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Total 174 results found since Jan 2013.

Disparities in Accessibility of Certified Primary Stroke Centers Clinical Sciences
Conclusions— There are significant geographic disparities in access to PSCs. Access is limited in nonurban areas. Despite the higher burden of cerebrovascular disease in stroke belt states, access to care is lower in these areas. Selecting demographic and healthcare factors is strongly associated with access to care in smaller cities, but not in other areas, including major cities.
Source: Stroke - October 27, 2014 Category: Neurology Authors: Mullen, M. T., Wiebe, D. J., Bowman, A., Wolff, C. S., Albright, K. C., Roy, J., Balcer, L. J., Branas, C. C., Carr, B. G. Tags: Health policy and outcome research, Emergency treatment of Stroke Clinical Sciences Source Type: research

Comparative Risk of Ischemic Stroke Among Users of Clopidogrel Together With Individual Proton Pump Inhibitors Clinical Sciences
Conclusions— PPIs of interest did not increase the rate of ischemic stroke among clopidogrel users when compared with pantoprazole, a PPI thought to be devoid of the potential to interact with clopidogrel.
Source: Stroke - February 23, 2015 Category: Neurology Authors: Leonard, C. E., Bilker, W. B., Brensinger, C. M., Flockhart, D. A., Freeman, C. P., Kasner, S. E., Kimmel, S. E., Hennessy, S. Tags: Platelet function inhibitors, Acute Cerebral Infarction, Acute Stroke Syndromes, Antiplatelets, Epidemiology Clinical Sciences Source Type: research

Ethnic Comparison of 30-Day Potentially Preventable Readmissions After Stroke in Hawaii Clinical Sciences
Conclusions— In Hawaii, Chinese may have a higher risk of 30-day PPR after stroke compared with whites. However, this seems to be driven by the high number of repeated PPR within the Chinese ethnic group.
Source: Stroke - September 25, 2016 Category: Neurology Authors: Nakagawa, K., Ahn, H. J., Taira, D. A., Miyamura, J., Sentell, T. L. Tags: Race and Ethnicity, Complications, Quality and Outcomes, Cerebrovascular Disease/Stroke Clinical Sciences Source Type: research

Incorporating Stroke Severity Into Hospital Measures of 30-Day Mortality After Ischemic Stroke Hospitalization Clinical Sciences
Conclusions—We developed 3 quality measures that demonstrate better discrimination than the Centers for Medicare & Medicaid Services’ existing stroke mortality measure, adjust for stroke severity, and could be implemented in a variety of settings.
Source: Stroke - October 23, 2017 Category: Neurology Authors: Jennifer Schwartz, Yongfei Wang, Li Qin, Lee H. Schwamm, Gregg C. Fonarow, Nicole Cormier, Karen Dorsey, Robert L. McNamara, Lisa G. Suter, Harlan M. Krumholz, Susannah M. Bernheim Tags: Health Services, Mortality/Survival, Quality and Outcomes, Ischemic Stroke Original Contributions Source Type: research

Stroke Outcomes Measures Must Be Appropriately Risk Adjusted to Ensure Quality Care of Patients: A Presidential Advisory From the American Heart Association/American Stroke Association AHA/ASA Presidential Advisory
This article details (1) why the Centers for Medicare & Medicaid Services acute ischemic stroke outcome measures in their present form may not provide adequate risk adjustment, (2) why the measures as currently designed may lead to inaccurate representation of hospital performance and have the potential for serious unintended consequences, (3) what activities the American Heart Association/American Stroke Association has engaged in to highlight these concerns to the Centers for Medicare & Medicaid Services and other interested parties, and (4) alternative approaches and opportunities that should be considered for m...
Source: Stroke - April 28, 2014 Category: Neurology Authors: Fonarow, G. C., Alberts, M. J., Broderick, J. P., Jauch, E. C., Kleindorfer, D. O., Saver, J. L., Solis, P., Suter, R., Schwamm, L. H. Tags: AHA Statements and Guidelines AHA/ASA Presidential Advisory 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

