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Specialty: Emergency Medicine
Management: National Institutes of Health (NIH)
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Total 29 results found since Jan 2013.
The Usefulness of the Kurashiki Prehospital Stroke Scale in Identifying Thrombolytic Candidates in Acute Ischemic Stroke
Patients with acute ischemic stroke should be rapidly triaged to a stroke center with the highest quality of stroke care to assess the severity of a stroke within an appropriate time. However, the important information about the severity of a stroke cannot be provided by widely used prehospital stroke scales. The Kurashiki prehospital stroke scale (KPSS) was constructed using four metrics, including level of consciousness, disturbance of consciousness, motor weakness, and language, with total scores ranging from 0 to 13. The maximum of 13 points represented the most severe symptoms. The KPSS was developed in 2008 to assess...
Source: The Journal of Emergency Medicine - January 23, 2014 Category: Emergency Medicine Authors: J.S. You, H.S. Chung, S.P. Chung, J. Jang, H.S. Lee Source Type: research
Predictors of hospital readmission 1 year after ischemic stroke
AbstractPredictors of short-term readmission after ischemic stroke have been previously identified, but few studies analyzed predictors of long-term readmission, namely early imaging findings and treatment with intravenous thrombolysis (IVT). To characterize predictors of hospital readmission during the first year after hospitalization for ischemic stroke. The study consists of a retrospective cohort of consecutive ischemic stroke patients admitted in a Portuguese university hospital during 2013, who survived index hospitalization. We collected clinical and imaging information using the electronical clinical record. Inform...
Source: Internal and Emergency Medicine - August 5, 2016 Category: Emergency Medicine Source Type: research
Epidemiology of acute kidney injury in patients with stroke: a retrospective analysis from the neurology ICU
AbstractAcute kidney injury (AKI) is proven to be an independent risk factor for adverse clinical outcomes in patients with stroke, but data about the epidemiology of AKI in these patients are not well characterized. Therefore, we investigated the incidence, risk factors, and the impact of AKI on the clinical outcomes in a group of Chinese patients with stroke. We retrospectively recruited 647 stroke patients from the neurology ICU between 2012 and 2013. AKI was identified according to the 2012 KDIGO criteria. Baseline estimated glomerular filtration rate (eGFR) was calculated using modified Chronic Kidney Disease Epidemio...
Source: Internal and Emergency Medicine - June 27, 2017 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
External Validation of the ASTRAL and DRAGON Scores for Prediction of Functional Outcome in Stroke
The ability to predict outcomes after acute stroke facilitates treatment and eases communication with patients. Acute Stroke Registry and Analysis of Lausanne (ASTRAL) was developed for use in acute ischemic stroke patients and does not require imaging. The other score is designed for stroke patients that have been treated with intravenous tissue-type plasminogen activator (tPA) includes dense middle cerebral artery sign, prestroke modifed Rankin Scale score [mRS], age, glucose, onset to treatment, National Institutes of Health Stroke Scale [NIHSS] score (DRAGON).
Source: The Journal of Emergency Medicine - September 30, 2016 Category: Emergency Medicine Authors: Nigel S. George Tags: Abstract Source Type: research
The efficacy and safety of high-dose statins in acute phase of ischemic stroke and transient ischemic attack: a systematic review
AbstractInconsistent findings in the studies have been observed concerning the higher dose of statins use in the acute phase of ischemic stroke and transient ischemic attack (TIA). Therefore, we performed a systematic review to assess this issue. A computerized literature search in PubMed, Cochrane Library databases, and EMBASE for randomized controlled trials (RCTs) was conducted. The efficacy outcome indicators were National Institutes of Health Stroke Scale (NIHSS) score, infarct volume, and recurrence of stroke; the safety outcome indicators were intracranial hemorrhage events, cardiovascular and cerebrovascular events...
Source: Internal and Emergency Medicine - March 15, 2017 Category: Emergency Medicine Source Type: research
PreHospital Ambulance Stroke Test - pilot study of a novel stroke test
There is a need for a prehospital stroke test that in addition to high sensitivity for stroke, also is able to communicate stroke severity similar to the National Institute of Health Stroke Scale (NIHSS).
Source: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine - April 11, 2017 Category: Emergency Medicine Authors: Gunnar Andsberg, Magnus Esbj örnsson, Arne Olofsson, Arne Lindgren, Bo Norrving and Mia von Euler Source Type: research
Lacunar stroke syndromes as predictors of lacunar and non-lacunar infarcts on neuroimaging: a hospital-based study
AbstractLacunar syndromes are usually caused by small ischemic lesions called lacunar infarcts. However, non-lacunar infarcts account for about 20% of lacunar syndromes. The aim of this study was to identify clinical predictors of lacunar syndromes led by non-lacunar infarcts. The following single centre, observational study was conducted on an analysis of the “Perugia hospital-based Stroke Registry” database enrolling consecutive patients admitted with ischemic stroke during the period 2010–2017. We evaluated patient risk factors and clinical features linked to stroke syndrome (lacunar/non-lacunar) and to cerebral i...
