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Substantial Progress Yet Significant Opportunity for Improvement in Stroke Care in China Clinical Sciences
Conclusions—Adherence to stroke performance metrics has increased over time, but significant opportunities remain for further improvement. Continuous stroke quality improvement program should be developed as a national priority in China.
Source: Stroke - October 23, 2016 Category: Neurology Authors: Li, Z., Wang, C., Zhao, X., Liu, L., , Li, H., Shen, H., Liang, L., Bettger, J., Yang, Q., Wang, D., Wang, A., Pan, Y., Jiang, Y., Yang, X., Zhang, C., Fonarow, G. C., Schwamm, L. H., Hu, B., Peterson, E. D., Xian, Y., Wang, Y., Tags: Clinical Studies, Health Services, Quality and Outcomes, Cerebrovascular Disease/Stroke Original Contributions Source Type: research

World Stroke Organization Global Stroke Services Guidelines and Action Plan
Every two seconds, someone across the globe suffers a symptomatic stroke. ‘Silent’ cerebrovascular disease insidiously contributes to worldwide disability by causing cognitive impairment in the elderly. The risk of cerebrovascular disease is disproportionately higher in low to middle income countries where there may be barriers to stroke care. The last two decades have seen a major transformation in the stroke field with the emergence of evidence‐based approaches to stroke prevention, acute stroke management, and stroke recovery. The current challenge lies in implementing these interventions, particularly in regions ...
Source: International Journal of Stroke - September 23, 2014 Category: Neurology Authors: Patrice Lindsay, Karen L. Furie, Stephen M. Davis, Geoffrey A. Donnan, Bo Norrving Tags: Guidelines Source Type: research

Perception Of Stroke Symptoms And Utilization Of Emergency Medical Systems In Argentina (P7.132)
CONCLUSIONS:These results suggest a low level of stroke symptoms awareness in our country even in a population of middle/high socioeconomic level. The role and procedures of EMS in Argentina should be revised as early arrival and treatment appear to be associated with no utilization of them.Study Supported by:Disclosure: Dr. Hawkes has nothing to disclose. Dr. Calandri has nothing to disclose. Dr. Farez has received personal compensation for activities with Merck Serono. Dr. Farez has received research support from Novartis. Dr. Arena has nothing to disclose. Dr. Pujol Lereis has nothing to disclose. Dr. Ameriso has nothing to disclose.
Source: Neurology - April 9, 2014 Category: Neurology Authors: Hawkes, M., Calandri, I., Farez, M., Arena, J., Pujol Lereis, V., Ameriso, S. Tags: Cerebrovascular Disease and Interventional Neurology: Barriers and Opportunities in Acute Stroke Treatment Source Type: research

Why Ischemic Stroke Patients Do Not Receive Thrombolytic Treatment? (P7.122)
CONCLUSIONS:This retrospective analysis suggests that less than half of the patients presenting within 4 hours of symptom onset receive rt-PA. The most common reason was minor or rapidly improving symptoms. A significant proportion of patients did not receive rt-PA because patient or family refused. Minority of patients had absolute contraindication. More patient and family education is needed to allay fears of rt-PA use.Disclosure: Dr. Lee has nothing to disclose.
Source: Neurology - April 9, 2014 Category: Neurology Authors: Lahoti, S., Lee, J. Tags: Cerebrovascular Disease and Interventional Neurology: Issues in Acute Stroke Treatment Source Type: research

Frequency of Hemorrhage on Follow Up Imaging in Stroke Patients Treated With rt-PA Depending on Clinical Course
Conclusions: Frequency of hemorrhagic transformation in Routine follow-up brain imaging and consecutive changes in therapeutic management were different depending on clinical course measured by NHISS score. Introduction Brain imaging 24–36 h after systemic thrombolysis for acute ischemic stroke is recommended in American Stroke Association and European Stroke Organization guidelines (1, 2). Brain imaging is performed to detect secondary bleeding or hemorrhagic transformation in order to adapt medical stroke prevention if necessary. Guideline recommendations are based on the results of the first study on rt-PA...
Source: Frontiers in Neurology - April 15, 2019 Category: Neurology Source Type: research

Knowledge of Thrombolytic Therapy Amongst Hospital Staff: Preliminary Results and Treatment Implications Brief Reports
Conclusions— Hospital staff had adequate knowledge of stroke signs and symptoms; however, there was low awareness of thrombolysis therapy and its correct treatment time window among hospital staff. Targeted educational programmes among hospital staff regarding stroke are required to optimize acute stroke care.
Source: Stroke - November 23, 2015 Category: Neurology Authors: Mellon, L., Hasan, H., Lee, S., Williams, D., Hickey, A. Tags: Cardiopulmonary Resuscitation and Emergency Cardiac Care Brief Reports Source Type: research

Advances in the Stroke System of Care
Opinion statement The stroke system of care is undergoing significant evolution. There are promising data to suggest that with new technologies and approaches, primary prevention and community education will become easier and more accessible, and will allow people to have greater participation in their own healthcare. The evidence-based primary and comprehensive stroke center concepts have been translated into robust, rapidly growing certification programs. The continued dissemination of improved EMS routing protocols allows for better allocation of patients to stroke centers, even as we confront the challenge of...
Source: Current Treatment Options in Cardiovascular Medicine - November 5, 2014 Category: Cardiology Source Type: research

