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Impact of COVID-19 on stroke caseload in a major HyperAcute Stroke Unit
Northwick Park Hospital in London, United Kingdom (UK) is one of the busiest stroke units in the country and is located in one of the areas most heavily affected by the COVID-19 pandemic in the first half of 2020. Admissions to the stroke unit and changes during the peak of COVID-19 were reviewed. Compared with the previous year, mean 96 patients were admitted with suspected stroke during April and May 2020 compared with mean 116 per month in non-COVID periods, ratio 0.82, P=0.01. This reduction involved both strokes and mimics and was unlikely to have occurred by chance.
Source: Journal of Stroke and Cerebrovascular Diseases - October 5, 2020 Category: Neurology Authors: Fionn Mag Uidhir, Raj Bathula, Aravinth Sivagnanaratnam, Mudhar Abdul-Saheb, Joseph Devine, David L. Cohen Source Type: research

The Impact of COVID-19 on Acute Ischemic Stroke Admissions: Analysis from a Community-Based Tertiary Care Center
To evaluate the impact of the COVID-19 pandemic on hospital admissions and outcomes in patients admitted with acute ischemic stroke.
Source: Journal of Stroke and Cerebrovascular Diseases - September 24, 2020 Category: Neurology Authors: Jing Wang, Saqib A. Chaudhry, Pouya Tahsili-Fahadan, Laith R. Altaweel, Sairah Bashir, Zelalem Bahiru, Yun Fang, Adnan I. Qureshi Tags: Original Investigation - Rapid Communications Source Type: research

Prehospital continuous ECG is valuable for very early detection of atrial fibrillation in patients with acute stroke
Atrial fibrillation (AF) is a major risk factor for recurrent stroke and death in ischemic stroke patients.1,2 Due to its elusive nature AF often goes undetected.3 The use of continuous ECG (cECG) improves detection rates.4,5 Early detection, and therefore timely initiation of oral anticoagulant treatment may improve the prognosis after stroke.6 –8 In acute ischemic stroke patients guidelines recommend an admission in-hospital 12-lead ECG followed by at least 24 or 72 hours of continuous monitoring (American and European guidelines respectively).
Source: Journal of Stroke and Cerebrovascular Diseases - August 15, 2020 Category: Neurology Authors: Louise Feldborg Lyckhage, Morten Lock Hansen, Kristina Procida, Troels Wienecke Source Type: research

A hospital-based study on ischaemic stroke characteristics, management, and outcomes in Sarawak: Where do we stand?
Located on the Borneo Island, Sarawak is the largest state of Malaysia and has a population distinctive from Peninsular Malaysia. The ischaemic stroke data in Sarawak had not been reported despite the growing number of patients annually. We aimed to investigate patient characteristics, management, and outcomes of ischaemic stroke in Sarawak and benchmark the results with national and international published data.
Source: Journal of Stroke and Cerebrovascular Diseases - August 15, 2020 Category: Neurology Authors: Teck Long King, Lee Len Tiong, Zurainah Kaman, Win Moe Zaw, Zariah Abdul Aziz, Law Wan Chung Source Type: research

A quantitative analysis of the effect of continuity of care on 30-day readmission and in-hospital mortality among patients with acute ischemic stroke
Ischemic stroke patients are predisposed to 30-day readmissions and mortality. An evaluation of readmission rates among patients with acute ischemic strokes from several studies highlighted that a 30-day readmission rate among Medicare beneficiaries are between 12.4% and 14.4%1,2 and there is a 2.5 fold increase risk of mortality among ischemic stroke patients readmitted within 30 days.3 Additionally, evidence suggest that up to 29% of rehospitalized patients with ischemic stroke were associated with inadequate outpatient continuum of care.
Source: Journal of Stroke and Cerebrovascular Diseases - August 15, 2020 Category: Neurology Authors: Arinze Nkemdirim Okere, Vassiki Sanogo, Rajesh Balkrishnan, Vakaramoko Diaby Source Type: research