Socioeconomic Disparities in the Utilization of Mechanical Thrombectomy for Acute Ischemic Stroke
We examined the utilization rates of mechanical thrombectomy by race/ethnicity (white, black, Hispanic, and Asian/Pacific Islander), income quartile (first, second to third, and fourth), and insurance status (Medicare, Medicaid, self-pay, and private). We also studied thrombectomy utilization rates at hospitals that performed thrombectomy.Results: From 2006 to 2010, 2,087,017 patients were hospitalized with a primary diagnosis of acute ischemic stroke; 8946 patients (.4%) received mechanical thrombectomy. Compared with white patients, black patients had significantly lower rates of overall mechanical thrombectomy utilizati...
Source: Journal of Stroke and Cerebrovascular Diseases - October 10, 2013 Category: Neurology Authors: Waleed Brinjikji, Alejandro A. Rabinstein, Harry J. Cloft Tags: Original Articles Source Type: research

Impact of State Medicaid Coverage on Utilization of Inpatient Rehabilitation Facilities Among Patients With Stroke Brief Reports
Conclusions— State Medicaid coverage of IRFs is associated with IRF utilization among stroke patients with Medicaid. Given the increasing stroke incidence among the working age and Medicaid expansion under the Affordable Care Act, careful attention to state Medicaid policy for poststroke rehabilitation and analysis of its effects on stroke outcome disparities are warranted.
Source: Stroke - July 28, 2014 Category: Neurology Authors: Skolarus, L. E., Burke, J. F., Morgenstern, L. B., Meurer, W. J., Adelman, E. E., Kerber, K. A., Callaghan, B. C., Lisabeth, L. D. Tags: Health policy and outcome research Brief Reports Source Type: research

Episode-based care for stroke: Can neurologists play a leading role?
In this issue of Neurology® Clinical Practice, Dr. Michael Dobbs argues that episode-based care, which would encompass acute and longer-term associated care, is a likely candidate model of reimbursement for stroke.1 Physicians may be familiar with other bundled payment formats, particularly the diagnosis-related groups used by the Centers for Medicare & Medicaid Services (CMS) for determining inpatient care reimbursement to hospitals under Medicare part A.2 Episode-based care would have the advantages of looking at recurrent care and utilization events up to 1 year following the initial treatment and would be a bas...
Source: Nature Clinical Practice - June 9, 2014 Category: Neurology Authors: Ney, J. P. Tags: Medical care, Stroke prevention, Billing, Infarction Editorial Source Type: research

Boston Scientific dips on Medicare reimbursement hit for Watchman anti-stroke device
Boston Scientific (NYSE:BSX) shares took a hit yesterday after a Centers for Medicare & Medicaid Services proposal that would limit coverage for the Watchman anti-stroke device. Investors also likely reacted to a pair of Class II recalls from the FDA, sending BSX shares down -4.2% to $18.01 apiece yesterday. Watchman, a transcatheter implant designed to seal off the left atrial appendage to prevent the formation of blood clots that could cause stroke, was approved by the FDA in March and asked for a CMS coverage decision in May. The federal health insurer proposed to limit coverage for Watchman to patients in approv...
Source: Mass Device - November 12, 2015 Category: Medical Equipment Authors: Brad Perriello Tags: Cardiac Implants Cardiovascular Recalls Boston Scientific Cardiac Rhythm Management Stroke Source Type: news

Analysts: Worst case unlikely in Medicare call on Boston Scientific’s Watchman anti-stroke device
The worst-case Medicare reimbursement scenario for Boston Scientific‘s (NYSE:BSX) Watchman anti-stroke device is unlikely to play out, according to a pair of analysts. Boston Scientific shares took a hit earlier this month after the Centers for Medicare & Medicaid Services proposed to limit coverage for the Watchman device, a transcatheter implant designed to seal off the left atrial appendage to prevent the formation of blood clots that could cause stroke. The FDA approved Watchman in March. The federal health insurer proposed to limit coverage for Watchman to patients in approved clinical trials who can&#...
Source: Mass Device - November 23, 2015 Category: Medical Equipment Authors: Brad Perriello Tags: Cardiac Implants Wall Street Beat Boston Scientific Centers for Medicare and Medicaid Services (CMS) Reimbursement Stroke Source Type: news

