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Source: Circulation: Cardiovascular Quality and Outcomes

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Total 429 results found since Jan 2013.

Effectiveness of Left Atrial Appendage Exclusion Procedures to Reduce the Risk of Stroke: A Systematic Review of the Evidence Original Articles
Conclusions— There is limited evidence that the Watchman device may be noninferior to long-term OAC in selected patients. Data on effectiveness of LAA exclusion devices is lacking in patients ineligible for long-term OAC. Percutaneous LAA devices are associated with high rates of procedure-related harms. Although surgical LAA exclusion during heart surgery does not seem to add incremental harm, there is insufficient evidence of benefit.
Source: Circulation: Cardiovascular Quality and Outcomes - July 18, 2016 Category: Cardiology Authors: Noelck, N., Papak, J., Freeman, M., Paynter, R., Low, A., Motuapuaka, M., Kondo, K., Kansagara, D. Tags: Atrial Fibrillation, Anticoagulants, Cardiovascular Surgery, Complications, Ischemic Stroke Original Articles Source Type: research

Efficacy of a Chronic Care-Based Intervention on Secondary Stroke Prevention Among Vulnerable Stroke Survivors: A Randomized Controlled Trial Original Articles
Conclusions This intervention did not improve SBP control beyond that attained in usual care among vulnerable stroke survivors. A community-centered component could strengthen the intervention impact. Clinical Trial Registration URL: https://clinicaltrials.gov. Unique identifier: NCT00861081.
Source: Circulation: Cardiovascular Quality and Outcomes - January 10, 2018 Category: Cardiology Authors: Cheng, E. M., Cunningham, W. E., Towfighi, A., Sanossian, N., Bryg, R. J., Anderson, T. L., Barry, F., Douglas, S. M., Hudson, L., Ayala-Rivera, M., Guterman, J. J., Gross-Schulman, S., Beanes, S., Jones, A. S., Liu, H., Vickrey, B. G. Tags: Risk Factors, Secondary Prevention, Health Services, Quality and Outcomes, Cerebrovascular Disease/Stroke Original Articles Source Type: research

Trends in Vascular Risk Factor Treatment and Control in US Stroke Survivors: The National Health and Nutrition Examination Surveys (1999-2010) Original Articles
Conclusions— Despite improvements in blood pressure treatment and control and cholesterol treatment for women and cholesterol treatment and control for men, stroke secondary prevention through treatment and control of vascular risk factors remains suboptimal. Urgent action is needed to improve secondary prevention to reduce stroke morbidity and mortality in this high-risk group.
Source: Circulation: Cardiovascular Quality and Outcomes - May 21, 2013 Category: Cardiology Authors: Shah, N. S., Huffman, M. D., Ning, H., Lloyd-Jones, D. M. Tags: Other Stroke Treatment - Medical Original Articles Source Type: research

Cross-Sectional Survey of Workload and Burnout Among Japanese Physicians Working in Stroke Care: The Nationwide Survey of Acute Stroke Care Capacity for Proper Designation of Comprehensive Stroke Center in Japan (J-ASPECT) Study Original Articles
Conclusions— The primary risk factors for burnout are heavy workload, short sleep duration, relatively little experience, and low mental quality of life. Prospective research is required to confirm these findings and develop programs for preventing burnout.
Source: Circulation: Cardiovascular Quality and Outcomes - May 20, 2014 Category: Cardiology Authors: Nishimura, K., Nakamura, F., Takegami, M., Fukuhara, S., Nakagawara, J., Ogasawara, K., Ono, J., Shiokawa, Y., Miyachi, S., Nagata, I., Toyoda, K., Matsuda, S., Kataoka, H., Miyamoto, Y., Kitaoka, K., Kada, A., Iihara, K., J-ASPECT Study Group Tags: Behavioral/psychosocial - stroke, Other etiology, Epidemiology Original Articles Source Type: research

Abstract 11: Temporal Changes in NIHSS Documentation and Stroke Severity among Patients Treated with Thrombolysis in the Massachusetts Coverdell Registry Session Title: Concurrent I Session B: Oral Abstracts on Stroke Topics
Discussion: IV tPA use in MA Coverdell patients is increasing and now reaches 25% of all early arriving subjects. NIHSS documentation is increasing as well, especially among subjects with lower NIHSS scores. The median NIHSS in RISS or Too Mild patients is reassuringly low, and decreased significantly among Too Mild patients. These data, coupled with the fact that unadjusted rates of discharge home among IV tPA patients are increasing while severity-adjusted rates are not, suggests that more patients previously felt to be Too Mild are now receiving IV tPA. Further efforts are still warranted.
Source: Circulation: Cardiovascular Quality and Outcomes - June 2, 2014 Category: Cardiology Authors: Schwamm, L., Parkinson, G., Coe, L. Tags: Session Title: Concurrent I Session B: Oral Abstracts on Stroke Topics Source Type: research

Fragmentation of Care and the Use of Head Computed Tomography in Patients With Ischemic Stroke Original Articles
Conclusions— Rates of high-intensity CT use for patients with ischemic stroke reflect wide practice patterns across regions and races. Medicare expenditures parallel these disparities. Fragmentation of care is associated with high-intensity CT use.
Source: Circulation: Cardiovascular Quality and Outcomes - May 20, 2014 Category: Cardiology Authors: Bekelis, K., Roberts, D. W., Zhou, W., Skinner, J. S. Tags: Acute Cerebral Infarction, Computerized tomography and Magnetic Resonance Imaging, Pathology of Stroke Original Articles Source Type: research