A Prediction Model of Rehabilitation Motivation in Middle-Aged Survivors of Stroke in Rehabilitation Facilities in Korea
Background To improve the health outcomes of survivors of stroke, it is critical that they are highly motivated to engage in rehabilitation activities. Despite the increasing prevalence of strokes among middle-aged adults, there is limited knowledge regarding factors that may affect survivors' motivation to engage in rehabilitation. Objective The aim of this study was to examine the relationship among factors that predict the rehabilitation motivation of middle-aged survivors after a stroke through structural equation modeling. Methods A total of 200 middle-aged (40–64 years) survivors of stroke from 9 rehabilita...
Source: Journal of Cardiovascular Nursing - August 13, 2020 Category: Nursing Tags: ARTICLES: Stroke Source Type: research

Effect of Care Capacity on Stroke Patients ’ Recovery in Activities of Daily Living: A Multi-Hospital Study
This study aimed to investigate whether care capacity for patients following stroke contributes to improved activities of daily living (ADL) at discharge from hospital based on the degree of stroke severity.
Source: Journal of Stroke and Cerebrovascular Diseases - August 11, 2020 Category: Neurology Authors: Motoya Sugiyama, Katsunori Kondo, Seungwon Jeong, Nariaki Shiraishi, Daisuke Matsumoto, Takahiro Hayashi, Hirotaka Tanaka Source Type: research

A Comparison of Probabilistic and Deterministic Match Strategies for Linking Prehospital and in-Hospital Stroke Registry Data
Understanding and improving EMS stroke care requires linking data from both the prehospital and hospital settings. In the US, such data is collected in separate de-identified registries that cannot be directly linked due to lack of a common, unique patient identifier. In the absence of unique patient identifiers two common approaches to linking databases are deterministic matching, which uses combinations of non-unique matching variables to define matches, and probabilistic matching, which generates estimates of match probability based on the degree of similarity between records.
Source: Journal of Stroke and Cerebrovascular Diseases - August 11, 2020 Category: Neurology Authors: J. Adam Oostema, Adrienne Nickles, Mathew J. Reeves Source Type: research

Weekend Effect on in-Hospital Mortality for Ischemic and Hemorrhagic Stroke in US Rural and Urban Hospitals
Previous studies have reported a “weekend effect” on stroke mortality, whereby stroke patients admitted during weekends have a higher risk of in-hospital death than those admitted during weekdays.
Source: Journal of Stroke and Cerebrovascular Diseases - August 11, 2020 Category: Neurology Authors: Birook Mekonnen, Guijing Wang, Janani Rajbhandari-Thapa, Lu Shi, Kiran Thapa, Zheng Zhang, Donglan Zhang Source Type: research

Code Stroke patient referral by Emergency Medical Services during the public COVID-19 pandemic lockdown
During the coronavirus disease 2019 (COVID-19) pandemic the use of health care systems changed suddenly. Hospitals were overwhelmed as a result of the staggering COVID-19 patient numbers1 and/or modified their daily routine due to prophylactic allocation of resources.2 Public lockdowns with strict containment recommendations for the community have been announced around the world.3 Emergency Medical Services (EMS) and dispatch centers were confronted with increasing numbers of patients/calls and reorganization of the dispatch system including Code Stroke patient referral.
Source: Journal of Stroke and Cerebrovascular Diseases - July 20, 2020 Category: Neurology Authors: Benno Ikenberg, Bernhard Hemmer, Michael Dommasch, Karl-Georg Kanz, Silke Wunderlich, Benjamin Knier Source Type: research

Multicenter, retrospective analysis of endovascular treatment for acute ischemic stroke in nonagenarians
Background: With the increasing age of acute stroke patients being admitted to hospitals, more data are needed on indications, complications and outcome of endovascular treatment (EVT) in the very elderly. Methods: Retrospective observational study with data collection from Belgian, Swiss, Canadian comprehensive stroke centers and Swedish EVT National database. All patients with acute ischemic stroke were eligible if aged older than or ≥90 years and treated with EVT ± pretreatment with intravenous thrombolysis (IVT).
Source: Journal of Stroke and Cerebrovascular Diseases - July 15, 2020 Category: Neurology Authors: Helena Janssen, Stefania Nannoni, Olivier Francois, Tom Dewaele, Sofie De Blauwe, Geert Vanhooren, Johan Ghekiere, Joost Kager, Andr é Peeters, Pierre Goffette, Frank Hammer, Thierry Duprez, Jelle Demeestere, Robin Lemmens, Sandra Cornelissen, Sam Heye, Source Type: research

