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Factors Associated with Inpatient Mortality after Intracerebral Hemorrhage: Updated Information from the United States Nationwide Inpatient Sample
Background: To use a nationwide database of hospital admissions to assess for trends in inpatient mortality from acute spontaneous intracerebral hemorrhage as well as associated potentially contributing factors. Methods: Adults with intracerebral hemorrhage in the US National Inpatient Sample database from 2012 to 2015 were included in this study. We assessed for mortality rate as well as potential impact of various comorbidities and demographic factors such as ethnicity and median house hold income on inpatient mortality rate.
Source: Journal of Stroke and Cerebrovascular Diseases - December 18, 2019 Category: Neurology Authors: Vijayakumar Javalkar, Okkes Kuybu, Debra Davis, Roger E. Kelley Source Type: research

Influence of a Comorbid Diagnosis of Seizure on 30-Day Readmission Rates Following Hospitalization for an Index Stroke
Objective: To examine the association of a comorbid seizure diagnosis with early hospital readmission rates following an index hospitalization for stroke in the United States. Methods: Retrospective analysis of the 2014 National Readmission Database. The study population included adult patients (age>18 years old) with stroke, identified using the International Classification of Disease Ninth Revision, Clinical Modification (ICD-9-CM) codes 433.X1, 434.X1, and 436 for ischemic stroke as well as 430, 431, 432.0, 432.1, and 432.9 for hemorrhagic stroke.
Source: Journal of Stroke and Cerebrovascular Diseases - November 25, 2019 Category: Neurology Authors: Alain Lekoubou, Kinfe G Bishu, Bruce Ovbiagele Source Type: research

A Cross-Sectional Analysis of Differences in Physical Activity Levels between Stroke Belt and Non-Stroke Belt US Adults
Background: The Stroke Belt is a region of the United States with elevated stroke incidence and prevalence of stroke risk factors. Physical inactivity is an important stroke risk factor, but little is known about whether current physical activity levels differ between Stroke Belt and non-Stroke Belt states. In this nationally representative study, we determined whether unadjusted and adjusted physical activity levels differ between the Stroke Belt region and the rest of the United States. Methods: Using 2017 Behavioral Risk Factor Surveillance System data, we conducted bivariate analyses to obtain unadjusted physical activ...
Source: Journal of Stroke and Cerebrovascular Diseases - October 10, 2019 Category: Neurology Authors: Phoebe Tran, Lam Tran, Liem Tran Source Type: research

Letter to the Editor Regarding “Relationship of Malnutrition during Hospitalization with Functional Recovery and Postdischarge Destination in Elderly Stroke Patients”
We read with great interest the article by Sato et al on the relationship of malnutrition with acute stroke in 205 patients hospitalized at the Shinshu University hospital, Japan.1 We would like to provide an additional nationwide United States (US) perspective on outcomes of hospitalized stroke patients with protein energy malnutrition (PEM).
Source: Journal of Stroke and Cerebrovascular Diseases - September 2, 2019 Category: Neurology Authors: Rupak Desai, Alok R. Amraotkar Tags: Letter to the Editor Source Type: research

Older Age Is Not Associated with Worse Outcomes Following Decompressive Hemicraniectomy for Spontaneous Intracerebral Hemorrhage
Background: Decompressive hemicraniectomy (DHC) is commonly offered after large spontaneous intracerebral hemorrhage (ICH) as a life-saving measure. Based on limited available evidence, surgery is sometimes avoided in the elderly. The association between age and outcomes following DHC in spontaneous ICH remains largely understudied. Objective: The goal of this study is to investigate the influence of older age on outcomes of patients who undergo DHC for spontaneous ICH. Methods: In this retrospective cohort study, inpatient data were obtained from the United States Nationwide Inpatient Sample from 2000 to 2011.
Source: Journal of Stroke and Cerebrovascular Diseases - August 4, 2019 Category: Neurology Authors: Roy A. Poblete, Ling Zheng, Marcela Arenas, Alejandro Vazquez, Derek Yu, Benjamin A. Emanuel, May A. Kim-Tenser, Nerses Sanossian, William Mack Source Type: research