African Americans Are Less Likely to Be Adherent to Statins After Ischemic Stroke: An Analysis of Medicare Beneficiaries Following Hospital Discharge (I2.006)
Conclusions: African Americans may not be obtaining the recurrent stroke prevention therapy provided by statins, possibly contributing to the higher rate of recurrent stroke in this population.Disclosure: Dr. Albright has nothing to disclose. Dr. Blackburn has nothing to disclose. Dr. Zhao has nothing to disclose. Dr. Beasley has nothing to disclose. Dr. Limdi has nothing to disclose. Dr. Howard has nothing to disclose. Dr. Muntner has nothing to disclose.
Source: Neurology - April 3, 2016 Category: Neurology Authors: Albright, K., Blackburn, J., Zhao, H., Beasley, T., Limdi, N., Howard, V., Muntner, P. Tags: Stroke in the Elderly and Young: Challenges for the Next Decade Data Blitz Presentations Source Type: research

African Americans Are Less Likely to Be Adherent to Statins After Ischemic Stroke: An Analysis of Medicare Beneficiaries Following Hospital Discharge (S4.003)
Conclusions: African Americans may not be obtaining the recurrent stroke prevention therapy provided by statins, possibly contributing to the higher rate of recurrent stroke in this population.Disclosure: Dr. Albright has nothing to disclose. Dr. Blackburn has nothing to disclose. Dr. Zhao has nothing to disclose. Dr. Beasley has nothing to disclose. Dr. Limdi has nothing to disclose. Dr. Howard has nothing to disclose. Dr. Muntner has nothing to disclose.
Source: Neurology - April 3, 2016 Category: Neurology Authors: Albright, K., Blackburn, J., Zhao, H., Beasley, T., Limdi, N., Howard, V., Muntner, P. Tags: Health Disparities and Sex Differences in Stroke Source Type: research

Early transition to comfort measures only in acute stroke patients: Analysis from the Get With The Guidelines-Stroke registry
Conclusions: Early CMO was utilized in about 5% of stroke patients, being more common in ICH and SAH than IS. Early CMO use varies widely between hospitals and is influenced by patient and hospital characteristics.
Source: Neurology Clinical Practice - June 12, 2017 Category: Neurology Authors: Prabhakaran, S., Cox, M., Lytle, B., Schulte, P. J., Xian, Y., Zahuranec, D., Smith, E. E., Reeves, M., Fonarow, G. C., Schwamm, L. H. Tags: All Cerebrovascular disease/Stroke, Palliative care Research Source Type: research

Cost of Alteplase Has More Than Doubled Over the Past Decade Brief Report
Conclusions—We found a striking increase in the cost of alteplase over the last decade, with a 100 mg vial now with a CMS payment of ≈$6400, a>100% increase over 10 years. During the same time frame, the DRG base payment to hospitals increased by only 8%, and alteplase cost increased from 27% of the payment in 2006 to 53% in 2013. Researchers and stroke physicians should be aware of these changes in drug costs and their impact on cost-effectiveness analyses.
Source: Stroke - June 26, 2017 Category: Neurology Authors: Dawn Kleindorfer, Joseph Broderick, Bart Demaerschalk, Jeffrey Saver Tags: Cost-Effectiveness, Ischemic Stroke Brief Reports Source Type: research

Frequent users of US emergency departments: characteristics and opportunities for intervention
Conclusions Frequent ED users had a large burden of chronic diseases that also required high outpatient resources. Interventions designed to divert frequent ED users should focus on chronic disease management and access to outpatient services, particularly for Medicaid beneficiaries and other high risk subpopulations.
Source: Emergency Medicine Journal - June 12, 2014 Category: Emergency Medicine Authors: Vinton, D. T., Capp, R., Rooks, S. P., Abbott, J. T., Ginde, A. A. Tags: Editor's choice, Drugs: cardiovascular system, Stroke, Asthma Original article Source Type: research

Anticoagulant use for the prevention of stroke in patients with atrial fibrillation: findings from a multi-payer analysis
Conclusions: The AQuIA provided a consistent platform for analysis across multiple AF populations with varying baseline characteristics. Analyzer results show that many high-risk AF patients in selected commercial, Medicare-eligible, and Medicaid populations do not receive appropriate thromboprophylaxis, as recommended by treatment guidelines.
Source: BMC Health Services Research - July 28, 2014 Category: Journals (General) Authors: Kathleen LangDuygu BozkayaAarti PatelBrian MacomsonWinnie NelsonGary OwensSamir ModyJeff ScheinJoseph Menzin Source Type: research