Left Atrial Dilation and Risk of One-Year Readmission after Embolic Stroke of Undetermined Source
: Structural left atrial and ventricular abnormalities on the electrocardiogram (ECG) and transthoracic echocardiogram (TTE) at the time of ischemic stroke have been associated with morbidity and mortality. Yet, the prognostic impact of the same in embolic stroke of undetermined source (ESUS), a relevant subtype of ischemic stroke with a unique pathophysiology, has not been well studied to date. Our aim was to assess the predictive impact of left atrio-ventricular ECG and TTE abnormalities on one-year hospital readmission after ESUS from an ongoing single center prospective stroke registry in the U.S.
Source: Journal of Stroke and Cerebrovascular Diseases - July 15, 2020 Category: Neurology Authors: Vikrant Jagadeesan, Austin Culver, Nisha Raiker, Quinn Halverson, Sameer Prasada, Liqi Chen, Leah J. Welty, Shyam Prabhakaran, Kameswari Maganti Source Type: research

Is neutrophil/eosinophil ratio at admission a prognostic marker for in-hospital mortality of acute ischemic stroke?
This study aimed to investigate whether NER at admission is a prognostic marker for in-hospital mortality in patients with AIS.
Source: Journal of Stroke and Cerebrovascular Diseases - July 15, 2020 Category: Neurology Authors: Muzaffer G üneş Source Type: research

Universal laboratory testing for SARS-CoV-2 in hyperacute stroke during the COVID-19 pandemic
The coronavirus disease 2019 (COVID-19) pandemic necessitates organizational and structural adjustments to local health care systems to protect medical professionals and patients from infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (1). Particularly older individuals and those with cardiovascular comorbidities are thought to be at increased risk of COVID-19 (2). Consequently, stroke patients can be considered an at-risk population and might benefit from infection control screens at hospital entry (3,4).
Source: Journal of Stroke and Cerebrovascular Diseases - June 19, 2020 Category: Neurology Authors: Kristian Barlinn, Timo Siepmann, Lars-Peder Pallesen, Simon Winzer, Annahita Sedghi, Percy Schroettner, Kristina Hochauf-Stange, Alexandra Prakapenia, Haidar Moustafa, Katja de With, Jennifer Linn, Heinz Reichmann, Jessica Barlinn, Volker Puetz Tags: Original Article Source Type: research

Unprotected stroke management in an undiagnosed case of Severe Acute Respiratory Syndrome Coronavirus 2 infection
We report the case of a 79-year-old woman, who was admitted for a wake-up stroke due to occlusion of the left middle cerebral artery. She was treated outside the COVID-19-dedicated track of the hospital because she had no concomitant signs or symptoms suggestive of SARS-CoV-2 infection nor recent contact with other infected individuals.
Source: Journal of Stroke and Cerebrovascular Diseases - May 22, 2020 Category: Neurology Authors: Claudia Papi, Gregorio Spagni, Andrea Alexandre, Paolo Calabresi, Giacomo Della Marca, Aldobrando Broccolini Source Type: research

Association between obstructive sleep apnea and risk of post-stroke depression: A hospital-based study in ischemic stroke patients
This study aimed to detect the correlation between OSA severity and post-stroke depression (PSD) in ischemic stroke patients.
Source: Journal of Stroke and Cerebrovascular Diseases - May 13, 2020 Category: Neurology Authors: Chuanyou Li, Yuanyue Liu, Pengfei Xu, Qiqi Fan, Pengyu Gong, Caixia Ding, Lei Sheng, Xiaohao Zhang Source Type: research

Risk factors and pathogenic microorganism characteristics for pneumonia in convalescent patients with stroke: A retrospective study of 380 patients from a rehabilitation hospital
Stroke significantly impacts public health and ranks among the leading causes of death and disabilities, resulting in enormous costs measured in both health care resources and lost productivity. It results primarily from embolus or thrombosis for ischemic stroke and hypertension for hemorrhagic stroke, respectively [1]. In 2016, there were 5.5 million deaths and 116.4 million disability-adjusted life-years (DALYs) owed to stroke [2]. As reported, the impact of stroke on the Chinese population is more severe compared to average global levels, and the prevalence of stroke continues to surpass that of ischemic heart disease [3 –4].
Source: Journal of Stroke and Cerebrovascular Diseases - May 13, 2020 Category: Neurology Authors: Jia Xu, Zhiling Yang Source Type: research

