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Abstract 8: Association Between Hospital "Get With The Guidelines-Stroke" Performance Measures And Outcomes Among Patients With Acute Ischemic Stroke In China Session Title: Concurrent I Session B: Oral Abstracts on Stroke Topics
Conclusions: A significant association between hospital care process and outcomes was found, supporting the use of GWTG-Stroke performance metrics as a means of assessing and helping improve stroke care quality in China.
Source: Circulation: Cardiovascular Quality and Outcomes - June 2, 2014 Category: Cardiology Authors: Li, Z., Wang, Y., Wang, Y., Zhao, X., Wang, C., Liu, L., Wang, C., Zhang, C., Pan, Y., Yang, X. Tags: Session Title: Concurrent I Session B: Oral Abstracts on Stroke Topics Source Type: research

Abstract 21: Stroke Physician Report Cards Improve Physician Response Times for Thrombolytic Treatment Session Title: Concurrent Session IIC: Oral Abstracts - Stroke
Conclusion: The results show that direct, personal and comparative feedback to stroke physicians influences their page-to-response, page-to-needle times and may affect DTN times. There was a clear trend overall, and the page-to-response and page-to-needle times showed significant improvement. Though our numbers were too small to detect statistical significance for individuals, the benefit of improved treatment times is likely clinically significant.
Source: Circulation: Cardiovascular Quality and Outcomes - April 29, 2015 Category: Cardiology Authors: Yanase, L., Corless, L., Stuchiner, T., Baraban, E. Tags: Session Title: Concurrent Session IIC: Oral Abstracts - Stroke Source Type: research

Chronic Kidney Disease and Bleeding Complications After Intravenous Thrombolytic Therapy for Acute Ischemic Stroke Original Articles
Conclusions— Presence of CKD among patients with IS treated with intravenous tissue-type plasminogen activator is associated with higher unadjusted odds of symptomatic intracranial hemorrhage or serious systemic hemorrhage, but this is explained by non-CKD related factors.
Source: Circulation: Cardiovascular Quality and Outcomes - November 18, 2014 Category: Cardiology Authors: Ovbiagele, B., Smith, E. E., Schwamm, L. H., Grau-Sepulveda, M. V., Saver, J. L., Bhatt, D. L., Hernandez, A. F., Peterson, E. D., Fonarow, G. C. Tags: Cerebrovascular disease/stroke, Risk Factors, Acute Cerebral Infarction, Thrombolysis Original Articles Source Type: research

Academic-Community Hospital Comparison of Vulnerabilities in Door-to-Needle Process for Acute Ischemic Stroke Original Articles
Conclusions— Although the identification of common critical failures suggests opportunities for a generalizable process redesign, differences in the criticality and nature of failures must be addressed at the individual hospital level, to develop robust and sustainable solutions to reduce DTN time.
Source: Circulation: Cardiovascular Quality and Outcomes - October 29, 2015 Category: Cardiology Authors: Prabhakaran, S., Khorzad, R., Brown, A., Nannicelli, A. P., Khare, R., Holl, J. L. Tags: Treatment, Ethics and Policy, Ischemic Stroke Original Articles Source Type: research

Abstract 205: Stroke Risk and Symptom Recognition Post Cardiac Catheterization Session Title: Poster Session PM
Over 1.4 million cardiac catheterization procedures (CCPs) take place yearly. CPP related stroke incidence in 1973 was reported as 0.23%. CCPs are invasive in nature with complications occurring due to unintentional trauma to preexisting atherosclerotic aortic plaques or thrombus formation at catheter/guidewire tips. Less common causes of ischemic stroke are air, left ventricular clot, hypotension, arterial dissection, fractured guidewire. Transient neurological deficits have been reported following high-osmolar contrast injection into carotid/vertebral arteries. With improved practice, current stroke incidence is 0.06%. P...
Source: Circulation: Cardiovascular Quality and Outcomes - April 5, 2018 Category: Cardiology Authors: Rivet, C., Schaefer, K., Strom, C. Tags: Session Title: Poster Session PM Source Type: research