Prognostic factors for discharge destination after acute stroke: a comprehensive literature review.
Conclusion: Patient initial medical care, age and sex, neurological and medical complications and environmental/socio-economic factors should be considered in the decision-making process for discharge destination. [Box: see text]. PMID: 25250810 [PubMed - as supplied by publisher]
Source: Disability and Rehabilitation - September 24, 2014 Category: Rehabilitation Authors: Van der Cruyssen K, Vereeck L, Saeys W, Remmen R Tags: Disabil Rehabil Source Type: research

Relationship between Stroke and Mortality in Dialysis Patients.
CONCLUSIONS: Dialysis recipients have high mortality after a stroke with corresponding decrements in remaining years of life. Poststroke mortality does not differ by race. PMID: 25318759 [PubMed - as supplied by publisher]
Source: Clinical Journal of the American Society of Nephrology : CJASN - October 15, 2014 Category: Urology & Nephrology Authors: Wetmore JB, Phadnis MA, Ellerbeck EF, Shireman TI, Rigler SK, Mahnken JD Tags: Clin J Am Soc Nephrol Source Type: research

Effect of clinical and social risk factors on hospital profiling for stroke readmission: a cohort study.
CONCLUSION: In the VA, more comprehensive models that included social risk and clinical factors did not affect hospital comparisons based on 30-day readmission rates. PRIMARY FUNDING SOURCE: U.S. Department of Veterans Affairs. PMID: 25437405 [PubMed - in process]
Source: Annals of Internal Medicine - December 2, 2014 Category: Internal Medicine Authors: Keyhani S, Myers LJ, Cheng E, Hebert P, Williams LS, Bravata DM Tags: Ann Intern Med Source Type: research

Centers for Medicare and Medicaid Services Medicare Data and Stroke Research: Goldmine or Landmine? Topical Reviews
Source: Stroke - January 26, 2015 Category: Neurology Authors: Lichtman, J. H., Leifheit-Limson, E. C., Goldstein, L. B. Tags: Health policy and outcome research, Acute Cerebral Hemorrhage, Acute Cerebral Infarction Topical Reviews Source Type: research

Health disparities and stroke: the influence of insurance status on the prevalence of patient safety indicators and hospital-acquired conditions.
CONCLUSIONS Insurance status is an independent predictor of patient safety events after stroke. Private insurance is associated with lower mortality, shorter lengths of stay, and improved clinical outcomes. PMID: 25658779 [PubMed - as supplied by publisher]
Source: Journal of Neurosurgery - February 6, 2015 Category: Neurosurgery Authors: Fargen KM, Neal D, Blackburn SL, Hoh BL, Rahman M Tags: J Neurosurg Source Type: research

Analysis of 30 Day Unexpected Readmission Rates in Stroke Patients at an Academic Acute-care Hospital (P5.151)
CONCLUSIONS:SNFs accounted for the greatest percentage of unexpected stroke patient readmissions occurring within 30 days, while IR accounted for none. Main readmitting causes included cerebrovascular, cardiovascular, infections, and dehydration. 70[percnt] of readmissions were geriatric patients. Study Supported by: None.Disclosure: Dr. Kushner has nothing to disclose. Dr. Kelly has nothing to disclose. Dr. Morrison has nothing to disclose. Dr. Camfield has nothing to disclose.
Source: Neurology - April 8, 2015 Category: Neurology Authors: Kushner, D., Kelly, E., Morrison, R., Camfield, K. Tags: Cerebrovascular Disease and Interventional Neurology: Quality Research and Initiatives Source Type: research

Engaging Residents in Stroke Quality Measures with Financial Incentives and Electronic Checklist (S11.007)
CONCLUSIONS: Implementing a real-time, interactive decision support checklist and pay-for-performance program for residents improved compliance with stroke process measures. Empowering residents through leadership roles has been an important step toward integrating them into the quality infrastructure of the health system.Disclosure: Dr. Dean has nothing to disclose. Dr. Rashid has nothing to disclose. Dr. Wiese-Rometsch has nothing to disclose. Dr. Arsene has nothing to disclose. Dr. Hamstra has nothing to disclose. Dr. White has nothing to disclose. Dr. Hussain has nothing to disclose.
Source: Neurology - April 8, 2015 Category: Neurology Authors: Dean, M., Rashid, S., Wiese-Rometsch, W., Arsene, C., Hamstra, C., White, S., Hussain, S. Tags: Practice, Policy, and Ethics Source Type: research