Factors associated with quality of life early after ischemic stroke: the role of resilience.
DISCUSSION: Resilience was an independent predictor of quality of life beyond anxiety and depression in patients with ischemic stroke. Interventions aimed at improving resilience at acute hospitalization might be a worthwhile addition to improve quality of life early after stroke. PMID: 30957683 [PubMed - as supplied by publisher]
Source: Topics in Stroke Rehabilitation - April 7, 2019 Category: Neurology Authors: Liu Z, Zhou X, Zhang W, Zhou L Tags: Top Stroke Rehabil Source Type: research

Impact of Transcranial Doppler Ultrasound on Logistics and Outcomes in Stroke Thrombolysis Clinical Sciences
Background and Purpose—Diagnostic transcranial Doppler ultrasound (TCD) is commonly used in patients with acute stroke before or during treatment with intravenous thrombolysis (IVT). We aimed to assess how much TCD delays IVT initiation and whether TCD influences outcomes.Methods—We analyzed data from the SITS-ISTR (Safe Implementation of Thrombolysis in Stroke–International Stroke Thrombolysis Register) collected from December 2002 to December 2011. Outcomes were door-to-needle time, symptomatic intracerebral hemorrhage, functional outcome per the modified Rankin Scale, and mortality at 3 months.Results—In hospita...
Source: Stroke - June 25, 2018 Category: Neurology Authors: Michael V. Mazya, Niaz Ahmed, Elsa Azevedo, Antoni Davalos, Laura Dorado, Michal Karlinski, Svetlana Lorenzano, Jiři Neumann, Danilo Toni, Tiago P. Moreira Tags: Ultrasound, Health Services, Ischemic Stroke Original Contributions Source Type: research

Elevated Plasma D-Dimer Level Is Associated With Short-Term Risk of Ischemic Stroke in Patients With Acute Heart Failure Brief Report
We examined 721 consecutive hospitalized AHF patients with plasma D-dimer level on admission from our prospective registry between January 2013 and May 2016. The study end points were incidence of ischemic stroke during hospitalization and at 30 days after admission.Results—Of the total participants (mean age, 76 years; male, 60%; atrial fibrillation, 54%; mean left ventricular ejection fraction, 38%), in-hospital ischemic stroke occurred in 18 patients (2.5%) during a median hospitalization period of 21 days, and 30-day ischemic stroke occurred in 16 patients (2.2%). Higher D-dimer level on admission was an independent ...
Source: Stroke - June 25, 2018 Category: Neurology Authors: Yasuhiro Hamatani, Toshiyuki Nagai, Michikazu Nakai, Kunihiro Nishimura, Yasuyuki Honda, Hiroki Nakano, Satoshi Honda, Naotsugu Iwakami, Yasuo Sugano, Yasuhide Asaumi, Takeshi Aiba, Teruo Noguchi, Kengo Kusano, Kazunori Toyoda, Satoshi Yasuda, Hiroyuki Yo Tags: Heart Failure, Ischemic Stroke Brief Reports Source Type: research

Population-Based Assessment of the Long-Term Risk of Seizures in Survivors of Stroke Clinical Sciences
Background and Purpose—We sought to determine the long-term risk of seizures after stroke according to age, sex, race, and stroke subtype.Methods—We performed a retrospective cohort study using administrative claims from 2 complementary patient data sets. First, we analyzed data from all emergency department visits and hospitalizations in California, Florida, and New York from 2005 to 2013. Second, we evaluated inpatient and outpatient claims from a nationally representative 5% random sample of Medicare beneficiaries. Our cohort consisted of all adults at the time of acute stroke hospitalization without a prior history...
Source: Stroke - May 25, 2018 Category: Neurology Authors: Alexander E. Merkler, Gino Gialdini, Michael P. Lerario, Neal S. Parikh, Nicholas A. Morris, Benjamin Kummer, Lauren Dunn, Michael E. Reznik, Santosh B. Murthy, Babak B. Navi, Zachary M. Grinspan, Costantino Iadecola, Hooman Kamel Tags: Risk Factors, Cerebrovascular Disease/Stroke Original Contributions Source Type: research

