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Are Treatment Preferences of Those Who Died Ever Heard?: The Lack of Documentation of Preferences in a State-Wide Cohort of Patients Who Died Following Ischemic Stroke (S47.004)
CONCLUSIONS: Among a representative sample of California patients who died within 30 days after an ischemic stroke, less than half had documented discussions about LSI. The new Medicare policy could serve as an additional barrier to increasing communication about preferences, as physicians may fear that these discussions would lead to withdrawal of LSI, increased 30-day mortality, and thus misleading estimates of the hospital’s quality of care. Study Supported by:California OSHPD, RWJCSPDisclosure: Dr. Robinson has nothing to disclose. Dr. Vickrey has received personal compensation for activities with EMD Serono as a...
Source: Neurology - April 8, 2015 Category: Neurology Authors: Robinson, M., Vickrey, B., Holloway, R., Chong, K., Williams, L., Parikh, P., Leng, M., Zingmond, D. Tags: Cerebrovascular Disease and Interventional Neurology Source Type: research

Racial And Ethnic Disparities In Stroke. Declining Age At Time Of Stroke. Analysis Of The Nationwide Inpatient Sample 1988-2010 (S12.002)
CONCLUSIONS: In this longitudinal national sample age at time of stroke became younger for blacks and Hispanics, but not Caucasians. This has increased the disparity of age of onset between blacks and Caucasians. Over time the number of comorbidities have increased, perhaps due to upcoding by hospitals rather than worsening health status of the population.Disclosure: Dr. Costa has nothing to disclose. Dr. Dubinsky has received personal compensation for activities with Allergan Inc. Dr. Dubinsky has received research support from Allergan Inc., Medevation Pharmaceuticals, and from the National Institutes of Health.
Source: Neurology - April 9, 2014 Category: Neurology Authors: Costa, C., Dubinsky, R. Tags: Cerebrovascular Disease and Interventional Neurology: Epidemiology and Risk Factors Source Type: research

Medicare's New Two Midnight Rule for In-patient Status Admission Applied to Transient Ischemic Attack Patients Predicted by Hypertension History and Age (P6.275)
CONCLUSIONS:In our population of TIA patients, history of hypertension and age >70 years were the only baseline variables that significantly predicted LOS >2 days or 2 midnights. Our findings suggests that consideration of age and pre-existing hypertension may facilitate accurate prediction of patients who will exceed the 2 midnight Medicare rule and require in-patient admission versus observation status for TIA patients. Our findings require validation in a larger sample in a different population to determine generalizabilty.Study Supported by: Disclosure: Dr. Chavez-Keatts has nothing to disclose. Dr. Monlezun, ...
Source: Neurology - April 9, 2014 Category: Neurology Authors: Chavez-Keatts, M., Monlezun, D., George, A., El Khoury, R., Martin-Schild, S. Tags: Cerebrovascular Disease and Interventional Neurology: Risk Factors Source Type: research

Comparability of Charges and Payments for Hospitalized Stroke (P2.130)
Conclusions: For profit organizations were more likely to submit higher charges, but collect less in payments, with higher comparability of billing, compared to non-profit organizations across all DRGs.Disclosure: Dr. Bulic has nothing to disclose. Dr. Kim-Tenser has nothing to disclose. Dr. He has nothing to disclose. Dr. Kazaryan has nothing to disclose. Dr. Cen has nothing to disclose. Dr. He has nothing to disclose. Dr. Mack has nothing to disclose. Dr. Sanossian has received personal compensation for activities with Boehringer-Ingelheim Pharmaceutical Inc.
Source: Neurology - April 9, 2014 Category: Neurology Authors: Bulic, S., Kim, M., He, S., Kazaryan, S., Cen, S., He, S., Mack, W., Sanossian, N. Tags: Cerebrovascular Disease and Interventional Neurology: Evaluation, Cost, and Quality Source Type: research

Show or No-Show - That Is the Question: Lack of Outpatient Follow-up a After Acute Stroke. (P2.131)
CONCLUSION: Poor follow up rates were seen overall. Medicare, Medicaid, and self-pay patients were least likely to follow up. Patients discharged to inpatient rehabilitation or nursing facilities had a low follow-up rate, as did those patients living at a geographic distance from our facilities. Better education of the importance of follow-up prior to discharge is needed.Disclosure: Dr. Chaudhary has nothing to disclose. Dr. Lee has nothing to disclose.
Source: Neurology - April 9, 2014 Category: Neurology Authors: Chaudhary, G., Lee, J. Tags: Cerebrovascular Disease and Interventional Neurology: Evaluation, Cost, and Quality Source Type: research

