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Centers for Medicare and Medicaid Services Medicare Data and Stroke Research: Goldmine or Landmine? Topical Reviews
Source: Stroke - January 26, 2015 Category: Neurology Authors: Lichtman, J. H., Leifheit-Limson, E. C., Goldstein, L. B. Tags: Health policy and outcome research, Acute Cerebral Hemorrhage, Acute Cerebral Infarction Topical Reviews 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

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

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

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

Patterns of Emergency Medical Services Use and Its Association With Timely Stroke Treatment: Findings From Get With the Guidelines-Stroke Original Articles
Conclusions— Although EMS use is independently associated with more rapid evaluation and treatment of stroke, more than one third of stroke patients fail to use EMSs. Interventions aimed at increasing EMS activation should target populations at risk, particularly younger patients and those of minority race and ethnicity.
Source: Circulation: Cardiovascular Quality and Outcomes - May 21, 2013 Category: Cardiology Authors: Ekundayo, O. J., Saver, J. L., Fonarow, G. C., Schwamm, L. H., Xian, Y., Zhao, X., Hernandez, A. F., Peterson, E. D., Cheng, E. M. Tags: Emergency treatment of Stroke Original Articles Source Type: research

Insurance Status and Outcome after Intracerebral Hemorrhage: Findings from Get With The Guidelines-Stroke
Backgound: Few studies have examined associations among insurance status, treatment, and outcomes in patients hospitalized for intracerebral hemorrhage (ICH).Methods: Through retrospective analyses of the Get With The Guidelines (GWTG)-Stroke database, a national prospective stroke registry, from April 2003 to April 2011, we identified 95,986 nontransferred subjects hospitalized with ICH. Insurance status was categorized as Private/Other, Medicaid, Medicare, or None/Not Documented (ND). Associations between insurance status and in-hospital outcomes and quality of care measures were analyzed using patient- and hospital-spec...
Source: Journal of Stroke and Cerebrovascular Diseases - March 28, 2013 Category: Neurology Authors: Michael L. James, Maria V. Grau-Sepulveda, DaiWai M. Olson, Eric E. Smith, Adrian F. Hernandez, Eric D. Peterson, Lee H. Schwamm, Deepak L. Bhatt, Gregg C. Fonarow Tags: Original Articles Source Type: research

Atrial fibrillation and risk of stroke in dialysis patients
Abstract: Purpose: Both stroke and chronic atrial fibrillation (AF) are common in dialysis patients, but uncertainty exists in the incidence of new strokes and the risk conferred by chronic AF.Methods: A cohort of dually eligible (Medicare and Medicaid) incident dialysis patients was constructed. Medicare claims were used to determine the onset of chronic AF, which was specifically treated as a time-dependent covariate. Cox proportional hazards models were used to model time to stroke.Results: Of 56,734 patients studied, 5629 (9.9%) developed chronic AF. There were 22.8 ischemic and 5.0 hemorrhagic strokes per 1000 patient...
Source: Annals of Epidemiology - January 18, 2013 Category: Epidemiology Authors: James B. Wetmore, Edward F. Ellerbeck, Jonathan D. Mahnken, Milind Phadnis, Sally K. Rigler, Purna Mukhopadhyay, John A. Spertus, Xinhua Zhou, Qingjiang Hou, Theresa I. Shireman Source Type: research

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