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Patient characteristics affecting stroke identification by emergency medical service providers in Brooklyn, New York
This study aims to identify patient characteristics that affect prehospital identification of stroke by Long Island college hospital (LICH) emergency medical services (EMS). All suspected strokes brought to LICH by LICH ambulances from January 1, 2010 to December 31, 2011 were included in the study. We compared prehospital care report-based diagnosis against the get with the guidelines (GWTG) database. Age-adjusted logistic regression models were used to study that the effect of individual patient characteristics have on EMS providers’ diagnosis. Included in the study were 10,384 patients with mean age 43.9 years. Of wh...
Source: Internal and Emergency Medicine - November 9, 2015 Category: Emergency Medicine Source Type: research

Predictors of in-hospital mortality and dependence at discharge in patients with MCA stroke with intravenous thrombolysis
AbstractEarly risk stratification of mortality and dependence is important for guiding medical decision-making in stroke care. The study aim is to evaluate whether there are any differences between risk factors for in-hospital mortality and dependence at discharge in patients with first-episode ischemic stroke in the middle cerebral artery (MCA) receiving intravenous thrombolysis (IVT) treatment. The study comprised a single-center cohort of patients admitted consecutively for first-episode MCA ischemic stroke. A logistic regression analysis was performed to determine the variables associated with in-hospital mortality and...
Source: Internal and Emergency Medicine - December 26, 2016 Category: Emergency Medicine Source Type: research

Outcomes of reperfusion therapy for acute ischaemic stroke in patients aged 90 years or older: a retrospective study
AbstractThe benefits and risks of acute reperfusion therapy (RT) in acute ischaemic stroke (AIS) remain uncertain in older patients, especially in nonagenarians. We aimed to assess the impact of RT in this population. Single-center retrospective cohort study comparing patients  ≥ 90 years old admitted to a Stroke Unit (2008–2018) with AIS, submitted or not to RT [intravenous thrombolysis(IVT), mechanical thrombectomy(MT) or both]. Baseline characteristics, in-hospital complications and 3-month outcomes were compared. The primary outcome was 3-month “favorable o utcome”, defined as modified Rankin Scale score 0...
Source: Internal and Emergency Medicine - April 3, 2020 Category: Emergency Medicine Source Type: research

Request of hospital care dropped for TIA but remained stable for stroke during COVID-19 pandemic at a large Italian university hospital
AbstractReduced incidence of stroke during COVID-19 pandemic was sometimes  reported. While decrease in stroke incidence and fear of patients to go to the hospitals were sometimes invoked to explain this decrease, reduction in urban pollution was also hypothesized as a possible cause. We investigated statistically the incidence of ischemic and hemorrhagic stroke, and of transient ischemic attacks, at a large Italian tertiary stroke center during the pandemic. We analyzed statistically the number of transient ischemic attacks (TIA), ischemic strokes (IS) and hemorrhagic strokes (HS) between March 8 and May 2, 2020, the pe...
Source: Internal and Emergency Medicine - October 15, 2020 Category: Emergency Medicine Source Type: research

SMASH-U classification: a tool for aetiology-oriented management of patients with acute haemorrhagic stroke
AbstractIntracerebral haemorrhage (ICH) is responsible for disproportionately high morbidity and mortality rates. The most used ICH classification system is based on the anatomical site. We used SMASH-U, an aetiological based classification system for ICH by predefined criteria: structural vascular lesions (S), medication (M), amyloid angiopathy (A), systemic disease (S), hypertension (H), or undetermined (U). We aimed to correlate SMASH-U classification of our patients to the intra-hospital mortality rates. We performed a single centre retrospective study at the Santa Maria Della Misericordia Hospital, Perugia (Italy) inc...
Source: Internal and Emergency Medicine - April 7, 2020 Category: Emergency Medicine Source Type: research