Source: Internal and Emergency Medicine - September 17, 2019 Category: Emergency Medicine Source Type: research
Intravenous Thrombolysis at 3.5 Hours From Onset of Pediatric Acute Ischemic Stroke
We report the case of a 14-year-old girl who presented with right-sided weakness and ataxia, loss of sensation, and altered mental status. Magnetic resonance imaging with diffusion-weighted imaging showed an acute lesion in the distribution of the left posterior cerebral artery, and magnetic resonance angiogram demonstrated occlusion of the third branch of the left posterior cerebral artery. With parental consent, clinicians decided to infuse an adult dose of weight-adjusted intravenous alteplase at 3.5 hours from onset of symptoms, with subsequent improvement in National Institutes of Health Stroke Scale score from 11 to ...
Source: Pediatric Emergency Care - January 1, 2020 Category: Emergency Medicine Tags: Illustrative Cases 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
Stroke Code. Intravenous Thrombolysis in Ischemic Stroke. Experience and Results
To analyze the performance and clinical outcomes of the implementation of a stroke code protocol in our field. Descriptive, observational study of all patients treated with intravenous thrombolysis with alteplase (rt-PA) over a 5-year period and analysis of the stroke code circuit performance, response time, clinical, neurological (National Institutes of Health Stroke Scale [NIHSS]), and functional status (modified Rankin scale [mRS]) after treatment and 3 months later.
Source: The Journal of Emergency Medicine - January 23, 2014 Category: Emergency Medicine Authors: D.R. Seguí, A.M. Destruels, J.G. Mora, M.C.B. Oliva, A.P. Guinjoan, F.X. Avilés Jurado, X. Ustrell Source Type: research
Prophylactic antibiotic treatment in severe acute ischemic stroke: the A ntimicrobial chemop R rophylaxis for I schemic ST rok E I n Mace D on I a –Thrace S tudy (ARISTEIDIS)
AbstractInfections represent a leading cause of mortality in patients with acute ischemic stroke, but it is unclear whether prophylactic antibiotic treatment improves the outcome. We aimed to evaluate the effects of this treatment on infection incidence and short-term mortality. This was a pragmatic, prospective multicenter real-world analysis of previously independent consecutive patients with acute ischemic stroke who were>18 years, and who had at admission National Institutes of Health Stroke Scale (NIHSS)>11. Patients with infection at admission or during the preceding month, with axillary temperature at admiss...
Source: Internal and Emergency Medicine - September 21, 2016 Category: Emergency Medicine Source Type: research
Thrombolysis with alteplase 3 –4.5 hours after acute ischaemic stroke: trial reanalysis adjusted for baseline imbalances
In patients presenting to the emergency department with acute stroke, previous evidence from the Third European Cooperative Acute Stroke Study (ECASS III) recommended alteplase treatment within 3 to 4.5 hours of symptoms onset. Factors taken into consideration in the original report include time to treatment, history of smoking or hypertension, and an adjusted National Institute of Health Stroke Scale (NIHSS) score. However, it is unclear if accounting for history of stroke and baseline differences in NIHSS score on arrival may alter outcomes in patients given alteplase.
Source: The Journal of Emergency Medicine - October 1, 2020 Category: Emergency Medicine Authors: Anne Kathryn Watson, Amanda Young Tags: Abstract Source Type: research
Orolingual Angioedema with Alteplase Administration for Treatment of Acute Ischemic Stroke
A 68-year-old African-American male with a history of hypertension and gout (on lisinopril for approximately 1 year) presented to the Emergency Department with 2.5 h of left-arm weakness and numbness. Of note, the patient was in newly discovered rapid atrial fibrillation and, in light of persistent neurologic deficits (National Institutes of Health Stroke Scale 16→7) within 4.5 h, the decision was made to administer i.v. tissue plasminogen activator (tPA) for treatment of presumed embolic right middle cerebral artery stroke. Approximately 30 min post infusion, the patient developed severe diffuse orolingual angioedema of...
Source: The Journal of Emergency Medicine - May 13, 2013 Category: Emergency Medicine Authors: Elizabeth M. Gorski, Michael J. Schmidt Tags: Visual Diagnosis in Emergency Medicine Source Type: research
Readministration of intravenous alteplase in acute ischemic stroke patients: case series and systematic review
Background: Because of a high risk of recurrence of ischemic events, some patients may be candidates for readministration of intravenous (IV) alteplase. Methods: We performed a single-center review and performed a search on PubMed from January 1966 to April 2014 for cases of readministration of alteplase. Favorable outcome was defined by a modified Rankin scale of 0 to 2 at discharge or at 1 to 3 months, improvement of greater than or equal to 4 points within 24 hours in the National Institutes of Health Stroke Scale score, or as a major improvement in the 72-hour National Institutes of Health Stroke Scale score.
Source: The American Journal of Emergency Medicine - July 30, 2014 Category: Emergency Medicine Authors: Adnan I. Qureshi, Ahmed A. Malik, Melissa Freese, Michelle J. Thompson, Asif A. Khan, M. Fareed K. Suri Tags: Case Report Source Type: research
