Schlaganfallkonsortium Rhein-Neckar (Stroke Consortium Rhine-Neckar)

Study Overview
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Brief Summary
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FAST is an investigator-initiated multicenter study embedded in a German multistate acute stroke network. The main objectives of the FAST study are to improve outcomes and quality of care for stroke patients, to quantify the number of patients in need of thrombectomy within an integrated stroke network, to study the best way of delivering and performing thrombectomy and to investigate the best model of pre-hospital selection and referral for stroke patients.

Detailed Description
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Since 2015, mechanical thrombectomy in patients with large vessel occlusion has become an evidence based highly efficient treatment. In contrast to thrombolysis, thrombectomy can only be delivered by qualified interventionalists at comprehensive stroke centers. Thus, the implementation of thrombectomy into clinical practice remains a challenge. The investigators aim to establish a population based approach within a patient registry in a federal state overarching regional stroke network covering over 4 million inhabitants and integrating approximately 30 hospitals with different levels of expertise. The registry will include data from all acute ischemic stroke patients - approx. 12.000 patients p.a - within the network. The investigators plan to establish a central multi-interface platform integrating clinical data from the prehospital, intrahospital and rehabilitation phase including mandatory quality assurance, neurological and neuroradiological treatment and outcome data. The registry will allow addressing important questions, such as how many patients are candidates for thrombectomy, how many resources are needed to meet that demand and how treatment procedures and times can be improved. The overarching aim is to deliver high quality stroke care to every patient in the region.

Official Title
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Schlaganfallkonsortium Rhein-Neckar (Stroke Consortium Rhine-Neckar)

Conditions
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Ischemic Stroke, Vascular Diseases, Cardiovascular Diseases

Intervention / Treatment
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* Other: not applicable (observational study)


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: 18 years or older Patients with ischemic stroke who are admitted to one of the hospitals of the Stroke Consortium Rhein-Neckar (FAST) informed consent Exclusion Criteria: no informed consent

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Primary CSC (Comprehensive Stroke center) admission<br>Patients with primary admission to endovascular-ready hospital (comprehensive stroke center) | Other: not applicable (observational study)<br>* Observational study without study related intervention<br>|
| Primary non-CSC (non-Comprehensive Stroke Center) SU (Stroke Unit) admission<br>Patients with primary admission to non-endovascular-ready hospital with (regional/local) stroke unit | Other: not applicable (observational study)<br>* Observational study without study related intervention<br>|
| Non-acute stroke hospital admission<br>Patients with primary admission to non-acute stroke-ready hospital | Other: not applicable (observational study)<br>* Observational study without study related intervention<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Functional outcome | Functional outcome according to the modified Rankin Scale (mRS) | 3 months after intervention | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Number of patients receiving acute recanalisation therapies of all referrals | Number of patients receiving thrombolysis and/or thrombectomy of all patients included in to the Network via the database. | 24 h after stroke onset | 
| Referral rates | Referral rates by stroke service level (i.e. type of treatment center) | Stroke onset to discharge from acute hospital; through study completion, an average of 2 years | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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stroke network, acute stroke care, emergency medical services, integrated care