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Condition: Hemorrhagic Stroke
Management: Medicare

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Total 103 results found since Jan 2013.

Cardiovascular, Bleeding, and Mortality Risks in Elderly Medicare Patients Treated with Dabigatran or Warfarin for Non-Valvular Atrial Fibrillation.
CONCLUSIONS: -In general practice settings, dabigatran was associated with reduced risk of ischemic stroke, intracranial hemorrhage, and death, and increased risk of major gastrointestinal hemorrhage compared with warfarin in elderly patients with non-valvular AF. These associations were most pronounced in patients treated with dabigatran 150 mg twice daily, whereas the association of 75 mg twice daily with study outcomes was indistinguishable from warfarin except for a lower risk of intracranial hemorrhage with dabigatran. PMID: 25359164 [PubMed - as supplied by publisher]
Source: Circulation - October 30, 2014 Category: Cardiology Authors: Graham DJ, Reichman ME, Wernecke M, Zhang R, Southworth MR, Levenson M, Sheu TC, Mott K, Goulding MR, Houstoun M, MaCurdy TE, Worrall C, Kelman JA Tags: Circulation Source Type: research

Relationship between Stroke and Mortality in Dialysis Patients.
CONCLUSIONS: Dialysis recipients have high mortality after a stroke with corresponding decrements in remaining years of life. Poststroke mortality does not differ by race. PMID: 25318759 [PubMed - as supplied by publisher]
Source: Clinical Journal of the American Society of Nephrology : CJASN - October 15, 2014 Category: Urology & Nephrology Authors: Wetmore JB, Phadnis MA, Ellerbeck EF, Shireman TI, Rigler SK, Mahnken JD Tags: Clin J Am Soc Nephrol Source Type: research

Long term safety of sacral nerve modulation in medicare beneficiaries
ConclusionsUrological, infectious, and bowel complication occurrences were low after SNS among Medicare beneficiaries with multiple comorbidities. There were infrequent serious complications like hemorrhage and stroke postoperatively. Although SNS appears safe in this high‐risk population, a comprehensive registry will ensure continuous safety. Neurourol. Urodynam. © 2014 Wiley Periodicals, Inc.
Source: Neurourology and Urodynamics - July 25, 2014 Category: Urology & Nephrology Authors: Bilal Chughtai, Art Sedrakyan, Abby Isaacs, Richard Lee, Alexis Te, Steven Kaplan Tags: Original Basic Science Article Source Type: research

Incidence of stroke in the elderly has dropped by 40 percent over the last 20 years
(Elsevier Health Sciences) A new analysis of data from 1988-2008 has revealed a 40 percent decrease in the incidence of stroke in Medicare patients 65 years of age and older. This decline is greater than anticipated considering this population's risk factors for stroke, and applies to both ischemic and hemorrhagic strokes. Investigators also found death resulting from stroke declined during the same period. Their findings are published in the July issue of The American Journal of Medicine.
Source: EurekAlert! - Medicine and Health - July 17, 2014 Category: Global & Universal Source Type: news

Validity of Claims-Based Stroke Algorithms in Contemporary Medicare Data: Reasons for Geographic and Racial Differences in Stroke (REGARDS) Study Linked With Medicare Claims Methods Paper
Conclusions— Claims-based algorithms to identify stroke in a contemporary Medicare cohort had high positive predictive value and specificity, supporting their use as outcomes for etiologic and comparative effectiveness studies in similar populations. These inpatient algorithms are unsuitable for estimating stroke incidence because of low sensitivity.
Source: Circulation: Cardiovascular Quality and Outcomes - July 15, 2014 Category: Cardiology Authors: Kumamaru, H., Judd, S. E., Curtis, J. R., Ramachandran, R., Hardy, N. C., Rhodes, J. D., Safford, M. M., Kissela, B. M., Howard, G., Jalbert, J. J., Brott, T. G., Setoguchi, S. Tags: Health policy and outcome research, Acute Cerebral Hemorrhage, Acute Cerebral Infarction Methods Paper Source Type: research

