1From the Institute of Clinical Epidemiology and Biometry (S.W., S.H., P.U.H.), Comprehensive Heart Failure Centre (S.W., P.U.H.), University of Würzburg, Würzburg, Germany; Stroke Programme/Agency for Health Quality and Assessment of Catalonia, Barcelona, Spain (S.A.); Department of Clinical Neurosciences, Western General Hospital, Edinburgh, United Kingdom (M.D.); Bavarian Permanent Working Party for Quality Assurance, Munich, Germany (P.H.); Department of Experimental and Clinical Pharmacology, Medical University of Warsaw, Warsaw, Poland (M.N.); Department of Clinical Sciences, Neurology, Lund University, Lund, Sweden (B.N.); Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden (K.A.); and Division of Health and Social Care Research (A.G.R.) and National Institute for Health Research Biomedical Research Centre Guy’s & St Thomas’ NHS Foundation Trust (C.D.A.W.), King’s College London, London, United Kingdom.
BACKGROUND AND PURPOSE—: We compared compliance with standards of acute stroke care between 6 European audits and identified factors associated with delivery of appropriate care. METHODS—: Data were derived from stroke audits in Germany, Poland, Scotland, Catalonia, Sweden, and England/Wales/Northern-Ireland participating within the European Implementation Score (EIS) collaboration. Associations between demographic and clinical characteristics with adherence to predefined quality indicators were investigated by hierarchical logistic regression analyses. RESULTS—: In 2007/2008 data from 329 122 patients with stroke were documented. Substantial variations in adherence to quality indicators were found; older age was associated with a lower probability of receiving thrombolytic therapy,... anticoagulant therapy, or stroke unit treatment and a higher probability of being tested for dysphagia. Women were less likely to receive anticoagulant or antiplatelet therapy or stroke unit treatment. No major weekend effect was found. CONCLUSIONS—: Detected variations in performance of acute stroke services were found. Differences in adherence to quality indicators might indicate population subgroups with specific needs for improving care delivery.