Medicare Coverage Increases Odds of In-Hospital Mortality but Lack of Insurance Increases Odds of Poor Functional Outcome by Modified Rankin Score (mRS) (P2.138)
CONCLUSIONS:Medicare patients have greater odds of in-hospital mortality compared to uninsured, private, and VA patients, though uninsured patients had the highest odds of poor functional outcome on discharge. Further studies are needed to determine whether coverage is a stronger predictor of admission or in-hospital variables to determine if the observed outcome differences are more associated with variance in admission or in-hospital care.Disclosure: Dr. Friedant has nothing to disclose. Dr. Monlezun, Jr has nothing to disclose. Dr. Baranwal has nothing to disclose. Dr. Valmoria has nothing to disclose. Dr. Shaban has no...
Source: Neurology - April 9, 2014 Category: Neurology Authors: Friedant, A., Monlezun, D., Baranwal, P., Valmoria, M., Shaban, A., George, A., El Khoury, R., Martin-Schild, S. Tags: Cerebrovascular Disease and Interventional Neurology: Disparity Source Type: research

Uninsured Patients May Lack Diagnoses for Chronic Diseases That Are Known Stroke Risk Predictors (P2.140)
CONCLUSIONS:In our population, uninsured patients were significantly less likely to have risk factors for stroke based on past medical history. However, the same population had the higher prevalence of systolic hypertension and elevated LDL on admission and were not taking medications at home. Together, this suggests that uninsured patients may lack access to resources needed to diagnose and treat known chronic risk factors for stroke.Disclosure: Dr. Baranwal has nothing to disclose. Dr. Monlezun, Jr has nothing to disclose. Dr. Lanceta has nothing to disclose. Dr. Shaban has nothing to disclose. Dr. George has received re...
Source: Neurology - April 9, 2014 Category: Neurology Authors: Baranwal, P., Monlezun, D., Lanceta, J., Shaban, A., George, A., Martin-Schild, S., El Khoury, R. Tags: Cerebrovascular Disease and Interventional Neurology: Disparity Source Type: research

Factors Associated With 30-Day Readmission Rate Among Stroke Patients From 2009-2012 At Two Tertiary Level Hospitals In Metro Portland Area (P3.090)
CONCLUSIONS:Elderly patients with stroke with shorter length of stay who are discharged home are at the highest risk for getting readmitted within 30 days. These subgroups could be targeted for interventions in preventing 30 day readmission. These findings should be validated in larger studies.Disclosure: Dr. Kansara has nothing to disclose. Dr. Stuchiner has nothing to disclose. Dr. Baraban has nothing to disclose. Dr. Bhatt has nothing to disclose.
Source: Neurology - April 9, 2014 Category: Neurology Authors: Kansara, A., Stuchiner, T., Baraban, E., Bhatt, A. Tags: Cerebrovascular Disease and Interventional Neurology: Clinical Management Source Type: research

Incidence and prevalence of treated epilepsy among poor health and low-income Americans
Conclusions: The Medicaid population has a high incidence and prevalence of epilepsy, in an order of magnitude greater than that reported in the US general population. This indigent population carries a disproportionate amount of the epilepsy burden and deserves more attention for its health care needs and support services.
Source: Neurology - May 20, 2013 Category: Neurology Authors: Kaiboriboon, K., Bakaki, P. M., Lhatoo, S. D., Koroukian, S. Tags: Cohort studies, Prevalence studies, Incidence studies, All Epilepsy/Seizures ARTICLE Source Type: research

Risk Factor Prevalence in a Young Stroke Population: Get with the Guidelines (P03.155)
CONCLUSIONS: Our data suggest a high prevalence of stroke risk factors in a young population. More importantly, we observed a significantly increased prevalence of HTN, DM and dyslipidemia in patients 40-50years of age. Our findings suggest a need for more aggressive screening for primary stroke prevention at younger ages than previously recommended.Disclosure: Dr. Pikula has nothing to disclose. Dr. Un Candan has nothing to disclose. Dr. Lau has nothing to disclose. Dr. Romero has nothing to disclose. Dr. Nguyen has nothing to disclose. Dr. Babikian has nothing to disclose. Dr. Kase has nothing to disclose.
Source: Neurology - February 14, 2013 Category: Neurology Authors: Pikula, A., Un Candan, F., Lau, H., Romero, J., Nguyen, T., Babikian, V., Kase, C. Tags: P03 Cerebrovascular Disease III Source Type: research

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