European Heart Journal Advance Access originally published online on March 11, 2005
European Heart Journal 2005 26(8):848; doi:10.1093/eurheartj/ehi209
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Comment on stroke with atrial fibrillation: data from the Austrian stroke registry
a
Department of Internal Medicine
Bjelovar General Hospital
Mihanovi
eva 8
HR-43000 Bjelovar
Croatia
Tel: +385 43 279 228
Fax: +385 43 279 333
E-mail address: mivanusa{at}vip.hr
a
Department of Neurology
Bjelovar General Hospital
Mihanovieva 8
HR-43000 Bjelovar
Croatia
We read with great interest the recent article by Steger et al.1 This report confirmed the important reality that stroke with atrial fibrillation is associated with worse in-hospital outcome. The accompanying editorial by Thijs2 provides us with an excellent overview about the key principles in the management of acute complications in this potentially deadly disease.
Steger et al. unfortunately do not give us the information of exact number of acute cerebral computed tomography (CT) or magnetic resonance imaging; so we do not have precise insight into how the stroke pathological type was documented. Although we know from the article by Brainin et al.3 that the rates of acute CT scanning in stroke patients in Austria are high, this information will be useful as a quality measure.
In addition, it was not obvious from the article in which departments the patients were treated (i.e. neurological wards, stroke units, intensive neurological units, or central intensive care units) and by whom the patients were treated (neurologists, intensive care specialists, or internists). The level of education, physician volume, and intensity of medical care are associated with outcomes of patients with cerebrovascular4,5 and cardiovascular diseases.6 The authors only report the fact that mortality did not differ among hospital departments regarding the number of included patients.
References
- Steger C, Pratter A, Martinek-Bregel M, Avanzini M, Valentin A, Slany J, Stollberger C. Stroke patients with atrial fibrillation have a worse prognosis than patients without: data from the Austrian Stroke registry. Eur Heart J 2004;25:1734–1740.
[Abstract/Free Full Text] - Thijs V. More bad news about atrial fibrillation. Eur Heart J 2004;25:1670–1671.
[Free Full Text] - Brainin M, Bornstein N, Boysen G, Demarin V, for the EFNS Task Force on Acute Neurological Stroke Care. Acute neurological stroke care in Europe: results of the European Stroke Care Inventory. Eur J Neurol 2000;7:5–10.[CrossRef][ISI][Medline]
- Caplan L. Stroke is best managed by neurologists. Stroke 2003;34:2763.
[Free Full Text] - Brainin M, Olsen TS, Chamorro A, Diener HC, Ferro J, Hennerici MG, Langhorne P, Sivenius J, for the EUSI Executive Committee and the EUSI Writing Committee. Organisation of stroke care: education, referral, emergency management and imaging, stroke units and rehabilitation. Cerebrovasc Dis 2004;17 (Suppl. 2):1–14.[ISI][Medline]
- Tu JV, Austin PC, Chan BTB. Relationship between annual volume of patients treated by admitting physician and mortality after acute myocardial infarction. JAMA 2001;285:3116–3122.
[Abstract/Free Full Text]
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