Abstract 235: Acute Care Measures of Rehabilitation Needs Associated with Discharge to Rehabilitation for Patients with Minor Stroke Poster Session II
Conclusions: Rehabilitation needs were documented for patients with minor stroke and almost one third were discharged to receive inpatient rehabilitation in an IRF or SNF. Taking pre-stroke disability into consideration for transition planning from acute care could facilitate earlier communication and planning with the next point of care.
Source: Circulation: Cardiovascular Quality and Outcomes - May 15, 2013 Category: Cardiology Authors: Prvu Bettger, J., Stein, J., Magdon-Ismail, Z., Hedeman, R., Sicklick, A., Schwamm, L. H. Tags: Poster Session II Source Type: research

Abstract 238: Utilization and Safety of a Heparin Nomogram in Treating Thrombotic Comorbidities in Stroke Patients Poster Session II
CONCLUSION: The heparin stroke nomogram appears safe in that it does not increase risk of ICH. However, therapeutic aPTTs are not reached quickly with less than half of patients therapeutic at 24 hours, nor are they maintained at steady state. This nomogram could be too conservative in cases where clinical situation requires rapid anticoagulation.
Source: Circulation: Cardiovascular Quality and Outcomes - May 15, 2013 Category: Cardiology Authors: Grantz, M. R., Proctor, P., Skalabrin, E., Pendleton, R. C., Majersik, J. J. Tags: Poster Session II Source Type: research

Abstract 201: Are Patients With Atrial Fibrillation Willing to Consider New Strategies to Prevent Stroke? A Qualitative Analysis of Community-Based Focus Groups Session Title: Abstract Poster Session II
Conclusion: Focus group participants expressed a fear of debilitating stroke, with varying levels of acceptance of inconveniences and potential bleeding associated with blood thinners. Among a subset of participants, there was willingness to consider new stroke prevention therapies; however, this was preferred with a known, trusted physician. Subspecialized clinicians offering new therapies may be challenged to establish perceived mutual respect with patients, traditionally built over time, and this may be required for patients to consider new therapies. Future research is needed to determine best practices for both establ...
Source: Circulation: Cardiovascular Quality and Outcomes - February 26, 2016 Category: Cardiology Authors: ONeill, E. S., Grande, S. W., Coylewright, M. Tags: Session Title: Abstract Poster Session II Source Type: research

Abstract 122: Quality of Care for Patients With Acute Ischemic Stroke as a Function of Hospital Intravenous Thrombolysis With Recombinant Tissue Plasminogen Activator Capability: Insights From China National Stroke Registry II Session Title: Poster Session I
Conclusions: The CNSR II hospitals were associated with better performance in some of the hospitals but not all of them. The difference in conformity between rt-PA-capable hospitals and rt-PA-incapable hospitals was modest for performance measures of stroke care. However, more room for improvement still exists in key quality performance measures and further studies should be explored.
Source: Circulation: Cardiovascular Quality and Outcomes - March 31, 2017 Category: Cardiology Authors: Rao, Z., Li, Z., Gu, H., Wang, Y., Wang, Y. Tags: Session Title: Poster Session I Source Type: research

Abstract 160: Impact of Medication Adherence on Risk of Stroke, Major Bleeding and Other Outcomes in Atrial Fibrillation Patients Using Novel Oral Anticoagulants (Dabigatran and Rivaroxaban) Session Title: Poster Session II
Conclusion: In our sample, adherence to NOACs was associated with a reduction in stroke and DVTPE risk but did not substantially increase bleeding risk. Further studies with newer NOACs are warranted.
Source: Circulation: Cardiovascular Quality and Outcomes - March 31, 2017 Category: Cardiology Authors: Deshpande, C. G., Willey Temkin, C., Laforge, R., Kogut, S. Tags: Session Title: Poster Session II Source Type: research