Asian Study of Cerebral Venous Thrombosis
The objective of the present study is to identify risk factors, presentation, and outcome of CVT in Asian patients. Methods: Asian CVT registry is a prospective multinational observational study that included patients (aged> 16 years) with symptomatic CVT. Results: Eight hundred and twelve patients (59% women) from 20 centers in 9 Asian countries were included.
Source: Journal of Stroke and Cerebrovascular Diseases - July 23, 2019 Category: Neurology Authors: Mohammad Wasay, Subash Kaul, Bindu Menon, Alper I. Dai, Mohammad Saadatnia, Abdul Malik, Ahmed Khalifa, Afshin Borhani-Haghigi, Manmohan Mehndiratta, Maria Khan, Nimalendu Bikash Bhowmik, Safia Awan Source Type: research

Integration of Real-Time Electronic Health Records and Wireless Technology in a Mobile Stroke Unit
Background: UCHealth's Mobile Stroke Unit (MSU) at University of Colorado Hospital is an ambulance equipped with a computed tomography (CT) scanner and tele-stroke capabilities that began clinical operation in Aurora, Colorado January 2016. As one of the first MSU's in the United States, it was necessary to design unique and dynamic information technology infrastructure. This includes high-speed cellular connectivity, Health Insurance Portability and Accountability Act compliance, cloud-based and remote access to electronic medical records (EMR), and reliable and rapid image transfer.
Source: Journal of Stroke and Cerebrovascular Diseases - July 11, 2019 Category: Neurology Authors: Brandi Schimpf, Kathy Deanda, David A. Severenuk, Tara M. Montgomery, Gregory D. Cooley, Robert G. Kowalski, Daniel Vela-Duarte, William J. Jones Source Type: research

Pre-existing Renal Failure Increases In-Hospital Mortality in Patients With Intracerebral Hemorrhage
We read with interest the study of Khatri et al that concluded pre-existing renal failure increased the risk of in-hospital mortality among patients with intracerebral hemorrhage (ICH).1 These results were derived from a retrospective analysis of over 328,000 adult patients (11.8% with pre-existing renal failure) who were admitted to hospitals in the United States with ICH over a 5-year period.
Source: Journal of Stroke and Cerebrovascular Diseases - May 22, 2019 Category: Neurology Authors: Ruemon Bhattacharyya, Larry E. Miller Tags: Letter to the Editor Source Type: research

Recent Trends in Electively Treated Unruptured Intracranial Aneurysms
Background and Purpose: To determine recent treatment and outcome trends in patients undergoing elective surgical clipping (SC) or endovascular therapy (EVT) for unruptured intracranial aneurysms (UIAs) in the United States. Methods: Data were extracted and analyzed from the National Inpatient Sample, Healthcare Cost and Utilization Project, Agency for Healthcare Research and Quality for all patients admitted for elective EVT or SC of UIAs between 2011 and 2014. Treatment trends, in-hospital mortality, complication rates, length of stay (LOS) and total hospital costs were evaluated and analyzed.
Source: Journal of Stroke and Cerebrovascular Diseases - April 10, 2019 Category: Neurology Authors: Hisham Salahuddin, Nauman Siddiqui, Alicia C. Castonguay, Mark Johnson, Syed F. Zaidi, Mouhammad A. Jumaa Source Type: research

Endovascular Thrombolysis or Thrombectomy for Cerebral Venous Thrombosis: Study of Nationwide Inpatient Sample 2004-2014
In this study, we analyze Nationwide Inpatient Sample (NIS) data to evaluate the safety and efficacy of endovascular therapy (ET) versus medical management in CVT. We also examined the yearly trends of ET utilization in the United States. Methods: International Classification of Diseases, Ninth Revision, Clinical Modification codes were utilized to identify CVT patients who received ET.
Source: Journal of Stroke and Cerebrovascular Diseases - April 1, 2019 Category: Neurology Authors: Fazeel M. Siddiqui, Matthew W. Weber, Sudeepta Dandapat, Steve Scaife, Michael Buhnerkempe, Santiago Ortega-Gutierrez, Nazan Aksan, Augusto Elias, Jonathan M. Coutinho Source Type: research