The Case Files: Unusual Headache
By Al-Hashimi, Siddhartha DO; Leavens, John MD A 23-year-old woman with a history of migraine headaches presented to the emergency department for a different-than-usual headache. She had a six-day history of intermittent headaches. The onset was at rest, and there was no history of trauma.   The headache was located behind her left eye, and it radiated into the posterior portion of her head. She characterized it as being 8/10 in intensity. Bright lights were reported as an exacerbating factor. The headache was associated with nausea and multiple episodes of emesis. She had 10 episodes of vomiting the evening prior to arri...
Source: The Case Files - June 5, 2014 Category: Emergency Medicine Tags: Blog Posts Source Type: research

Atrial Fibrillation, Stroke, and Anticoagulation in Medicare Beneficiaries: Trends by Age, Sex, and Race, 1992-2010 Stroke
Conclusions Ischemic stroke rates among Medicare AF patients decreased significantly in all demographic subpopulations from 1992–2010, coincident with increasing warfarin use. Ischemic stroke rates remained higher and warfarin use rates remained lower for women and blacks with AF, groups whose baseline CHADS scores were higher.
Source: JAHA:Journal of the American Heart Association - June 3, 2014 Category: Cardiology Authors: Shroff, G. R., Solid, C. A., Herzog, C. A. Tags: Stroke 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

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

Medicare and VA Patients Have More Inpatient Complications and Less Neuroimaging Than Uninsured Patients (P2.139)
CONCLUSIONS:Our results indicate that uninsured patients receive more neuroimaging and experience fewer inpatient complications than patients with other insurance types. Further studies are warranted to explain why these differences in coverage impact clinical care to maintain equitable care appropriate for the degree of clinical severity for stroke patients.Disclosure: Dr. Baranwal has nothing to disclose. Dr. Monlezun, Jr has nothing to disclose. Dr. Ryan has nothing to disclose. Dr. Pineda has nothing to disclose. Dr. Shaban has nothing to disclose. Dr. George has received research support from Tulane University School ...
Source: Neurology - April 9, 2014 Category: Neurology Authors: Baranwal, P., Monlezun, D., Ryan, M., Pineda, D., Shaban, A., George, A., El Khoury, R., Martin-Schild, S. 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

Risk of intracranial hemorrhage associated with autosomal dominant polycystic kidney disease in patients with end stage renal disease
Conclusions: ADPKD is a significant risk factor for ICH among patients on maintenance dialysis. Our Medicare primary cohort was older than in previous studies of intracranial aneurysm rupture among ADPKD patients. There are also limitations inherent to using the USRDS database.
Source: BioMed Central - February 26, 2014 Category: Journals (General) Authors: David J YooLawrence AgodoaChristina M YuanKevin C AbbottRobert Nee Source Type: research

Comparison of Medicare Claims Versus Physician Adjudication for Identifying Stroke Outcomes in the Women's Health Initiative Clinical Sciences
Conclusions— Medicare data seem useful for population-based stroke research; however, performance characteristics depend on the definition selected.
Source: Stroke - February 24, 2014 Category: Neurology Authors: Lakshminarayan, K., Larson, J. C., Virnig, B., Fuller, C., Allen, N. B., Limacher, M., Winkelmayer, W. C., Safford, M. M., Burwen, D. R. Tags: Health policy and outcome research Clinical Sciences Source Type: research

Race, Ethnicity, and State-by-State Geographic Variation in Hemorrhagic Stroke in Dialysis Patients.
CONCLUSION: Race and ethnicity, or other factors that covary with these, appear to explain a substantial portion of state-by-state geographic variation in hemorrhagic stroke. This finding suggests that the factors underlying the high rate of hemorrhagic strokes in dialysis patients are likely to be system-wide and that further investigations into regional variations in clinical practices are unlikely to identify large opportunities for preventive interventions for this disorder. PMID: 24458073 [PubMed - as supplied by publisher]
Source: Clinical Journal of the American Society of Nephrology : CJASN - January 23, 2014 Category: Urology & Nephrology Authors: Wetmore JB, Phadnis MA, Mahnken JD, Ellerbeck EF, Rigler SK, Zhou X, Shireman TI Tags: Clin J Am Soc Nephrol Source Type: research