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Demography

Demography. Control group. TEMPiS. 1151. No patients. 1971. Sex. 49%. 53%. Age [Mean, years]. 72,7. 72,9. Lancet Neurol 2006; 5: 742–48. Quality of procedures. Control group. TEMPiS. Systemic rtPA. 4.6%. 0.4% *. Carotis duplex. 83%. 62% *. Speech therapy. 82%. 10% *.

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Demography

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  1. Demography Control group TEMPiS 1151 No patients 1971 Sex 49% 53% Age [Mean, years] 72,7 72,9 Lancet Neurol 2006; 5: 742–48

  2. Quality of procedures Control group TEMPiS Systemic rtPA 4.6% 0.4%* Carotis duplex 83% 62%* Speech therapy 82% 10%* Test of swallowing dysfunction 78% 51%* In-hospital stay [days] 10.7 11.9* External transfers 10% 11% Lancet Neurology 2006

  3. Poor Outcome after 3 Months -10,4%** At home withsevere disability 21% 14,3% InstitutionalCare 14,2% 12,5% Dead 16,2% 18,1% TEMPiS Control hospitals Lancet Neurology 2006

  4. Odds Ratios for Poor Outcome TEMPiS OR=0,63 65-75 years OR=1,63 76-85 years OR=2,74 Reference age<65 >85 years OR=6,39 moderate deficits OR=2,28 Reference mild deficits severe deficits OR=6,23 very severe deficits OR=23,06 Intracerebral hemorrhage OR=2,88 Living with a partner OR=0,69 Diabetes mellitus OR=1,50 Atrial fibrillation OR=1,35 other vascular disease OR=1,35

  5. Summary • European health care systems have to prepare for a growing number of stroke cases in the next 20 years • Telemedical networks offer a new and innovative approache to improve stroke care in underserved, non-urban areas • Tele-Thrombolysis is safe and effective • Network Stroke care reduces the probability of poor outcome after 3 months

  6. Penumbra Concept of Ischemic Stroke Infract core Penumbra = Tissue at risk 0 h 1 h 8 h 8-12 h Penumbra Concept  Driving force of acute stroke care: Time is brain!

  7. North Karelia Project Community based Intervention  Multilevel Riscfactor-Modification (Media, GPs, Industry…)  Treating and preventing all CV Risc factors

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