A Successful Quality Improvement Project for Detection and Management of Acute Stroke in Hospitalized Patients
CONCLUSION: The new IHS protocol has led to a marked increase in cases identified, rapid evaluation, and high utilization rate of acute stroke therapies.
Source: Journal of Neuroscience Nursing - July 30, 2020 Category: Neuroscience Tags: Clinical Nursing Focus Source Type: research

Stroke Code Simulation Lab; Save Time Save Brain! (P2.375)
CONCLUSIONS: The stroke code simulation lab met its objectives of improving the neurology residents’ knowledge and experience managing stroke codes. It was perceived as a valuable exercise. Further data will determine if the stroke code simulation lab improves patient care.Disclosure: Dr. Mao has nothing to disclose. Dr. Zidan has nothing to disclose. Dr. Afzal has nothing to disclose. Dr. Cherukuri has nothing to disclose. Dr. Qadeer has nothing to disclose. Dr. Bradshaw has received research support from Cytokinetcs.
Source: Neurology - April 3, 2016 Category: Neurology Authors: Mao, Y., Zidan, A., Afzal, U., Cherukuri, R., Qadeer, U., Bradshaw, D. Tags: Research Methodology and Education: Patient Safety and Quality Source Type: research

Getting to the Core of Stroke Care: Real Time Chart Review Improves Hospital Compliance with Core Measures (P6.269)
Conclusions:Real time chart review, utilization of a MQA, and alerting of providers is significantly more effective than a process utilizing retrospective chart review based on sampling and manual abstraction in increasing CM compliance. Implementation of these methods reduces CM deficiencies and leads to improved stroke care.Disclosure: Dr. Katsafanas has nothing to disclose. Dr. Furbeyre has nothing to disclose. Dr. Coppen has nothing to disclose. Dr. Hodges has nothing to disclose. Dr. Schnepel has nothing to disclose. Dr. Falk has nothing to disclose. Dr. Alonso has nothing to disclose. Dr. Tran has nothing to disclose...
Source: Neurology - April 17, 2017 Category: Neurology Authors: Katsafanas, C., Furbeyre, J., Coppen, V., Hodges, W., Schnepel, L., Falk, D., Alonso, J., Tran, A., Northcut, M., Toback, A., Silliman, S. Tags: Cerebrovascular Disease Health Services Research Source Type: research

Factors Influencing Quality of Life Six Months after a First-Ever Ischemic Stroke: Focus on Thrombolyzed Patients
Conclusion: In this study, most patients were treated with thrombolysis, and QoL results resembled those of earlier studies on patients without thrombolysis. Despite good physical recovery, the patients reported impairments in QoL. QoL assessments can give clinicians a more holistic picture of stroke recovery from the patient's perspective.Folia Phoniatr Logop 2016;68:86-91
Source: Folia Phoniatrica et Logopaedica - September 29, 2016 Category: Speech Therapy Source Type: research

Depressive symptoms in stroke patients treated and non-treated with intravenous thrombolytic therapy: a 1-year follow-up study
Conclusions(1) Thrombolysed and non-thrombolysed stroke survivors had similar frequency of depressive symptoms although the thrombolysed patients had more severe neurological deficits in the acute phase. It can be assumed that if thrombolysis had not been used, depressive symptoms would have been more frequent. (2) Lack of the rt-PA treatment was associated with three-time greater odds of screening for PSD at 3  months post-stroke, after adjustment for other PSD correlates. (3) Therefore, thrombolytic therapy seems to have a positive, but indirect, effect on patients’ mood, especially in the first months after stroke. (...
Source: Journal of Neurology - June 18, 2018 Category: Neurology Source Type: research

Organizing stroke systems in the field for patients with suspected large vessel occlusion acute stroke.
Authors: Almekhlafi MA, Holodinsky JK, Hill MD, Kamal N, Goyal M Abstract INTRODUCTION: The dawn of endovascular stroke therapy has reshaped stroke care. Eligible patients need to be rushed to capable centers for intervention. This may entail bypassing closer hospitals that could confirm the diagnosis, administer thrombolytic therapy, then transfer patients for intervention. This has created a set of challenges: identifying endovascular candidates in the field, determining the best transport destination, and getting patients there quickly. Areas covered: This review provides a context for these emerging challenges....
Source: Expert Review of Cardiovascular Therapy - November 20, 2018 Category: Cardiology Tags: Expert Rev Cardiovasc Ther Source Type: research

Telemedicine remote controlled stroke evaluation and treatment, the experience of radiographers, paramedics and junior doctors in a novel rural stroke management team
CONCLUSIONS: The telemedicine-based, remote controlled, stroke evaluation and treatment was experienced, by the participants, to be well organised and of high quality. Communication and image reading appear to be the salient challenges. Regular training sessions and follow-up, as well as an evaluation of incidents by the project manager, proved to be of great importance in retaining and securing the continued running of the service and ensuring high-quality treatment. Further research is indicated in the comparison of this telemedicine service with stroke treatment given in a mainstream hospital.PMID:34090447 | DOI:10.1186/s12913-021-06591-1
Source: Rural Remote Health - June 6, 2021 Category: Rural Health Authors: Elin Kjelle Aud Mette Myklebust Source Type: research

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