Rate and Risk Factors of Recurrent 30-Day Readmissions following Hospitalization for Ischemic Stroke (S47.003)
CONCLUSIONS: Patients with 30-day readmissions after index hospitalization for ischemic stroke remain at further risk for recurrent 30-day readmissions. Characterization of magnitude and risk factors of recurrent 30-day readmissions may provide framework for reducing such preventable readmissions.Disclosure: Dr. Moradiya has nothing to disclose. Dr. Murthy has nothing to disclose. Dr. Modi has nothing to disclose. Dr. Naval has nothing to disclose.
Source: Neurology - April 8, 2015 Category: Neurology Authors: Moradiya, Y., Murthy, S., Modi, S., Naval, N. Tags: Cerebrovascular Disease and Interventional Neurology Source Type: research

Are Treatment Preferences of Those Who Died Ever Heard?: The Lack of Documentation of Preferences in a State-Wide Cohort of Patients Who Died Following Ischemic Stroke (S47.004)
CONCLUSIONS: Among a representative sample of California patients who died within 30 days after an ischemic stroke, less than half had documented discussions about LSI. The new Medicare policy could serve as an additional barrier to increasing communication about preferences, as physicians may fear that these discussions would lead to withdrawal of LSI, increased 30-day mortality, and thus misleading estimates of the hospital’s quality of care. Study Supported by:California OSHPD, RWJCSPDisclosure: Dr. Robinson has nothing to disclose. Dr. Vickrey has received personal compensation for activities with EMD Serono as a...
Source: Neurology - April 8, 2015 Category: Neurology Authors: Robinson, M., Vickrey, B., Holloway, R., Chong, K., Williams, L., Parikh, P., Leng, M., Zingmond, D. Tags: Cerebrovascular Disease and Interventional Neurology Source Type: research

Cost effectiveness of left atrial appendage closure versus Warfarin for stroke risk reduction in non-valvular Atrial Fibrillation in CMS patients
Stroke is the most severe and debilitating consequence of atrial fibrillation (AF), with many patients ranking the resultant disability as worse than death. Warfarin, the established first-line therapy, is effective at reducing ischemic stroke, but is associated with increased bleeding risk and lower quality of life (QoL). Left atrial appendage closure (LAAC) with the Watchman Device has been found to be superior to warfarin at reducing risk of stroke in AF patients. This analysis sought to assess the cost effectiveness of LAAC versus warfarin for stroke prevention in non-valvular AF from the perspective of the US Centers ...
Source: Value in Health - May 1, 2015 Category: Global & Universal Authors: V. Reddy, R. Akehurst, S.L. Amorosi, S. Armstrong, S. Beard, C. Knight, C. Taggart, D. Holmes Source Type: research

Abstract 304: Developing a Patient Registry for Atrial Fibrillation to Improve The Quality of Stroke Prevention in a Safety Net Institution Session Title: Poster Session III
Conclusions: A baseline assessment of stroke prophylaxis among atrial fibrillation patients in a safety net health system demonstrates nonguideline-concordant anticoagulation use among low-risk patients and suboptimal anticoagulation use among high-risk patients, patterns that could not be explained by HAS-BLED score.
Source: Circulation: Cardiovascular Quality and Outcomes - April 29, 2015 Category: Cardiology Authors: Oronce, C. I., Valdez, C., Anderson, S. L., Vlasimsky, T. B., Marrs, J. C., Richesin, S. D., Hanratty, R. Tags: Session Title: Poster Session III Source Type: research

Stroke patients fare better with private insurance than with Medicaid
(University of Florida) Stroke victims who use Medicaid or are uninsured were more likely to die, stay hospitalized longer and have worse medical outcomes than patients with private insurance, a study by University of Florida Health researchers has found.
Source: EurekAlert! - Medicine and Health - September 11, 2015 Category: Global & Universal Source Type: news

Time to Cost-Effectiveness Following Stroke Reduction Strategies in AF Warfarin Versus NOACs Versus LAA Closure
ConclusionsBoth NOACs and LAAC with the Watchman device were cost-effective relative to warfarin, but LAAC was also found to be cost-effective and to offer better value relative to NOACs. The results of this analysis should be considered when formulating policy and practice guidelines for stroke prevention in AF.
Source: Journal of the American College of Cardiology - December 14, 2015 Category: Cardiology Source Type: research