Does the Volume of Ischemic Stroke Admissions Relate to Clinical Outcomes in the Ontario Stroke System? Original Articles
Conclusions— Hospital IS volume is associated with 30-day mortality in Ontario. Patients admitted to hospitals with annual IS volumes <126 annually are more likely to die within 30 days than patients admitted to hospitals that see on average 300 patients annually. This finding supports centralizing care in stroke-specialized hospitals.
Source: Circulation: Cardiovascular Quality and Outcomes - October 29, 2015 Category: Cardiology Authors: Hall, R. E., Fang, J., Hodwitz, K., Saposnik, G., Bayley, M. T. Tags: Ethics and Policy, Health Services, Quality and Outcomes, Ischemic Stroke Original Articles Source Type: research

Regional Variation in 30-Day Ischemic Stroke Outcomes for Medicare Beneficiaries Treated in Get With The Guidelines-Stroke Hospitals Original Articles
Conclusions— Thirty-day mortality and readmission rates vary substantially across HRRs and exhibit an inverse relationship. While regional variation in 30-day outcomes were explained by patient and hospital factors differently, much of the regional variation in both outcomes remains unexplained.
Source: Circulation: Cardiovascular Quality and Outcomes - August 10, 2017 Category: Cardiology Authors: Thompson, M. P., Zhao, X., Bekelis, K., Gottlieb, D. J., Fonarow, G. C., Schulte, P. J., Xian, Y., Lytle, B. L., Schwamm, L. H., Smith, E. E., Reeves, M. J. Tags: Quality and Outcomes, Ischemic Stroke Original Articles Source Type: research

The YOU CALL-WE CALL Randomized Clinical Trial: Impact of a Multimodal Support Intervention After a Mild Stroke Original Articles
Conclusions— Although the 2 groups improved equally over time, WE CALL intervention was perceived as helpful, whereas YOU CALL intervention was not used. Clinical Trial Registration— URL: http://www.controlled-trials.com. Unique identifier: ISRCTN95662526.
Source: Circulation: Cardiovascular Quality and Outcomes - November 19, 2013 Category: Cardiology Authors: Rochette, A., Korner-Bitensky, N., Bishop, D., Teasell, R., White, C. L., Bravo, G., Cote, R., Green, T., Lebrun, L.-H., Lanthier, S., Kapral, M., Bayley, M. Tags: Health policy and outcome research, Cerebrovascular disease/stroke, Clinical Studies, Rehabilitation, Stroke Original Articles Source Type: research

Abstract 9: Predictors of Poor Outcome in Patients Not Thrombolysed Due to Mild or Resolving Symptoms ("Too Good To Treat") Session Title: Concurrent I Session B: Oral Abstracts on Stroke Topics
Conclusion: A substantial percentage of patients deemed "too good" for IV tPA were unable to be discharged home. Factors such as advanced age and higher NIHSS should be considered in tPA decision-making to optimize outcomes. Large, multi-center prospective studies are underway to study the predictors of poor outcomes in this group.
Source: Circulation: Cardiovascular Quality and Outcomes - June 2, 2014 Category: Cardiology Authors: Ali, S. F., Faheem, U., Singhal, A. B., Viswanathan, A., Silverman, S. B., Rost, N. S., Schwamm, L. H. Tags: Session Title: Concurrent I Session B: Oral Abstracts on Stroke Topics 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

Abstract 16: Racial Disparities in Clinical Outcomes and Resource Utilization in Acute Ischemic Stroke Hospitalizations in the United States: Results from the 2012 National Inpatient Sample Session Title: Concurrent Session IIC: Oral Abstracts - Stroke
Conclusions: Blacks hospitalized for AIS have significantly lower in-hospital mortality compared to whites but are significantly less likely to receive thrombolysis compared to whites. Total charges and length of stay are significantly higher for racial minorities. Future studies should investigate mechanisms of this apparent protective effect of black race on in-hospital mortality in AIS.
Source: Circulation: Cardiovascular Quality and Outcomes - April 29, 2015 Category: Cardiology Authors: Kumar, N., Venkatraman, A., Garg, N. Tags: Session Title: Concurrent Session IIC: Oral Abstracts - Stroke Source Type: research

Smoking Paradox in Patients Hospitalized With Coronary Artery Disease or Acute Ischemic Stroke: Findings From Get With The Guidelines Original Articles
Conclusions— Among patients hospitalized with CAD and AIS, smoking is a risk factor for early age of onset, even among those with few vascular risk factors. The persistent association with lower in-hospital mortality after adjusted and stratified analyses probably represents residual unmeasured confounding, although a biological effect of smoking cannot be excluded. Further clinical and prospective population-based studies are needed to explore variables that contribute to outcomes in these patients.
Source: Circulation: Cardiovascular Quality and Outcomes - October 29, 2015 Category: Cardiology Authors: Ali, S. F., Smith, E. E., Reeves, M. J., Zhao, X., Xian, Y., Hernandez, A. F., Bhatt, D. L., Fonarow, G. C., Schwamm, L. H. Tags: Myocardial Infarction, Cerebrovascular Disease/Stroke, Ischemic Stroke, Acute Coronary Syndromes 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

Timely Reperfusion in Stroke and Myocardial Infarction Is Not Correlated: An Opportunity for Better Coordination of Acute Care Original Article
Conclusions— We found no correlation between hospitals’ observed or risk-adjusted DTN and D2B times. Opportunities exist to improve hospitals’ performance of time-critical care processes for AIS and STEMI in a coordinated approach.
Source: Circulation: Cardiovascular Quality and Outcomes - March 9, 2017 Category: Cardiology Authors: Sauser Zachrison, K., Levine, D. A., Fonarow, G. C., Bhatt, D. L., Cox, M., Schulte, P., Smith, E. E., Suter, R. E., Xian, Y., Schwamm, L. H. Tags: Myocardial Infarction, Health Services, Quality and Outcomes, Ischemic Stroke Original Article Source Type: research