Patient-Centered Decision Support in Acute Ischemic Stroke: Qualitative Study of Patients' and Providers' Perspectives Original Articles
Conclusions— This study suggests that a positively framed risk–benefit tool with graphical presentations of general and patient-specific risk estimates could support patients and providers in considering r-tPA for acute ischemic stroke. Clinical Trial Registration— URL: http://www.clinicaltrials.gov. Unique identifier: NCT01864928.
Source: Circulation: Cardiovascular Quality and Outcomes - October 29, 2015 Category: Cardiology Authors: Decker, C., Chhatriwalla, E., Gialde, E., Garavalia, B., Summers, D., Quinlan, M. E., Cheng, E., Rymer, M., Saver, J. L., Chen, E., Kent, D. M., Spertus, J. A. Tags: Cardiopulmonary Resuscitation and Emergency Cardiac Care Original Articles Source Type: research

Development and Validation of Electronic Quality Measures to Assess Care for Patients With Transient Ischemic Attack and Minor Ischemic Stroke Original Articles
Conclusions— It is feasible to construct valid eQMs for processes of transient ischemic attack and minor ischemic stroke care. Healthcare systems with EHRs should consider using electronic data to evaluate care for their patients with transient ischemic attack and to complement and expand quality measurement programs currently focused on patients with stroke.
Source: Circulation: Cardiovascular Quality and Outcomes - September 14, 2017 Category: Cardiology Authors: Bravata, D. M., Myers, L. J., Cheng, E., Reeves, M., Baye, F., Yu, Z., Damush, T., Miech, E. J., Sico, J., Phipps, M., Zillich, A., Johanning, J., Chaturvedi, S., Austin, C., Ferguson, J., Maryfield, B., Snow, K., Ofner, S., Graham, G., Rhude, R., William Tags: Quality and Outcomes, Transient Ischemic Attack (TIA) Original Articles Source Type: research

Improving Quality Measurement for Anticoagulation: Adding International Normalized Ratio Variability to Percent Time in Therapeutic Range Original Articles
Conclusions— Unstable anticoagulation predicts warfarin adverse effects independent of TTR. Moreover, knowledge about anticoagulation stability further stratifies the risk for adverse events at given levels of TTR.
Source: Circulation: Cardiovascular Quality and Outcomes - September 16, 2014 Category: Cardiology Authors: Razouki, Z., Ozonoff, A., Zhao, S., Jasuja, G. K., Rose, A. J. Tags: Coagulation, Coumarins, Thrombosis risk factors, Embolic stroke, Anticoagulants Original Articles Source Type: research

Improving Anticoagulation Measurement: Novel Warfarin Composite Measure Original Articles
Conclusions— WCM produces the largest range of risk for warfarin complications, widening the floor ceiling effects that limit the use of TTR and INR variability as separate measures. Anticoagulation clinics ranking changed considerably according to the anticoagulation measure that was selected.
Source: Circulation: Cardiovascular Quality and Outcomes - November 17, 2015 Category: Cardiology Authors: Razouki, Z., Burgess, J. F., Ozonoff, A., Zhao, S., Berlowitz, D., Rose, A. J. Tags: Anticoagulants, Ethics and Policy, Cerebrovascular Disease/Stroke, Thrombosis Original Articles Source Type: research

Abstract 232: Parenteral Antihypertensive Use on the First Day of Hospitalization after Acute Ischemic Stroke: A US Population Study Poster Session II
Conclusion: Approximately 16% of AIS patients receive IV AH medication in the first 24 hours of admission in the US. The rate of early AH treatment has increased over time both overall and among those who did not receive rt-PA. Whether this is due to increasingly aggressive BP treatment by physicians or higher BP on admission among AIS patients is unclear. Contrary to recommendations, nicardipine was used infrequently. More evidence is required to justify specific AH agents for BP treatment in AIS.
Source: Circulation: Cardiovascular Quality and Outcomes - May 15, 2013 Category: Cardiology Authors: Wang, Y., McDonough, E., Adeoye, O., LaPensee, K., Crothers, T. C., Kleindorfer, D. Tags: Poster Session II Source Type: research

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