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Academic-Community Hospital Comparison of Vulnerabilities in Door-to-Needle Process for Acute Ischemic Stroke Original Articles
Conclusions— Although the identification of common critical failures suggests opportunities for a generalizable process redesign, differences in the criticality and nature of failures must be addressed at the individual hospital level, to develop robust and sustainable solutions to reduce DTN time.
Source: Circulation: Cardiovascular Quality and Outcomes - October 29, 2015 Category: Cardiology Authors: Prabhakaran, S., Khorzad, R., Brown, A., Nannicelli, A. P., Khare, R., Holl, J. L. Tags: Treatment, Ethics and Policy, Ischemic Stroke Original Articles Source Type: research

Timely Reperfusion in Stroke and Myocardial Infarction Is Not Correlated: An Opportunity for Better Coordination of Acute Care Original Article
Conclusions— We found no correlation between hospitals’ observed or risk-adjusted DTN and D2B times. Opportunities exist to improve hospitals’ performance of time-critical care processes for AIS and STEMI in a coordinated approach.
Source: Circulation: Cardiovascular Quality and Outcomes - March 9, 2017 Category: Cardiology Authors: Sauser Zachrison, K., Levine, D. A., Fonarow, G. C., Bhatt, D. L., Cox, M., Schulte, P., Smith, E. E., Suter, R. E., Xian, Y., Schwamm, L. H. Tags: Myocardial Infarction, Health Services, Quality and Outcomes, Ischemic Stroke Original Article Source Type: research

Association Between Early Outpatient Visits and Readmissions After Ischemic Stroke Original Articles
Conclusions: Thirty-day outpatient follow-up was associated with a small reduction in hospital readmission among elderly patients with stroke discharged home. Further work should assess how outpatient care may be improved to further reduce readmissions.
Source: Circulation: Cardiovascular Quality and Outcomes - April 13, 2018 Category: Cardiology Authors: Terman, S. W., Reeves, M. J., Skolarus, L. E., Burke, J. F. Tags: Health Services, Quality and Outcomes, Ischemic Stroke Original Articles Source Type: research

Abstract 17: Association Between Pre-stroke Depression and Patient Reported Outcomes After Acute Ischemic Stroke Session Title: Poster Session Reception: Young Investigator Award Semi-Finalists
Conclusions: Pre-stroke depression is associated with worse patient reported outcomes and greater odds of functional decline after ischemic stroke discharge. Strategies to more effectively manage comorbid depression and improve outcomes in these patients are needed.
Source: Circulation: Cardiovascular Quality and Outcomes - April 5, 2018 Category: Cardiology Authors: Shah, S., Xu, H., Xian, Y., Maisch, L., Hannah, D., Lindholm, B., Lytle, B. L., Pencina, M. J., Olson, D. M., Smith, E. E., Fonarow, G. C., Schwamm, L. H., Bhatt, D. L., Hernandez, A. F., OBrien, E. C. Tags: Session Title: Poster Session Reception: Young Investigator Award Semi-Finalists Source Type: research

Abstract 107: Differential Ischemic Stroke Risk Among Women Veterans Across Age Strata Session Title: Poster Session AM
Conclusions: Nearly half of all women Veterans were found to be at high risk of ischemic stroke within the next 10-years. Furthermore, sex differences were noted across age strata, with women having a lower risk of stroke then men at younger ages and a higher risk at older ages. Given that women tend to have more severe strokes, higher mortality, and delayed diagnosis compared to men, further work is required to understand reasons for the differential stroke risk across sexes. Based on these study findings, implementing primary prevention programs for women Veterans would help to mitigate future ischemic stroke risk.
Source: Circulation: Cardiovascular Quality and Outcomes - April 5, 2018 Category: Cardiology Authors: Comer, A. R., Sico, J., Haggstrom, D. Tags: Session Title: Poster Session AM Source Type: research