Evolution of a US County System for Acute Comprehensive Stroke Care Clinical Sciences
We examined relationships between stroke details, reperfusion therapies, hospital transfers, and their change over time.Methods—All patients from January 1, 2013, to December 31, 2015, for whom 911 was called within 7 hours of onset in whom Emergency Medical Services personnel suspected acute stroke were evaluated.Results—Among 6132 patients, 3924 (64%) had confirmed diagnosis of stroke (74% ischemic/26% hemorrhagic), yielding diagnostic precision of 64% in the field. Of the 2892 patients with acute ischemic stroke, acute reperfusion therapy was given to 29.2% (21.7% intravenous tPA [tissue-type plasminogen activator] ...
Source: Stroke - April 23, 2018 Category: Neurology Authors: Radoslav I. Raychev, Dana Stradling, Nirav Patel, Joey R. Gee, David A. Lombardi, Johnson L. Moon, David M. Brown, Mayank Pathak, Wengui Yu, Samuel J. Stratton, Steven C. Cramer Tags: Cerebrovascular Disease/Stroke, Cerebrovascular Procedures, Ischemic Stroke Original Contributions Source Type: research

Distribution and Temporal Trends From 1993 to 2015 of Ischemic Stroke Subtypes Clinical Sciences
Background and Purpose—Preventive strategies, together with demographic and socioeconomic changes, might have modified the worldwide distribution of ischemic stroke (IS) subtypes. We investigated those changes by means of a systematic review and meta-analysis.Methods—We evaluated all population- and hospital-based studies reporting the distribution of IS etiologic subtypes according to the TOAST criteria (Trial of ORG 10172 in Acute Stroke Treatment). Studies were identified by searching articles indexed on PubMed and Scopus from January 1, 1993, to June 30, 2017. Two independent investigators extracted data and checke...
Source: Stroke - March 26, 2018 Category: Neurology Authors: Raffaele Ornello, Diana Degan, Cindy Tiseo, Caterina Di Carmine, Laura Perciballi, Francesca Pistoia, Antonio Carolei, Simona Sacco Tags: Epidemiology, Race and Ethnicity, Meta Analysis, Ischemic Stroke Original Contributions Source Type: research

Age-Specific Associations of Renal Impairment With Magnetic Resonance Imaging Markers of Cerebral Small Vessel Disease in Transient Ischemic Attack and Stroke Clinical Sciences
Background and Purpose—It has been hypothesized that cerebral small vessel disease (SVD) and chronic renal impairment may be part of a multisystem small-vessel disorder, but their association may simply be as a result of shared risk factors (eg, hypertension) rather than to a systemic susceptibility to premature SVD. However, most previous studies were hospital based, most had inadequate adjustment for hypertension, many were confined to patients with lacunar stroke, and none stratified by age.Methods—In a population-based study of transient ischemic attack and ischemic stroke (OXVASC [Oxford Vascular Study]), we evalu...
Source: Stroke - March 26, 2018 Category: Neurology Authors: Bian Liu, Kui Kai Lau, Linxin Li, Caroline Lovelock, Ming Liu, Wilhelm Kuker, Peter M. Rothwell Tags: Magnetic Resonance Imaging (MRI), Ischemic Stroke, Transient Ischemic Attack (TIA) Original Contributions Source Type: research

Posttreatment National Institutes of Health Stroke Scale Is Superior to the Initial Score or Thrombolysis in Cerebral Ischemia for 3-Month Outcome Clinical Sciences
Background and Purpose—The majority of ischemic stroke patients receiving endovascular recanalization therapy (EVT) experience variable changes of neurological severities during the hyperacute period. We hypothesized that the National Institutes of Health Stroke Scale (NIHSS) score after EVT is a better prognostic factor compared with the initial NIHSS score or revascularization status.Methods—We identified 566 stroke patients who received EVT at Seoul National University Bundang Hospital between April 2008 and December 2015. We prospectively collected post-EVT NIHSS score, which was measured in the angiography suite b...
Source: Stroke - March 26, 2018 Category: Neurology Authors: Han-Gil Jeong, Beom Joon Kim, Jay Chol Choi, Keun-Sik Hong, Mi Hwa Yang, Cheolkyu Jung, Moon-Ku Han, Hee-Joon Bae Tags: Ischemic Stroke Original Contributions Source Type: research

