Botulinum toxin A for post-stroke spasticity: Insights from the French National Hospital Discharge Database (2015-2023).

IF 4.5 3区医学 Q1 CLINICAL NEUROLOGY

European Stroke Journal Pub Date : 2025-09-19 DOI:10.1177/23969873251374771

Djamel Bensmail, Anne Forestier, Jean-Yves Loze, Pierre Karam

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引用次数: 0

Abstract

Background: Botulinum neurotoxin type A (BoNT-A) is a well-established treatment for post-stroke spasticity. However, its real-world use remains underexplored. This study evaluated BoNT-A use trends among stroke survivors in France from 2015 to 2023.

Methods: A retrospective cohort study was conducted using data from the French National Hospital Discharge Database. We analyzed stroke hospitalizations and BoNT-A treatment rates by age and care pathway. Among patients presenting with stroke between 2017 and 2019 who survived beyond 6 months post-stroke, we estimated the prevalence of patients with coded post-stroke spasticity, BoNT-A use, and time from stroke onset to spasticity coding and the first BoNT-A injection.

Results: Between 2015 and 2023, 1,170,436 hospitalizations for stroke were recorded in France. BoNT-A treatment rates remained low, ranging from 1.4% in 2015 to 1.9% in 2022. BoNT-A treatment rates increased from 3.3% to 3.8% in stroke survivors aged 20-29 and from 1.0% to 1.6% in those aged 70-79 between 2015 and 2022. Patients who, during their care pathway, stayed in a neurovascular or neurorehabilitation unit were more likely to receive BoNT-A treatment-rising from 2.0% in 2015 to 2.6% in 2022 and 7.3% to 9.6%, respectively-than those managed in non-specialized units, where rates increased from 0.9% in 2015 to 1.1% in 2022. Among 287,370 patients presenting with stroke between 2017 and 2019, 37,692 (13.1%) were coded with post-stroke spasticity, 8056 (2.8%) received ⩾1 BoNT-A injection between 2017 and 2023, 4360 (1.5%) received ⩾3 injections, and 1003 (0.35%) received ⩾3 injections spaced ⩽6 months apart. The median time from stroke onset to spasticity coding was 96 days, and to the first BoNT-A injection 258 days.

Conclusion: BoNT-A remains underutilized in the treatment of post-stroke spasticity in France. These results emphasize the need to enhance access to and adherence to BoNT-A therapy to optimize post-stroke spasticity management.

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A型肉毒杆菌毒素治疗中风后痉挛：来自法国国家医院出院数据库的见解（2015-2023）。

背景：A型肉毒杆菌神经毒素（BoNT-A）是一种公认的治疗中风后痉挛的方法。然而，它在现实世界中的应用仍未得到充分探索。本研究评估了2015年至2023年法国中风幸存者BoNT-A的使用趋势。方法：回顾性队列研究使用来自法国国家医院出院数据库的数据。我们根据年龄和护理途径分析了卒中住院率和BoNT-A治疗率。在2017年至2019年间卒中后存活超过6个月的卒中患者中，我们估计了卒中后痉挛编码患者的患病率、BoNT-A的使用、卒中发作到痉挛编码和首次注射BoNT-A的时间。结果：2015年至2023年间，法国记录了1,170,436例中风住院治疗。BoNT-A治疗率仍然很低，从2015年的1.4%到2022年的1.9%不等。2015年至2022年间，20-29岁中风幸存者的BoNT-A治疗率从3.3%增加到3.8%，70-79岁中风幸存者的BoNT-A治疗率从1.0%增加到1.6%。在护理过程中，待在神经血管或神经康复病房的患者更有可能接受BoNT-A治疗，分别从2015年的2.0%上升到2022年的2.6%和7.3%上升到9.6%，而非专科病房的患者接受BoNT-A治疗的比例从2015年的0.9%上升到2022年的1.1%。在2017年至2019年期间出现中风的287,370名患者中，37,692名（13.1%）被编码为卒中后痉挛，8056名（2.8%）在2017年至2023年期间接受了小于1次BoNT-A注射，4360名（1.5%）接受了小于3次注射，1003名（0.35%）接受了间隔为6个月的小于3次注射。从中风发作到痉挛编码的中位时间为96天，到第一次注射BoNT-A的中位时间为258天。结论：BoNT-A在法国脑卒中后痉挛的治疗中仍未充分利用。这些结果强调需要提高BoNT-A治疗的可及性和依从性，以优化卒中后痉挛管理。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

European Stroke Journal Multiple-

CiteScore

7.50

自引率

6.60%

发文量

102

期刊介绍： Launched in 2016 the European Stroke Journal (ESJ) is the official journal of the European Stroke Organisation (ESO), a professional non-profit organization with over 1,400 individual members, and affiliations to numerous related national and international societies. ESJ covers clinical stroke research from all fields, including clinical trials, epidemiology, primary and secondary prevention, diagnosis, acute and post-acute management, guidelines, translation of experimental findings into clinical practice, rehabilitation, organisation of stroke care, and societal impact. It is open to authors from all relevant medical and health professions. Article types include review articles, original research, protocols, guidelines, editorials and letters to the Editor. Through ESJ, authors and researchers have gained a new platform for the rapid and professional publication of peer reviewed scientific material of the highest standards; publication in ESJ is highly competitive. The journal and its editorial team has developed excellent cooperation with sister organisations such as the World Stroke Organisation and the International Journal of Stroke, and the American Heart Organization/American Stroke Association and the journal Stroke. ESJ is fully peer-reviewed and is a member of the Committee on Publication Ethics (COPE). Issues are published 4 times a year (March, June, September and December) and articles are published OnlineFirst prior to issue publication.