Abstract 236: Poor Recurrent Stroke Prevention Knowledge in High Risk Stroke Survivors Poster Session II
Stroke is highly prevalent. Control of hypertension, hyperlipidemia and appropriate antithrombotic use are important in preventing recurrent stroke. Inadequate control of cardiovascular (CV) risk factors and poor stroke knowledge among transient ischemic attack (TIA) and stroke survivors impact stroke recurrence.We used a community-based participatory approach to recruit TIA/stroke survivors from community and clinical sites into a randomized controlled stroke prevention educational intervention trial. We conducted a cross-sectional analysis of baseline survey responses describing demographics, clinical characteristics, an...
Source: Circulation: Cardiovascular Quality and Outcomes - May 15, 2013 Category: Cardiology Authors: Scobie, J. V., Fei, K., Negron, R., Turhim, S., Boden-Albala, B., Horowitz, C. R. Tags: Poster Session II Source Type: research

Abstract 269: Does Functional Recovery After Stroke Vary by Hospital Type? Session Title: Poster Session II
Conclusions: A third of acute ischemic stroke patients had moderate-severe disability three months after hospital discharge and these rates varied considerably among U.S. hospitals. Receiving stroke care at a teaching or primary stroke center hospital was associated with significantly better post discharge functional status.
Source: Circulation: Cardiovascular Quality and Outcomes - June 2, 2014 Category: Cardiology Authors: Prvu Bettger, J., Liang, L., Thomas, L., Bushnell, C., Xian, Y., Wu, J., Peterson, E. D. Tags: Session Title: Poster Session II Source Type: research

Abstract 116: Relationship of Stroke Unit Status With Quality of Care and Outcome for Acute Stroke Patients: Results From China National Stroke Registry II Session Title: Poster Session I
Conclusions: Our study showed that processes of care of AIS were better in patients in hospitals with stroke units. However, patients in hospitals with stroke units didn’t performance differences in clinical outcomes after discharge.
Source: Circulation: Cardiovascular Quality and Outcomes - March 31, 2017 Category: Cardiology Authors: Zhang, X., Li, Z., Wang, C., Wang, C., Yang, X., Gu, H., Pan, Y., Liu, L., Zhao, X., Wang, Y., Wang, Y. Tags: Session Title: Poster Session I Source Type: research

Abstract 109: Neurologists versus Hospitalists: The Effect of Physician Specialty on Stroke Care and Outcomes After Ischemic Stroke and TIA Session Title: Poster Session AM
Conclusions: There is no evidence that patients received dissimilar stroke related care or experienced different outcomes regardless of the physician specialty serving as the primary service. However, stroke patients with hospitalists as their primary team had shorter hospital stay. This difference may be due to hospitalists’ expertise in managing patients with multiple co-morbidities, including stroke patients with underlying diabetes, atrial fibrillation, and hypertension. Based on these findings, utilizing neurology as a consult service for stroke related care will not affect provision of stroke care or patient outcomes.
Source: Circulation: Cardiovascular Quality and Outcomes - April 5, 2018 Category: Cardiology Authors: Comer, A. R., Comer, A. D., Dethoff, A., Templeton, E. J., Slaven, J. J. Tags: Session Title: Poster Session AM Source Type: research

Abstract 145: Illinois Acute Stroke Ready Hospital Designation is Associated With Improved Door-to-Needle Best Practices Session Title: Poster Session AM
Conclusions: Since Illinois introduced ASRH designation in 2009, a steady improvement in meeting acute stroke benchmarks has been observed for hospitals providing care at the entry point of care. Statewide stroke legislation should be considered as a strategy for supporting system-wide implementation of acute stroke best practices.
Source: Circulation: Cardiovascular Quality and Outcomes - April 5, 2018 Category: Cardiology Authors: Richards, C. T., Jones, P., Sednew, R. M., Mirostaw, J., ONeill, K., Prabhakaran, S. Tags: Session Title: Poster Session AM Source Type: research