Study: Boston Scientific’s Watchman cheaper than drugs in reducing afib stroke risk
A study comparing the stroke risk for atrial fibrillation patients treated with Boston Scientific‘s (NYSE:BSX) Watchman device with the anticoagulant drug warfarin and non-warfarin oral anticoagulants found Watchman to be more cost-effective than its counterparts. Watchman is a catheter-delivered cardiac implant designed to close off the left atrial appendage, to prevent blood clots from forming there that could later cause a stroke. The study, published online in the Journal of the American College of Cardiology, showed that the Watchman device was cost-effective at 7 years at a cost of $42,994 per quality-adjust...
Source: Mass Device - December 15, 2015 Category: Medical Equipment Authors: Brad Perriello Tags: Wall Street Beat Cardiovascular Cardiac Implants Clinical Trials Boston Scientific Reimbursement Source Type: news

Recombinant Tissue Plasminogen Activator Stroke Therapy
The results of recently completed clinical trials of acute ischemic stroke that report a clear and unequivocal benefit of stent-retriever devices used with intravenous recombinant tissue plasminogen activator (rtPA) vs rtPA alone are the second revolutionary therapeutic breakthrough in acute stroke care in the last 50 years. This breakthrough makes the case for a new standard of care for the treatment of acute ischemic stroke. When we look back at the controversy surrounding interventional acute stroke therapies after multiple trials of interventional treatment, most notably International Management of Stroke III (IMS III)...
Source: JAMA Neurology - January 25, 2016 Category: Neurology Source Type: research

Disparities in Home Health Service Providers among Medicare Beneficiaries with Stroke.
This study examined the intensity of home health (HH) services, as defined by the number of visits and service delivery by rehabilitation specialists, among Medicare beneficiaries with stroke. A cross-sectional secondary data analysis was conducted using 2009 HH claims data obtained from the Centers for Medicare and Medicaid Services' Research Data Assistance Center. There were no significant rural-urban differences in the number of HH visits. Rural beneficiaries were significantly less likely than urban beneficiaries to receive services from rehabilitation specialists. Current HH payment reform recommendations may have un...
Source: Home Health Care Services Quarterly - April 12, 2016 Category: Nursing Tags: Home Health Care Serv Q Source Type: research

The lack of documentation of preferences in a cohort of adults who died after ischemic stroke
Conclusions: Documented discussions about limitations on life-sustaining interventions during hospitalization were low, even though this cohort died within 30 days poststroke. Improving the documentation of preferences may be difficult given the 2015 Centers for Medicare and Medicaid 30-day stroke mortality hospital performance measure that is unadjusted for patient preferences regarding life-sustaining interventions.
Source: Neurology - May 29, 2016 Category: Neurology Authors: Robinson, M. T., Vickrey, B. G., Holloway, R. G., Chong, K., Williams, L. S., Brook, R. H., Leng, M., Parikh, P., Zingmond, D. S. Tags: Outcome research, Quality of life, Infarction, Palliative care ARTICLE Source Type: research

Depression and Anxiety Screens as Predictors of 8-Year Incidence of Myocardial Infarction and Stroke in Primary Care Patients
We examined depression and anxiety screens, and their individual items, as predictors of incident hard CVD events, myocardial infarction, and stroke for 8 years in a diverse sample of 2041 older primary care patients initially free of CVD. At baseline, participants completed self-report depression and anxiety screens. Data regarding CVD events were obtained from an electronic medical record system and the Centers for Medicare and Medicaid Services analytic files. Results: During follow-up, 683 (33%) experienced a CVD event. Cox proportional hazards models—adjusted for demographic and CVD risk factors—revealed that a p...
Source: Psychosomatic Medicine - June 1, 2016 Category: Psychiatry & Psychology Tags: Original Articles Source Type: research