Effects of Prehospital Thrombolysis in Stroke Patients With Prestroke Dependency Clinical Sciences
Background and Purpose—Data on effects of intravenous thrombolysis on outcome of patients with ischemic stroke who are dependent on assistance in activities of daily living prestroke are scarce. Recent registry based analyses in activities of daily –independent patients suggest that earlier start of intravenous thrombolysis in the prehospital setting leads to better outcomes when compared with the treatment start in hospital. We evaluated whether these observations can be corroborated in patients with prestroke dependency.Methods—This observational, retrospective analysis included all patients with acute ischemic str...
Source: Stroke - February 26, 2018 Category: Neurology Authors: Christian H. Nolte, Martin Ebinger, Jan F. Scheitz, Alexander Kunz, Hebun Erdur, Frederik Geisler, Tim-Bastian Braemswig, Michal Rozanski, Joachim E. Weber, Matthias Wendt, Katja Zieschang, Jochen B. Fiebach, Kersten Villringer, Ulrike Grittner, Sabina Ka Tags: Cerebrovascular Disease/Stroke, Ischemic Stroke Original Contributions Source Type: research

Comorbid Psychiatric Disease Is Associated With Lower Rates of Thrombolysis in Ischemic Stroke Brief Report
Background and Purpose—Intravenous thrombolysis (IVT) improves outcomes after acute ischemic stroke but is underused in certain patient populations. Mental illness is pervasive in the United States, and patients with comorbid psychiatric disease experience inequities in treatment for a range of conditions. We aimed to determine whether comorbid psychiatric disease is associated with differences in IVT use in acute ischemic stroke.Methods—Acute ischemic stroke admissions between 2007 and 2011 were identified in the Nationwide Inpatient Sample. Psychiatric disease was defined by International Classification of Diseases, ...
Source: Stroke - February 26, 2018 Category: Neurology Authors: Diana M. Bongiorno, Gail L. Daumit, Rebecca F. Gottesman, Roland Faigle Tags: Quality and Outcomes, Ischemic Stroke Brief Reports Source Type: research

Quality of Life Is Poorer for Patients With Stroke Who Require an Interpreter Brief Report
Background and Purpose—In multicultural Australia, some patients with stroke cannot fully understand, or speak, English. Language barriers may reduce quality of care and consequent outcomes after stroke, yet little has been reported empirically.Methods—An observational study of patients with stroke or transient ischemic attack (2010–2015) captured from 45 hospitals participating in the Australian Stroke Clinical Registry. The use of interpreters in hospitals, which is routinely documented, was used as a proxy for severe language barriers. Health-Related Quality of Life was assessed using the EuroQoL-5 dimension-3 lev...
Source: Stroke - February 26, 2018 Category: Neurology Authors: Monique F. Kilkenny, Natasha A. Lannin, Craig S. Anderson, Helen M. Dewey, Joosup Kim, Karen Barclay-Moss, Chris Levi, Steven Faux, Kelvin Hill, Brenda Grabsch, Sandy Middleton, Amanda G. Thrift, Rohan Grimley, Geoffrey Donnan, Dominique A. Cadilhac Tags: Race and Ethnicity, Mortality/Survival, Quality and Outcomes, Ischemic Stroke, Transient Ischemic Attack (TIA) Brief Reports Source Type: research

Novel Telestroke Program Improves Thrombolysis for Acute Stroke Across 21 Hospitals of an Integrated Healthcare System Clinical Sciences
This study included 310 patients treated with alteplase in the pre–EXpediting the PRrocess of Evaluating and Stopping Stroke period and 557 patients treated with alteplase in the EXpediting the PRrocess of Evaluating and Stopping Stroke period. After implementation, alteplase administrations increased to 62/mo from 34/mo at baseline (P
Source: Stroke - December 22, 2017 Category: Neurology Authors: Mai N. Nguyen-Huynh, Jeffrey G. Klingman, Andrew L. Avins, Vivek A. Rao, Abigail Eaton, Sunil Bhopale, Anne C. Kim, John W. Morehouse, Alexander C. Flint Tags: Treatment, Cerebrovascular Disease/Stroke, Ischemic Stroke Original Contributions Source Type: research

Ischemic Stroke Profile, Risk Factors, and Outcomes in India Brief Report
Background and Purpose—The Indo-US Collaborative Stroke Project was designed to characterize ischemic stroke across 5 high-volume academic tertiary hospitals in India.Methods—From January 2012 to August 2014, research coordinators and physician coinvestigators prospectively collected data on 2066 patients with ischemic stroke admitted
Source: Stroke - December 22, 2017 Category: Neurology Authors: P.N. Sylaja, Jeyaraj Durai Pandian, Subhash Kaul, M.V. Padma Srivastava, Dheeraj Khurana, Lee H. Schwamm, Praveen Kesav, Deepti Arora, Aman Pannu, Tijy K. Thankachan, Aneesh B. Singhal Tags: Ischemic Stroke Brief Reports Source Type: research

