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Stroke Center Care and Outcome: Results from the CSPPC Stroke Program
AbstractThe aim of this study was to assess the association between admission to stroke centers for acute ischemic stroke and complications and mortality during hospitalization in a Chinese population by means of an observational study using data from the China Stroke Center Data-Sharing Platform. We compared in-hospital complications and mortality for patients admitted with acute ischemic stroke (N = 13,236) between November 1, 2018 and December 31, 2018 at stroke center (SH) and non-stroke center (CH) hospitals using distance to hospitals as an instrumental variable to adjust for potential prehospital selection bias....
Source: Translational Stroke Research - September 7, 2019 Category: Neurology Source Type: research

Tissue Plasminogen Activator Thrombolytic Therapy for Acute Ischemic Stroke in 4 Hospital Groups in Japan
In October 2005 in Japan, the recombinant tissue plasminogen activator (tPA) alteplase was approved for patients with acute ischemic stroke within 3 hours of onset at a dose of 0.6 mg/kg. The present study was undertaken to assess the safety and efficacy of alteplase in Japan. Between October 2005 and December 2009, a total of 114 consecutive patients admitted to 4 hospitals received intravenous tPA within 3 hours of stroke onset. Clinical backgrounds and outcomes were investigated. The patients were divided into 2 chronological groups: an early group, comprising 45 patients treated between October 2005 and December 2007,...
Source: Journal of Stroke and Cerebrovascular Diseases - October 4, 2011 Category: Neurology Authors: Syoichiro Kono, Kentaro Deguchi, Nobutoshi Morimoto, Tomoko Kurata, Shoko Deguchi, Tohru Yamashita, Yoshio Ikeda, Tohru Matsuura, Hisashi Narai, Nobuhiko Omori, Yasuhiro Manabe, Taijyun Yunoki, Yoshiki Takao, Sanami Kawata, Kenichi Kashihara, Koji Abe Tags: Original Articles Source Type: research

Time to ct scan imaging after symptom onset among ischeamic stroke patients presenting to a quaternary hospital in ghana
This study sought to determine the time of onset of symptoms to the time a CT imaging was done among patients presenting with acute stroke at the Korle-Bu Teaching Hospital.
Source: Journal of Stroke and Cerebrovascular Diseases - March 30, 2023 Category: Neurology Authors: F. Duodu, D. Brodie Mends, B. Agbinko-Djobalar, P. Pekyi-Boateng, M. Amerwornu, P Adjei, A Akpalu, K Nkromah Source Type: research

National Survey of Thrombolytic Therapy for Acute Ischemic Stroke in Taiwan 2003-2010
Data on thrombolytic therapy at the national level is scarce in Asia. Understanding current practice pattern is important for a policy maker in decision making. This cross-sectional study analyzed the utilization pattern of thrombolytic therapy for acute ischemic stroke (AIS) in Taiwan from 2003 through 2010 and identified factors associated with post-therapy intracerebral hemorrhage (ICH) and mortality. From the Taiwan National Health Insurance Research Database, we retrieved inpatient claims for patients with AIS. The frequency of thrombolytic therapy in AIS admissions and its association with the characteristics of pati...
Source: Journal of Stroke and Cerebrovascular Diseases - October 14, 2013 Category: Neurology Authors: Cheng-Yang Hsieh, Chih-Hung Chen, Yi-Chi Chen, Yea-Huei Kao Yang Tags: Original Articles Source Type: research

Predictors of In-hospital Mortality and the Risk of Symptomatic Intracerebral Hemorrhage after Thrombolytic Therapy with Recombinant Tissue Plasminogen Activator in Acute Ischemic Stroke
This study aimed to determine the independent predictors of in-hospital mortality (IHM) and the risk of sICH after rt-PA therapy. A total of 1007 patients (mean age, 72 ± 12 years; 52% women; mean National Institutes of Health Stroke Scale [NIHSS] score, 11.6 ± 5.6) with AIS treated with rt-PA were enrolled in this study during a 42-month period beginning in November 2007. Univariate and multivariate regression analyses were performed to estimate the predictors of IHM. Eighty-three of the 1007 patients (8.2%) died during hospitalization (mean duration of hospitalization, 10 ± 1.8 days). Logistic regression estimated the...
Source: Journal of Stroke and Cerebrovascular Diseases - May 14, 2012 Category: Neurology Authors: Mohamed Al-Khaled, Christine Matthis, Jürgen Eggers Tags: Original Articles Source Type: research

