Modeling and simulation of the modified Rankin Scale and National Institutes of Health Stroke Scale neurological endpoints in intracerebral hemorrhage

AbstractIntracerebral hemorrhage (ICH) is a form of stroke characterized by uncontrolled bleeding into the parenchyma of the brain. There is no approved therapy for ICH and it is associated with very poor neurological outcomes with around half of subjects dying within 1  month and most subjects showing complete or partial disability. A key challenge is to identify subjects who could benefit from intervention using characteristics such as baseline hemorrhage volume and the increase in hemorrhage volume in the first few hours, which have been correlated with final o utcomes in ICH. Combined longitudinal models were developed to describe stroke scales using categorical data (Modified Rankin Scale, mRS), continuous bounded data (National Institutes of Health Stroke Scale, NIHSS), and time to death. Covariate effects for baseline hematoma volume and maximum increa se in hematoma volume were incorporated to assess the improvement in outcome when hematoma volume increase would be reduced by a potential treatment. The combined model provided an adequate description of stroke scales, with patients split into a Non-survival and a High-survival sub-population, and dropout due to death was well described by a constant hazard survival model. Models were compared indicating that the combined mRS/NIHSS model provided the most information, followed by the NIHSS-only model, and the mRS-only model, and finally the traditional statistical analysis on dichotomized res ponse at 90 days....
Source: Journal of Pharmacokinetics and Pharmacodynamics - Category: Drugs & Pharmacology Source Type: research

Related Links:

AbstractThe optimal management of oral anticoagulation (OAC) in the acute phase of non valvular atrial fibrillation (NVAF)-related acute ischemic stroke (AIS) remains controversial, especially in very old patients. Therefore, the aim of our study was to evaluate the practical management of OAC in this context. We conducted an observational retrospective study on patients 85-years old and older admitted to two Italian hospitals for NVAF-related AIS. For each patient, clinical and brain computed tomography data were recorded. Type of OAC (vitamin K antagonists, VKAs or Direct Oral Anticoagulants, DOACs), dosage and starting ...
Source: Journal of Thrombosis and Thrombolysis - Category: Hematology Source Type: research
This article is protected by copyright. All rights reserved. PMID: 31581363 [PubMed - as supplied by publisher]
Source: Biomed Res - Category: Research Authors: Tags: J Biomed Mater Res A Source Type: research
CONCLUSIONS: In 2014, there were 28,212,820 (2.02% AIS and 5.50% LDs) hospitalizations. LDs patients had higher prevalence and odds of having AIS compared with non-LDs. Between 2003-2014, of the total 4,224,924 AIS hospitalizations, 451,645 (10.69%) had LDs. Patients with LDs had lower percentages and odds of mortality, risk of death, major/extreme disability, discharge to nursing facility, and complications including epilepsy, stroke-associated pneumonia, GI-bleeding and hemorrhagic-transformation compared to non-LDs. Although LDs are risk factors for AIS, concurrent LDs in AIS is not only associated with lower mortality ...
Source: Medicina (Kaunas) - Category: Universities & Medical Training Authors: Tags: Medicina (Kaunas) Source Type: research
Cerebral stroke is a leading cause of death and persistent disability of elderly in the world. Moreover, after the age of 55, the risk of stroke doubles with each passing decade. Of all strokes, approximately 85 percent are ischemic, caused by blockage of cerebral arteries and remaining hemorrhagic, caused by intracerebral or subarachnoid bleeding. Although stroke prevention by targeting several risk factors such as diabetes, smoking, sedentary lifestyle, hypertension, alcohol abuse and hyperlipidemia have decreased the stroke incidence, the total number of strokes is increasing due to the population aging. After an ischem...
Source: Frontiers in Neurology - Category: Neurology Source Type: research
AbstractPurpose of reviewAs one of the fastest growing portions of the population, nonagenarians will constitute a significant percentage of the stroke patient population in the near future. Nonagenarians are nevertheless not specifically targeted by most clinical guidelines. In this review, we aimed to summarise the available evidence guiding stroke prevention and treatment in this age group.Recent findingsSeveral recent observational studies have shown that the benefits of anticoagulation for the oldest old patients with atrial fibrillation may outweigh the bleeding risk. A sub-analysis of the IST-3 trial has shown for t...
Source: Current Treatment Options in Neurology - Category: Neurology Source Type: research
Maria R. Gancheva1*, Karlea L. Kremer1, Stan Gronthos2,3 and Simon A. Koblar1,3,4 1Stroke Research Programme Laboratory, Adelaide Medical School, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, SA, Australia 2Mesenchymal Stem Cell Laboratory, Adelaide Medical School, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, SA, Australia 3South Australian Health and Medical Research Institute, Adelaide, SA, Australia 4Central Adelaide Local Health Network, Adelaide, SA, Australia Stroke is a leading cause of permanent disability world-wide, but aside from rehabilitatio...
Source: Frontiers in Neurology - Category: Neurology Source Type: research
Emilio Rodríguez-Castro1,2, Manuel Rodríguez-Yáñez1,2, Susana Arias1,2, María Santamaría1,2, Iria López-Dequidt1,2, Ignacio López-Loureiro1, Manuel Rodríguez-Pérez1, Pablo Hervella1, Tomás Sobrino1, Francisco Campos1, José Castillo1* and Ramón Iglesias-Rey1* 1Clinical Neurosciences Research Laboratory, Department of Neurology, Clinical University Hospital, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain2Stroke Unit, Department of Neurology, Hospital Clínico Universitario, Santiago...
Source: Frontiers in Neurology - Category: Neurology Source Type: research
This study demonstrates that combination therapy is more effective than single therapy with either hUCBC or EPO for neurological recovery from subacute stroke. The common pathway underlying hUCBC and EPO treatment requires further study. Introduction Stroke, caused by the disruption of cerebral blood flow, is a leading cause of death and major disability throughout the world (1). However, the therapeutic options to deal with stroke are limited. Despite efforts to develop new therapies for stroke, all treatments have thus far failed to show a clinical effect or are known to have potential toxic effects. Although intra...
Source: Frontiers in Neurology - Category: Neurology Source Type: research
ConclusionsOver the last two decades Polish urban stroke units may have achieved a significant reduction of the occurrence of some noninfectious complications (i.e. MI, exacerbated CHF and DVT). However, the list of conditions associated with stroke unit mortality includes not only MI and exacerbated CHF but also PE, gastrointestinal bleeding and recurrent stroke.
Source: Polish Journal of Neurology and Neurosurgery - Category: Neurosurgery Source Type: research
By ANISH KOKA The weekend started with a tweet about an elderly man with atrial fibrillation.  Atrial fibrillation is an arrhythmia of the heart that predisposes those who suffer with it to strokes.  The strokes are a  result of clots being thrown from the heart into the brain.  The typical treatment for this condition in those deemed high enough risk is to thin the blood to help prevent these clots from forming, and thus reducing the risk of stroke. 101 year old with a history of a stroke stops his Pradaxa. Only other history hypertension. https://t.co/Ai5z519rcX — Anish Koka (@anish_koka) June ...
Source: The Health Care Blog - Category: Consumer Health News Authors: Tags: Uncategorized Source Type: blogs
More News: Bleeding | Brain | Disability | Drugs & Pharmacology | Hemorrhagic Stroke | National Institutes of Health (NIH) | Neurology | Statistics | Stroke