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Long-term morbidity and mortality in patients without early complications after stroke or transient ischemic attack.
Authors: Edwards JD, Kapral MK, Fang J, Swartz RH Abstract BACKGROUND: Secondary prevention after stroke and transient ischemic attack (TIA) has focused on high early risk of recurrence, but survivors of stroke can have substantial long-term morbidity and mortality. We quantified long-term morbidity and mortality for patients who had no early complications after stroke or TIA and community-based controls. METHODS: This longitudinal case-control study included all ambulatory or hospitalized patients with stroke or TIA (discharged from regional stroke centres in Ontario from 2003 to 2013) who survived for 90 days...
Source: Canadian Medical Association Journal - July 26, 2017 Category: General Medicine Tags: CMAJ Source Type: research

Value of routine echocardiography in the management of stroke.
Abstract BACKGROUND: Transthoracic echocardiography is routinely performed in patients with stroke or transient ischemic attack (TIA) to help plan secondary stroke management, but recent data evaluating its usefulness in this context are lacking. We sought to evaluate the value of echocardiography for identifying clinically actionable findings for secondary stroke prevention. METHODS: We conducted a multicentre cohort study of patients admitted to hospital with stroke or TIA between 2010 and 2015 at 2 academic hospitals in Toronto, Ontario, Canada. Clinically actionable echocardiographic findings for secondar...
Source: cmaj - August 5, 2019 Category: General Medicine Authors: Fralick M, Goldberg N, Rohailla S, Guo Y, Burke MJ, Lapointe-Shaw L, Kwan JL, Weinerman AS, Rawal S, Tang T, Razak F, Verma AA Tags: CMAJ Source Type: research

Secondary stroke prevention services in Canada: a cross-sectional survey and geospatial analysis of resources, capacity and geographic access.
Abstract BACKGROUND: Rapid assessment and management of transient ischemic attacks and nondisabling strokes by specialized stroke prevention services reduces the risk of recurrent stroke and improves outcomes. In Canada, with its vast geography and with 16.8% of the population living in rural areas, access to these services is challenging, and considerable variation in access to care exists. The purpose of this multiphase study was to identify sites across Canada providing stroke prevention services, evaluate resource capacity and determine geographic access for Canadians. METHODS: We developed a Stroke Preve...
Source: cmaj - February 21, 2018 Category: General Medicine Authors: Jewett L, Harroud A, Hill MD, Côté R, Wein T, Smith EE, Gubitz G, Demchuk AM, Sahlas DJ, Gladstone DJ, Lindsay MP Tags: CMAJ Open Source Type: research

Risk of stroke in patients with dengue fever: a population-based cohort study.
Authors: Li HM, Huang YK, Su YC, Kao CH Abstract BACKGROUND: Stroke is a severe neurologic complication of dengue fever, described in only a few case reports. The incidence and risk factors for stroke in patients with dengue remain unclear. We conducted a population-based retrospective cohort study to investigate the risk of stroke in patients with dengue. METHODS: Using data from the Taiwan National Health Insurance Research Database, we included a total of 13 787 patients with dengue newly diagnosed between 2000 and 2012. The control cohort consisted of patients who did not have dengue, matched 1:1 by demogra...
Source: Canadian Medical Association Journal - March 14, 2018 Category: General Medicine Tags: CMAJ Source Type: research

Automated CT Perfusion Imaging to Aid in the Selection of Patients With Acute Ischemic Stroke for Mechanical Thrombectomy: A Health Technology Assessment.
Conclusions: Automated CT perfusion imaging has an acceptable sensitivity and specificity for detecting brain areas that have been affected by stroke. In patients selected for mechanical thrombectomy using automated CT perfusion imaging, there was significant improvement in functional independence. Mechanical thrombectomy informed by automated CT perfusion imaging is likely to be cost-effective. We estimate that publicly funding automated CT perfusion imaging in Ontario would result in additional costs of $1.3 million in year 1 and $0.9 million per year thereafter. PMID: 33240454 [PubMed - in process]
Source: Ontario Health Technology Assessment Series - November 27, 2020 Category: General Medicine Tags: Ont Health Technol Assess Ser Source Type: research

