[Ten years' experience at a major stroke center].

BACKGROUND: About 1,300 stroke patients from a primarily rural area are treated each year at the Department of Neurology of the University Hospital of Heidelberg, Germany. Demographic and treatment data of all stroke patients there were prospectively collected. In a retrospective study we report on the changes in this patient population from 1996 to 2006, with special consideration of those suitable for intravenous thrombolysis.
METHODS: For all stroke patients the basic data were collected--age, sex, type of stroke (transient ischemic attack, stroke, or intracerebral hemorrhage), NIH Stroke Scale, duration between symptom onset and hospital arrival, delay between arrival and first doctor's contact, patient's further whereabouts, and for patients treated by iv thrombolysis, start of treatment and dosage.
RESULTS: There were no changes in the total number of stroke patients and median stroke severity, according to the NIH Stroke Scale, from 1996 to 2006. The proportion of stroke patients admitted within the first 3 h after symptom onset increased from 12.1% (1996) to 21.9% (2006). Thus we managed to treat 10.1% of all our ischemic stroke patients with iv thrombolysis, which means 39% of those patients with cerebral infarction arriving within 3 h. DISCUSSION: During the study period there were no significant changes in the patients' sociodemographic data. By consistent reduction of prehospital delay, the number of stroke patients that could be treated acutely by intravenous thrombolysis was increased.