Silk Road touts low stroke rate in 2 studies of Enroute TCAR system
Silk Road Medical yesterday released data from 2 studies of its Enroute transcarotid neuroprotection and stent system, including 1-year data from a pivotal trial of the device and an interim analysis of a post-approval study of the Enroute. Data from the studies was presented last month at the 44th annual Veith Symposium in New York. The Sunnyvale, Calif.-based company touts the Enroute system and stent as the 1st and only devices currently approved for transcarotid artery revascularization procedures by the FDA. Silk Road presented data from the Roadster 1 pivotal trial of the TCAR system, which examined the use of ...
Source: Mass Device - December 13, 2016 Category: Medical Equipment Authors: Fink Densford Tags: Clinical Trials Vascular Silk Road Medical Inc. Source Type: news

Stroke Risk Reduction Outweighed Bleeding Risk Increase from Vitamin K Antagonists Treatment among Nonvalvular Atrial Fibrillation Patients with High Stroke risk and Low Bleeding Risk.
CONCLUSION: In NVAF patients at high risk for stroke and low risk for bleeding, our data confirm the effectiveness of anticoagulation for stroke prevention. The decrease in stroke risk of anticoagulation may outweigh the risk of major bleeding events, particularly among elderly patients. Potential risks of warfarin during initiation warrant attention, especially among patients who stop and start therapy repeatedly. PMID: 28008771 [PubMed - as supplied by publisher]
Source: Current Medical Research and Opinion - December 25, 2016 Category: Research Tags: Curr Med Res Opin Source Type: research

Prevalence of epilepsy/seizures as a comorbidity of neurologic disorders in nursing homes
Conclusions: The prevalence of epi/sz in the elderly nursing home population is >7-fold higher compared to community-dwelling elderly and is 7 to 30 times higher among those with certain comorbid neurologic conditions. Demographics and clinical characteristics had weaker associations with epi/sz prevalence.
Source: Neurology - February 19, 2017 Category: Neurology Authors: Birnbaum, A. K., Leppik, I. E., Svensden, K., Eberly, L. E. Tags: All Cerebrovascular disease/Stroke, All Cognitive Disorders/Dementia, Brain trauma, Prevalence studies, All Epilepsy/Seizures ARTICLE Source Type: research

Derivation and Validation of a Proposed Long Length of Stay (>= 7 days) Score in Patients Hospitalized for Acute Ischemic Stroke (P1.067)
Conclusions:Many factors play a role in determining the length of stay for AIS patients. Our study provides a scoring system that may help physicians predict which patients are more likely to have a prolonged hospital stay.Disclosure: Dr. Mahmood has nothing to disclose. Dr. Ali has nothing to disclose. Dr. Chauhan has nothing to disclose. Dr. Bianchi has nothing to disclose. Dr. Singhal has received personal compensation for activities with Medicolegal, ACTION Trial Stroke, Biogen, and Dock Technologies. Dr. Singhal holds stock and/or stock options in Biogen. Dr. Singhal has received research support from Boehringer Ingel...
Source: Neurology - April 17, 2017 Category: Neurology Authors: Mahmood, S., Ali, S., Chauhan, M. A., Bianchi, N., Singhal, A., Schwamm, L. Tags: Practice, Policy, and Ethics I Source Type: research

National trends in utilization of Intravenous thrombolysis and endovascular treatment in acute ischemic stroke (P5.044)
Conclusions:At national level, use of intravenous rt-PA is increasing among all groups proving positive impact of the efforts by organizations and patient education. Given endovascular treatment has now become standard of care; we need to create stroke care models to target this most vulnerable subset of patient population including Hispanics, patients residing in rural areas and insurance status like Medicaid or self-pay status to provide them similar and equal opportunities of treatment as others.Disclosure: Dr. Khatri has nothing to disclose. Dr. Afzal has nothing to disclose. Dr. Qureshi has nothing to disclose. Dr. Qu...
Source: Neurology - April 17, 2017 Category: Neurology Authors: Khatri, R., rauf-afzal, m., Qureshi, M. A., Qureshi, I. A., Maud, A., Rodriguez, G., Cruz-Flores, S. Tags: Neurocritical Care: Ischemic Injury 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