Mobile Interventional Stroke Teams Lead to Faster Treatment Times for Thrombectomy in Large Vessel Occlusion Clinical Sciences
Background and Purpose—Endovascular recanalization treatment for acute ischemic stroke is a complex, time-sensitive intervention. Trip-and-treat is an interhospital service delivery model that has not previously been evaluated in the literature and consists of a shared mobile interventional stroke team that travels to primary stroke centers to provide on-site interventional capability. We compared treatment times between the trip-and-treat model and the traditional drip-and-ship model.Methods—We performed a retrospective analysis on 86 consecutive eligible patients with acute ischemic stroke secondary to large vessel o...
Source: Stroke - November 27, 2017 Category: Neurology Authors: Daniel Wei, Thomas J. Oxley, Dominic A. Nistal, Justin R. Mascitelli, Natalie Wilson, Laura Stein, John Liang, Lena M. Turkheimer, Jacob R. Morey, Claire Schwegel, Ahmed J. Awad, Hazem Shoirah, Christopher P. Kellner, Reade A. De Leacy, Stephan A. Mayer, Tags: Revascularization, Cerebrovascular Disease/Stroke, Cerebrovascular Procedures, Ischemic Stroke Original Contributions Source Type: research

Incidence and Outcomes of Myocardial Infarction in Patients Admitted With Acute Ischemic Stroke Clinical Sciences
Background and Purpose—Data on the incidence and outcomes of acute myocardial infarction (AMI) complicating acute ischemic stroke (AIS) are limited. We aim to evaluate the incidence, treatment patterns, and outcomes of AMI in patients with AIS using a nationwide database.Methods—The National Inpatient Sample was used to identify patient with AIS between 2003 and 2014. Trends of incidence of AMI and its associated in-hospital mortality were evaluated. Univariate and multivariate logistic regressions were used to evaluate predictors of AMI. The impact of AMI on in-hospital outcomes was assessed in a comparative analysis ...
Source: Stroke - October 23, 2017 Category: Neurology Authors: Fahad Alqahtani, Sami Aljohani, Abdul Tarabishy, Tatiana Busu, Amelia Adcock, Mohamad Alkhouli Tags: Myocardial Infarction, Ischemic Stroke Original Contributions Source Type: research

Tissue-Selective Salvage of the White Matter by Successful Endovascular Stroke Therapy Clinical Sciences
This study examines occurrence, determinants, and clinical significance of such effects.Methods—Three hundred twenty-two patients with acute middle cerebral artery occlusion subjected to mechanical thrombectomy were included. Infarct patterns were categorized into WM− (sparing the WM) and WM+ (involving WM). National Institutes of Health Stroke Scale–based measures of neurological outcome, including National Institutes of Health Stroke Scale improvement or National Institutes of Health Stroke Scale worsening, good functional midterm outcome (day 90-modified Rankin Scale score of ≤2), the occurrence of malignant swe...
Source: Stroke - September 25, 2017 Category: Neurology Authors: Justus F. Kleine, Mirjam Kaesmacher, Benedikt Wiestler, Johannes Kaesmacher Tags: Cerebrovascular Procedures, Ischemic Stroke Original Contributions Source Type: research

Dolichoectasia and Small Vessel Disease in Young Patients With Transient Ischemic Attack and Stroke Clinical Sciences
Background and Purpose—We evaluated whether basilar dolichoectasia is associated with markers of cerebral small vessel disease in younger transient ischemic attack and ischemic stroke patients.Methods—We used data from the SIFAP1 study (Stroke in Young Fabry Patients), a large prospective, hospital-based, screening study for Fabry disease in young (
Source: Stroke - August 28, 2017 Category: Neurology Authors: Vincent Thijs, Ulrike Grittner, Franz Fazekas, Dominick J.H. McCabe, Anne-Katrin Giese, Christof Kessler, Peter Martus, Bo Norrving, Erich Bernd Ringelstein, Reinhold Schmidt, Christian Tanislav, Jukka Putaala, Turgut Tatlisumak, Bettina von Sarnowski, Ar Tags: Hypertension, Cerebrovascular Disease/Stroke, Ischemic Stroke, Transient Ischemic Attack (TIA), Vascular Disease Original Contributions Source Type: research