Effect of a provincial system of stroke care delivery on stroke care and outcomes.
Abstract BACKGROUND:Systems of stroke care delivery have been promoted as a means of improving the quality of stroke care, but little is known about their effectiveness. We assessed the effect of the Ontario Stroke System, a province-wide strategy of regionalized stroke care delivery, on stroke care and outcomes in Ontario, Canada. METHODS:We used population-based provincial administrative databases to identify all emergency department visits and hospital admissions for acute stroke and transient ischemic attack from Jan. 1, 2001, to Dec. 31, 2010. Using piecewise regression analyses, we assessed the effect of the...
Source: cmaj - May 27, 2013 Category: Journals (General) Authors: Kapral MK, Fang J, Silver FL, Hall R, Stamplecoski M, O'Callaghan C, Tu JV Tags: CMAJ Source Type: research

China stroke surveillance report 2021
AbstractSince 2015, stroke has become the leading cause of death and disability in China, posing a significant threat to the health of its citizens as a major chronic non-communicable disease. According to the China Stroke High-risk Population Screening and Intervention Program, an estimated 17.8 million [95% confidence interval (CI) 17.6 –18.0 million] adults in China had experienced a stroke in 2020, with 3.4 million (95% CI 3.3–3.5 million) experiencing their first-ever stroke and another 2.3 million (95% CI 2.2–2.4 million) dying as a result. Additionally, approximately 12.5% (95% CI 12.4–12.5%) of stroke survi...
Source: Military Medical Research - July 19, 2023 Category: International Medicine & Public Health Source Type: research

Drip-and-Ship Thrombolytic Therapy Supported by the Telestroke System for Acute Ischemic Stroke Patients Living in Medically Under-served Areas.
Authors: Kageji T, Obata F, Oka H, Kanematsu Y, Tabata R, Tani K, Bando H, Nagahiro S Abstract There are a few stroke specialists in medically under-served areas in Japan. Consequently, in remote area patients may not receive thrombolysis with intravenous recombinant tissue plasminogen activator (iv rt-PA), the standard treatment for acute ischemic stroke. Using a mobile telestroke support system (TSS) that accesses the internet via a smart phone, we implemented iv rt-PA infusion therapy under a drip-and-ship protocol to treat the stroke patients in medically under-served areas. The physicians at the Tokushima Pref...
Source: Neurologia Medico-Chirurgica - June 25, 2016 Category: Neurosurgery Tags: Neurol Med Chir (Tokyo) Source Type: research

IJERPH, Vol. 17, Pages 618: Risk Factors Associated with Outcomes of Recombinant Tissue Plasminogen Activator Therapy in Patients with Acute Ischemic Stroke
eng Tsong-Hai Lee Ischemic stroke is the most common type of stroke, and early interventional treatment is associated with favorable outcomes. In the guidelines, thrombolytic therapy using recombinant tissue-type plasminogen activator (rt-PA) is recommended for eligible patients with acute ischemic stroke. However, the risk of hemorrhagic complications limits the use of rt-PA, and the risk factors for poor treatment outcomes need to be identified. To identify the risk factors associated with in-hospital poor outcomes in patients treated with rt-PA, we analyzed the electronic medical records of patients who were diagn...
Source: International Journal of Environmental Research and Public Health - January 17, 2020 Category: Environmental Health Authors: Yi-Ju Tseng Ru-Fang Hu Shin-Tyng Lee Yu-Li Lin Chien-Lung Hsu Shih-Wei Lin Chia-Wei Liou Jiann-Der Lee Tsung-I Peng Tsong-Hai Lee Tags: Article Source Type: research

Acute Ischemic Stroke With Mild Symptoms –To Thrombolyse or Not to Thrombolyse?
The objective of this review is to evaluate the current literature and evidence regarding the management of minor stroke, with a particular emphasis on the role of IV thrombolysis. Definition of minor stroke, pre-hospital recognition of minor stroke and stroke of unknown onset are discussed together with neuroimaging aspects and existing evidence for IV thrombolysis in minor strokes. Though current guidelines advise against the use of thrombolysis in those without clearly disabling symptoms due to a paucity of evidence, advanced imaging techniques may be able to identify those likely to benefit. Further research on this topic is ongoing.
Source: Frontiers in Neurology - November 18, 2021 Category: Neurology Source Type: research