Disparities in Delivery of Endovascular Therapy: The Florida Puerto Rico Collaboration to Reduce Stroke Disparities Study (CReSD) (S19.003)
Conclusions:There are significant race, regional and hospital disparities in delivery of endovascular care. Efforts should be made to improve access to endovascular treatment to all eligible patients.Disclosure: Dr. Asdaghi has nothing to disclose. Dr. Granzoti Cintra has nothing to disclose. Dr. Wang has nothing to disclose. Dr. Dong has nothing to disclose. Dr. Ciliberti-Vargas has nothing to disclose. Dr. Gutierrez has nothing to disclose. Dr. Koch has nothing to disclose. Dr. Gardener has nothing to disclose. Dr. Marulanda-Londoño has nothing to disclose. Dr. Mueller has nothing to disclose. Dr. Yavagal has rece...
Source: Neurology - April 17, 2017 Category: Neurology Authors: Asdaghi, N., Cintra, L. G., Wang, K., Dong, C., Ciliberti-Vargas, M. A., Gutierrez, C. M., Koch, S., Gardener, H., Marulanda-Londono, E., Mueller, N., Yavagal, D., Mehta, B., Hanel, R., Rose, D. Z., Waddy, S. P., Robichaux, M., Foster, D., Zevallos, J. C. Tags: Best Of: Cerbrovascular Disease and Interventional Neurology Source Type: research

UCLA Health launches pioneering mobile stroke unit with support from L.A. County
Roughly every 40 seconds, someone in the United States will have a stroke. Almost every four minutes, one of those people will die as a result. Against that backdrop, UCLA Health has officially launched the first mobile stroke unit on the West Coast, enabling rapid delivery of brain-saving medications to stroke patients who might otherwise face debilitating delays in treatment.  As part of the first phase of a pilot program, the specialized ambulance unit and highly trained personnel began responding in September to select 911 calls in Santa Monica in coordination with the Santa Monica Fire Department. With support from t...
Source: UCLA Newsroom: Health Sciences - October 26, 2017 Category: Universities & Medical Training Source Type: news

Endovascular Therapy and Ethnic Disparities in Stroke Outcomes
Conclusions: Despite unique baseline characteristics, African-Americans treated with ET for large vessel occlusion strokes have similar outcomes as Caucasians. Greater availability of ET may diminish the ethnic/racial disparities in stroke outcomes.Intervent Neurol 2018;7:389 –398
Source: Interventional Neurology - June 19, 2018 Category: Neurology Source Type: research

Retention of Stroke Education Provided during Hospitalization: Does Provision of Required Education Increase Stroke Knowledge?
Discussion: While stroke education is required during hospitalization, its ability to produce retention may be poor. We propose study of test-enhanced learning methods through the Targeted Education in Stroke Trial (TEST) to examine the effect of novel teaching methods on patient/caregiver knowledge retention.Intervent Neurol 2018;7:471 –478
Source: Interventional Neurology - July 26, 2018 Category: Neurology Source Type: research

Identification of reversible causes of minority inequity in stroke: severity related to race and socio-economic status.
CONCLUSIONS: Patients who are uninsured minorities may be at an increased risk for severe strokes. This increase in risk appears to be related to the increased incidence of risk factors and lack of treatment. The lack of funds, care access, and limited education in these patients may be related to their increase in risk factors. This paper identifies potentially reversible environmental and societal factors that can lead to improved outcomes in indigent minority patients. PMID: 30325276 [PubMed - in process]
Source: Brain Injury - October 17, 2018 Category: Neurology Tags: Brain Inj Source Type: research

First Do No Harm: An Opinion on Bundled Care for Stroke Patients
This article argues for elimination of the diagnosis of stroke from the proposed demonstration project due to misaligned financial incentives that will severely compromise patient outcomes.
Source: Archives of Physical Medicine and Rehabilitation - October 26, 2018 Category: Rehabilitation Authors: Mark J. Ashley, Wayne A. Gordon, Brent E. Masel, Peter W. Thomas, Susan H. Connors 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

Stroke Survivors' Perspectives on Post-Acute Rehabilitation Options, Goals, Satisfaction, and Transition to Home.
CONCLUSION: Despite recommendations to include stroke patients in PAC selection and goal setting, many former inpatient rehabilitation facility and skilled nursing facility patients report not being involved in either aspect of care.Video Abstract available for more insights from the authors (see Supplemental Digital Content 1, available at: http://links.lww.com/JNPT/A273). PMID: 31205230 [PubMed - in process]
Source: Physical Therapy - June 19, 2019 Category: Physiotherapy Authors: Krishnan S, Hay CC, Pappadis MR, Deutsch A, Reistetter TA Tags: J Neurol Phys Ther Source Type: research