22. European Stroke Conference 508 Epidemiology of stroke Incidence of perioperative stroke, cardiovascular events and bleeding complications related to dental procedure in patients receiving antithrombotic therapy J. Kessava1, Y. Nilanon2 Faculty of medicine , siriraj hospital, Bangkok, THAILAND1, faculty of medicine , siriraj hospi-tal, Bangkok, THAILAND2 Background Antiplatelet and/or anticoagulant given for primary or secondary prevention of cardiovascular dis-ease, stroke and other thromboembolic event is frequently withdrawn prior to dental procedures to reduce bleeding complications. This may expose patients to increased morbidity and mortality from thromboembolic event . Aim of the study was to collect data of thromboembolic events because of periprocedural antiplatelet and/or anticoagulant withdrawal in many dental procedure and bleeding risks with the continuation of antiplatelet and/or anticoagulant Methods and Results This was a prospective, cohort study of patients given antiplatelet and/or anticoagulant more than 1 month in dentistry department of siriraj hospital from august 2011 to September 2012 . Patients were followed up for 1 week for thromboembolism and bleeding in both drug withdrawal and drug continuation group 1010 patients were enrolled. No patients had an episode of thromboembolism, There were 6 episodes of minor bleeding. And 1 episode of major bleeding .Major bleeding oc-curred with warfarin withdrawal , minor bleeding occurred with drug continuation ( 4 for warfarin alone ,1 for aspirin and clopidogrel and 1 for aspirin plus warfarin ) . There was no death in this study . Conclusion : There was no thromboembolic event in both drug continuation and drug withdrawal group . Antiplatelet and anticoagulant was not increase perioperative bleeding in the study popula-tion significantly .This study may change practical guideline in management of dental procedure in special population in Thailand 614 © 2013 S. Karger AG, Basel Scientific Programme 509 Epidemiology of stroke Variations in indicators for quality of acute stroke care in 7 European regions: the European Implementation Score (EIS) Collaboration S. Wiedmann1, S. Abilleira2, M. Dennis3, P. Hermanek4, M. Niewada5, B. Norrving6, A. Rudd7, V. Thijs8, Wolfe9, P.U. Heuschmann10 on behalf of the European Implementation Score (EIS) collaboration University of Würzburg, Würzburg, GERMANY1, Stroke Programme/ Catalan Agency for Health Information, Assessment and Quality, Barcelona, SPAIN2, Western General Hospital, Edin-burgh, UNITED KINGDOM3, Bavarian Permanent Working Party for Quality Assurance, Munich, GERMANY4, Warsaw Medical University, Warsaw, POLAND5, Lund University, Lund, SWEDEN6, King’s College London, London, UNITED KINGDOM7, University of Leuven, Leuven, BEL-GIUM8, King’s College London, London, UNITED KINGDOM9,University of Würzburg, Würz-burg, GERMANY10 Background: Several countries or regions in Europe have established audits for measuring quali-ty of acute hospital stroke care on a regional or national level. The aim of the present study was to compare variations in indicators of quality of care that were collected in a comparable way within a number of these audits. Methods: Adherence to indicators of quality of care was compared between seven national or re-gional stroke audits (Flanders-Belgium, Germany, Poland, Scotland, Catalonia-Spain, Sweden, En-gland/ Wales/Northern-Ireland) collaborating within the European Union FP7 funded project “The European Implementation Score (EIS)”. Indicators of quality of care of acute care hospitals were defined a priori by a European consensus group within the EIS project. Compliance with quality indicators was estimated for those measures that could be calculated in at least six of the seven par-ticipating audits. Overall means were calculated as arithmetic means of country means and p-values were adjusted for age and sex by logistic regression modelling. Results: From 2007 and/or 2008 individual data from more than 400,000 patients were documented in the participating audits. Thrombolytic therapy was delivered in 5% (1 to 10%; p<0.001) of isch-emic stroke patients. Dysphagia screening was performed in 73% (48 to 95%; p<0.001) of stroke patients. 34% of ischemic stroke patients with atrial fibrillation have been prescribed anticoagulants (18 to 58%; p<0.001). Antiplatelet therapy was prescribed in 71% (58 to 78%; p<0.001) of ischemic stroke patients. 4% of ischemic stroke patients were dead at 7 days (4 to 7%; p<0.001). Conclusion: Adherence to a common set of a priori selected indicators for quality of care varied across participating audits. These variations might be caused by variations in case mix or patient se-lection across participating hospitals and countries or by real differences in quality of care provided.
Karger_ESC London_2013
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