Changes in ischemic stroke presentations, management and outcomes during the first year of the COVID-19 pandemic in Alberta: a population study
CMAJ. 2022 Mar 28;194(12):E444-E455. doi: 10.1503/cmaj.211003.ABSTRACTBACKGROUND: Pandemics may promote hospital avoidance, and added precautions may exacerbate treatment delays for medical emergencies such as stroke. We sought to evaluate ischemic stroke presentations, management and outcomes during the first year of the COVID-19 pandemic.METHODS: We conducted a population-based study, using linked administrative and stroke registry data from Alberta to identify all patients presenting with stroke before the pandemic (Jan. 1, 2016 to Feb. 27, 2020) and in 5 periods over the first pandemic year (Feb. 28, 2020 to Mar. 31, 2...
Source: Canadian Medical Association Journal - March 29, 2022 Category: General Medicine Authors: Aravind Ganesh Jillian M Stang Finlay A McAlister Oleksandr Shlakhter Jessalyn K Holodinsky Balraj Mann Michael D Hill Eric E Smith Source Type: research

Secondary prevention treatment after acute stroke in older South Asian, Chinese and other Canadians: a retrospective data analysis.
Abstract BACKGROUND: Little is known about whether there are differences in medication use between older patients of Chinese descent, those of South Asian descent and other Canadian patients after acute ischemic or primary intracerebral hemorrhagic stroke. The aim of this population-based study was to evaluate potential ethnic differences in secondary prevention pharmacotherapy after acute stroke. METHODS: Using health administrative data, we conducted a retrospective analysis of all patients aged 66 years or more admitted to hospital with acute stroke in Ontario (1997-2011) and British Columbia (1997-2009). ...
Source: cmaj - September 11, 2017 Category: General Medicine Authors: Khan NA, McAlister FA, Pilote L, Palepu A, Quan H, Hill MD, Fang J, Kapral MK Tags: CMAJ Open Source Type: research

Outcomes, experiences and palliative care in major stroke: a multicentre, mixed-method, longitudinal study.
Authors: Kendall M, Cowey E, Mead G, Barber M, McAlpine C, Stott DJ, Boyd K, Murray SA Abstract BACKGROUND: Case fatality after total anterior circulation stroke is high. Our objective was to describe the experiences and needs of patients and caregivers, and to explore whether, and how, palliative care should be integrated into stroke care. METHODS: From 3 stroke services in Scotland, we recruited a purposive sample of people with total anterior circulation stroke, and conducted serial, qualitative interviews with them and their informal and professional caregivers at 6 weeks, 6 months and 1 year. Interviews we...
Source: Canadian Medical Association Journal - March 7, 2018 Category: General Medicine Tags: CMAJ Source Type: research

Self-reported sleep disturbances among people who have had a stroke: a cross-sectional analysis
CMAJ. 2023 Mar 14;195(10):E354-E362. doi: 10.1503/cmaj.221063.ABSTRACTBACKGROUND: Sleep disturbances and their potential association with stroke remains understudied at a population level. We sought to determine the prevalence of sleep disturbances among people who have effects of stroke compared with the general population.METHODS: We used data from people aged 18 years or older who responded to the sleep and chronic disease modules of the 2017-2018 cycle of the Canadian Community Health Survey (CCHS). We measured sleep disturbances by self-reports of having trouble staying awake most or all of the time; either short (<...
Source: Canadian Medical Association Journal - March 14, 2023 Category: General Medicine Authors: Matthew S Jeffers Alison C Pittman Tetyana Kendzerska Dale Corbett Kathryn S Hayward Yue Chen Source Type: research

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