Trends in Interhospital Transfers and Mechanical Thrombectomy for United States Acute Ischemic Stroke Inpatients
Objective: Stroke care in the US is increasingly regionalized. Many patients undergo interhospital transfer to access specialized, time-sensitive interventions such as mechanical thrombectomy. Methods: Using a stratified survey design of the US Nationwide Inpatient Sample (2009-2014) we examined trends in interhospital transfers for ischemic stroke resulting in mechanical thrombectomy. International Classification of Disease —Ninth Revision (ICD-9) codes were used to identify stroke admissions and inpatient procedures within endovascular-capable hospitals.
Source: Journal of Stroke and Cerebrovascular Diseases - January 9, 2019 Category: Neurology Authors: Benjamin P. George, Thomas A. Pieters, Christopher G. Zammit, Adam G. Kelly, Kevin N. Sheth, Tarun Bhalla Source Type: research

Geographic Disparities in the Incidence of Stroke among Patients with Atrial Fibrillation in the United States
Aim: To determine whether regional variation in stroke incidence exists among individuals with AF. Methods: Using healthcare utilization claims from 2 large US databases, MarketScan (2007-2014) and Optum Clinformatics (2009-2015), and the 2010 US population as the standard, we estimated age-, sex-, race- (only in Optum) standardized stroke incidence rates by the 9 US census divisions. We also used Poisson regression to examine incidence rate ratios (IRR) of stroke and the probability of anticoagulation prescription fills across divisions.
Source: Journal of Stroke and Cerebrovascular Diseases - December 21, 2018 Category: Neurology Authors: J'Neka S. Claxton, Pamela L. Lutsey, Richard F. MacLehose, Lin Y. Chen, Ten é T. Lewis, Alvaro Alonso Source Type: research

Modeling the Impact of Transcendental Meditation on Stroke Incidence and Mortality
Meditation has shown promise in clinical trials in reducing systolic blood pressure, one of the main risk factors for stroke. We aim to estimate the potential benefits of popularizing meditation on stroke incidence and mortality in the United States (U.S.).
Source: Journal of Stroke and Cerebrovascular Diseases - November 24, 2018 Category: Neurology Authors: Raj Anil Ambavane, Amin Khademi, Donglan Zhang, Lu Shi Source Type: research

Pre-Existing Renal Failure Increases In-Hospital Mortality in Patients with Intracerebral Hemorrhage
To determine the clinical outcome for intracerebral hemorrhage (ICH) patients with pre-existing renal failure in the United States.
Source: Journal of Stroke and Cerebrovascular Diseases - November 14, 2018 Category: Neurology Authors: Rakesh Khatri, Mohammad Rauf Afzal, Mohtashim Arbaab Qureshi, Alberto Maud, Dou Huanyu, Gustavo Jose Rodriguez Source Type: research

Hospital Quality Metrics: “America's Best Hospitals” and Outcomes After Ischemic Stroke
Background: Developing quality metrics to assess hospital-level care and outcomes is increasingly popular in the United States. The U.S. News& World Report ranking of “America's Best Hospitals” is an existing, popular hospital-profiling system, but it is unknown whether top-ranked hospitals in their report have better outcomes according to other hospital quality metrics such as the Centers for Medicare and Medicaid Services (CMS) publicly reported 30-day stro ke measures. Methods: The analysis was based on the 2015-2016 U.S.
Source: Journal of Stroke and Cerebrovascular Diseases - November 8, 2018 Category: Neurology Authors: Judith H. Lichtman, Erica C. Leifheit, Yun Wang, Larry B. Goldstein Source Type: research

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