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The article on prehospital management of stroke includes the sentence: “Patients with suspected acute stroke should be given the highest priority for transfer to a specialized stroke unit.” The trend to admit all stroke patients to a stroke unit is questionable in terms of health economics; only 10% of stroke patients are suitable to receive thrombolysis. The admitting physician should differentiate and take heed of the contraindications (tumor patients, multimorbid patients from old people’s homes, dementia patients, patients who have had their second or third stroke within a year), which can be treated far more efficiently and cost effectively in specialized geriatric wards, which provide the opportunity for early rehabilitation by means of physiotherapists, speech therapists, and occupational therapists. However, this would mean that emergency physicians and ambulance drivers should not be subjected to the rule that each patient with suspected stroke should be admitted to a stroke center.

DOI: 10.3238/arztebl.2012.0234b

Dr. med. Klaus Broicher

Krefeld, klausbroicher@gmx.de

Conflict of interest statement
The author holds shares in Bayer, BASF, Merck, and Roche.

1.
Kessler C, Khaw AV, Nabavi DG, Glahn J, Grond M, Busse O: Standardized pre-hospital management of stroke. Dtsch Arztebl Int 2011; 108(36): 585–91. VOLLTEXT
1.Kessler C, Khaw AV, Nabavi DG, Glahn J, Grond M, Busse O: Standardized pre-hospital management of stroke. Dtsch Arztebl Int 2011; 108(36): 585–91. VOLLTEXT