedures observed in Germany between 2016 and 2019 was almost exclusively delivered by high-volume stroke centers performing more than 100 MT procedures per year in established neurovascular networks. As there is still a reasonable number of districts with low MT rates, further structural improvement including implementation of new or expansion of existing neurovascular networks and regional tailored MT triage concepts is needed.

Keywords: Health care structure; Neurointerventional center size; Patient migration; Stroke; Thrombectomy.

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Conflict of interest statement

Ralph Weber received speaker honoria from Medtronic/Covidien and Bristol Myers Squibb.

Dirk Bartig received orders for analysis of the G-DRG system from Boehringer Ingelheim.

Christos Krogias received speaker honoraria and/or travel grants for scientific meetings from Bayer Vital, Boehringer-Ingelheim and Daichii-Sankyo.

Daniel Richter receives a FoRUM grant (K136–20) of the Ruhr-University of Bochum.

Werner Hacke received speaker and consultancy honoraria from Boehringer Ingelheim, Medtronic, Cerenovus and a research grant to perform ECASS4 from Boehringer Ingelheim.

Jens Eyding received travel grants from Boehringer Ingelheim and Bayer Vital and grants for the realization of scientific meetings by Bayer Health Care, Boehringer Ingelheim, Sanofi Aventis, Pfizer.

Figures

Fig. 1
Fig. 1
Mechanical thrombectomy volume size of German hospitals 2016 and 2019
Fig. 2
Fig. 2
Cross-district patient migration for MT in Germany in 2019. Certified neurovascular networks as indicated by the German Stroke Society in April 2021 are indicated with “C” and high-volume neurointerventional centers (> 200 MT/year) are indicated with “H”. The neurovascular network in southern Bavaria with its 3 geographical locations has been marked with *. State capitals of all 16 German federal states are named
See this image and copyright information in PMC

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