Thrombolysis ImPlementation in Stroke (TIPS): evaluating the effectiveness of a strategy to increase the adoption of best evidence practice - protocol for a cluster randomised controlled trial in acute stroke care
DiscussionTIPS will trial a comprehensive, multi-component and multidisciplinary collaborative approach to improving thrombolysis rates at multiple sites. The trial has the potential to identify methods for optimal care which can be implemented for stroke patients during the acute phase. Study findings will include barriers and solutions to effective thrombolysis implementation and trial outcomes will be published whether significant or not.Trial registration: Australian New Zealand Clinical Trials Registry: ACTRN12613000939796
Source: Implementation Science - March 25, 2014 Category: Health Management Authors: Christine PaulChristopher LeviCatherine D¿EsteMark ParsonsChristopher BladinRichard LindleyJohn AttiaFrans HenskensErin LalorMark LongworthSandy MiddletonAnnika RyanErin KerrRobert Sanson-Fisher Source Type: research

Combining transcranial ultrasound with intelligent communication methods to enhance the remote assessment and management of stroke patients: Framework for a technology demonstrator
With over 150,000 strokes in the United Kingdom every year, and more than 1 million living survivors, stroke is the third most common cause of death and the leading cause of severe physical disability among adults. A major challenge in administering timely treatment is determining whether the stroke is due to vascular blockage (ischaemic) or haemorrhage. For patients with ischaemic stroke, thrombolysis (i.e. pharmacological ‘clot-busting’) can improve outcomes when delivered swiftly after onset, and current National Health Service Quality Improvement Scotland guidelines are for thrombolytic therapy to be provid...
Source: Health Informatics Journal - August 8, 2016 Category: Information Technology Authors: Mort, A., Eadie, L., Regan, L., Macaden, A., Heaney, D., Bouamrane, M.-M., Rushworth, G., Wilson, P. Tags: Articles Source Type: research

Safety and efficacy of desmoteplase given 3–9 h after ischaemic stroke in patients with occlusion or high-grade stenosis in major cerebral arteries (DIAS-3): a double-blind, randomised, placebo-controlled phase 3 trial
Publication date: Available online 30 April 2015 Source:The Lancet Neurology Author(s): Gregory W Albers , Rüdiger von Kummer , Thomas Truelsen , Jens-Kristian S Jensen , Gabriela M Ravn , Bjørn A Grønning , Hugues Chabriat , Ku-Chou Chang , Antonio E Davalos , Gary A Ford , James Grotta , Markku Kaste , Lee H Schwamm , Ashfaq Shuaib Background Current treatment of ischaemic stroke with thrombolytic therapy is restricted to 3–4·5 h after symptom onset. We aimed to assess the safety and efficacy of desmoteplase, a fibrin-dependent plasminogen activator, given between 3 h and 9 h after symptom onset in patients with ...
Source: The Lancet Neurology - May 1, 2015 Category: Neurology Source Type: research

Safety of tirofiban for patients with acute ischemic stroke in routine clinical practice.
Authors: Zhu YQ, Zhang YJ, Ruan HL, Liu Q, Zhan Q, Li Q Abstract The aim of the present study was to investigate the safety of tirofiban alone and in combination with various treatments in acute ischemic stroke (AIS). A total of 120 patients with AIS were included in the study, and these patients were divided into three treatment groups: Group A (tirofiban alone, n=68), group B (tirofiban plus thrombolytic therapy, n=26), and group C (tirofiban as a 'bridging therapy', n=26). Risk factors, stroke severity, initial imaging, treatment regimens, complications and long-term outcomes were analyzed. In total, eight patie...
Source: Experimental and Therapeutic Medicine - November 18, 2015 Category: Journals (General) Tags: Exp Ther Med Source Type: research

Complications associated with recombinant tissue plasminogen activator therapy for acute ischaemic stroke.
Abstract Intravenous recombinant human tissue plasminogen activato (rtPA, formulated as alteplase) is the primary therapy for acute ischaemic stroke by breaking down a clot of an occluded vessel. There are several randomised controlled trials and observational studies that support the use of rtPA to improve functional outcome following acute ischaemic stroke. However, thrombolytic therapy with rtPA can be associated with a number of complications. Many of the rtPA-related complications result from its thrombolytic action including bleeding (intracerebral and systemic haemorrhage), reperfusion injury with oedema, a...
Source: CNS and Neurological Disorders Drug Targets - February 4, 2013 Category: Drugs & Pharmacology Authors: Balami JS, Sutherland BA, Buchan AM Tags: CNS Neurol Disord Drug Targets Source Type: research

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