Abstract 205: Stroke Risk and Symptom Recognition Post Cardiac Catheterization Session Title: Poster Session PM
Over 1.4 million cardiac catheterization procedures (CCPs) take place yearly. CPP related stroke incidence in 1973 was reported as 0.23%. CCPs are invasive in nature with complications occurring due to unintentional trauma to preexisting atherosclerotic aortic plaques or thrombus formation at catheter/guidewire tips. Less common causes of ischemic stroke are air, left ventricular clot, hypotension, arterial dissection, fractured guidewire. Transient neurological deficits have been reported following high-osmolar contrast injection into carotid/vertebral arteries. With improved practice, current stroke incidence is 0.06%. P...
Source: Circulation: Cardiovascular Quality and Outcomes - April 5, 2018 Category: Cardiology Authors: Rivet, C., Schaefer, K., Strom, C. Tags: Session Title: Poster Session PM Source Type: research

Abstract 206: Expansion Of Emergency Medical Services Routing For Stroke In The United States Poster Session II
Conclusions: In 2010 a majority of stroke patients in the United States were hospitalized in an area with established or transitioning to EMS diversion. This milestone coverage of half the US population is a major advance in systematic stroke care, and emphasizes the need for novel approaches, such as telemedicine, to further extend access to stroke center care to all patients.
Source: Circulation: Cardiovascular Quality and Outcomes - May 15, 2013 Category: Cardiology Authors: Sanossian, N., Hanks, N., He, S., Wen, G., Krug, A. M., Kim-Tenser, M., Cen, S., Song, S., Saver, J. L., Adamczyk, P., Mack, W. J. Tags: Poster Session II Source Type: research

Abstract 221: National and Regional Trends in Hospitalizations for Ischemic Stroke after Acute Myocardial Infarction in the United States: 1999-2010 Poster Session II
Conclusions: From 1999 to 2010, the hospitalization rates of ischemic stroke after AMI decreased overall and for demographic subgroups and those undergoing PCI, CABG, or no revascularization. Declines were seen for all regions, but were consistently higher for stroke belt states. Post-AMI strokes 30-day mortality rates decreased over time.
Source: Circulation: Cardiovascular Quality and Outcomes - May 15, 2013 Category: Cardiology Authors: Shi, R., Wang, Y., Lichtman, J. H., Krumholz, H. M., Dharmarajan, K., Masoudi, F. A., Dodson, J. A., Chen, J., Chaudhry, S. I., Spertus, J. A., Nallamothu, B. K. Tags: Poster Session II Source Type: research

Validity of International Classification of Disease Codes to Identify Ischemic Stroke and Intracranial Hemorrhage Among Individuals With Associated Diagnosis of Atrial Fibrillation Original Articles
Conclusions— Using ICD-9 stroke and AF codes to identify patients with stroke plus AF resulted in inaccuracies. Given the expanded financial and policy implications of patient-oriented research, conclusions derived solely from administrative data without validation of outcome events should be interpreted with caution.
Source: Circulation: Cardiovascular Quality and Outcomes - January 20, 2015 Category: Cardiology Authors: Thigpen, J. L., Dillon, C., Forster, K. B., Henault, L., Quinn, E. K., Tripodis, Y., Berger, P. B., Hylek, E. M., Limdi, N. A. Tags: Health policy and outcome research, Acute Cerebral Hemorrhage, Acute Cerebral Infarction Original Articles Source Type: research

Abstract 302: Stroke Legislation Impacts Distribution of Certified Stroke Centers in the United States Session Title: Poster Session III
Conclusion: State stroke legislation significantly increased the number of certified stroke centers in the United States, potentially improving accessibility of standardized care for patients with acute ischemic stroke.
Source: Circulation: Cardiovascular Quality and Outcomes - April 29, 2015 Category: Cardiology Authors: Man, S., Schold, J., Katzan, I. L., Uchino, K. Tags: Session Title: Poster Session III Source Type: research

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