Impact of Stroke Center Certification on Mortality After Ischemic Stroke Clinical Sciences
This study aimed to understand whether PSC certification reduced stroke mortality.Methods—We examined Medicare fee-for-service beneficiaries aged ≥65 years who were hospitalized between 2009 and 2013 for ischemic stroke. Hospitals were classified into 3 groups: new PSCs, the hospitals that received initial PSC certification between 2009 and 2013 (n=634); existing PSCs, the PSCs certified before 2009 (n=785); and non-SCs, the hospitals that have never been certified as PSCs (n=2640). Multivariate logistic regression and Cox proportional hazards model was used to compare the mortality among the 3 groups.Results—Existin...
Source: Stroke - August 28, 2017 Category: Neurology Authors: Shumei Man, Jesse D. Schold, Ken Uchino Tags: Health Services, Quality and Outcomes, Cerebrovascular Disease/Stroke Original Contributions Source Type: research

Palliative Care for Hospitalized Patients With Stroke Clinical Sciences
This study explores patterns of palliative care utilization and death in hospitalized patients with stroke across the United States.Methods—Using the 2010 to 2012 nationwide inpatient sample databases, we included all patients discharged with stroke identified by International Classification of Diseases-Ninth Revision codes. Strokes were subclassified as ischemic, intracerebral, and subarachnoid hemorrhage. We compared demographics, comorbidities, procedures, and outcomes between patients with and without a palliative care encounter (PCE) as defined by the International Classification of Diseases-Ninth Revision code V66....
Source: Stroke - August 28, 2017 Category: Neurology Authors: Tarvinder Singh, Steven R. Peters, David L. Tirschwell, Claire J. Creutzfeldt Tags: Race and Ethnicity, Quality and Outcomes, Cerebrovascular Disease/Stroke, Intracranial Hemorrhage, Ischemic Stroke Original Contributions Source Type: research

Acute Ischemic Stroke After Moderate to Severe Traumatic Brain Injury Clinical Sciences
Background and Purpose—Traumatic brain injury (TBI) leads to nearly 300 000 annual US hospitalizations and increased lifetime risk of acute ischemic stroke (AIS). Occurrence of AIS immediately after TBI has not been well characterized. We evaluated AIS acutely after TBI and its impact on outcome.Methods—A prospective database of moderate to severe TBI survivors, admitted to inpatient rehabilitation at 22 Traumatic Brain Injury Model Systems centers and their referring acute-care hospitals, was analyzed. Outcome measures were AIS incidence, duration of posttraumatic amnesia, Functional Independence Measure, and Disabi...
Source: Stroke - June 26, 2017 Category: Neurology Authors: Robert G. Kowalski, Juliet K. Haarbauer–Krupa, Jeneita M. Bell, John D. Corrigan, Flora M. Hammond, Michel T. Torbey, Melissa C. Hofmann, Kristen Dams–O’Connor, A. Cate Miller, Gale G. Whiteneck Tags: Hypertension, Computerized Tomography (CT), Prognosis, Ischemic Stroke Original Contributions Source Type: research

Prehospital Emergency Care in Childhood Arterial Ischemic Stroke Brief Report
Background and Purpose—Immediately calling an ambulance is the key factor in reducing time to hospital presentation for adult stroke. Little is known about prehospital care in childhood arterial ischemic stroke (AIS). We aimed to determine emergency medical services call-taker and paramedic diagnostic sensitivity and to describe timelines of care in childhood AIS.Methods—This is a retrospective study of ambulance-transported children aged
Source: Stroke - March 27, 2017 Category: Neurology Authors: Belinda Stojanovski, Paul T. Monagle, Ian Mosley, Leonid Churilov, Fiona Newall, Grant Hocking, Mark T. Mackay Tags: Basic Science Research, Cerebrovascular Disease/Stroke, Ischemic Stroke Brief Reports Source Type: research

Impact of Rehabilitation on Outcomes in Patients With Ischemic Stroke Clinical Sciences
Background and Purpose—We aimed to examine the concurrent effects of timing and intensity of rehabilitation on improving activities of daily living (ADL) among patients with ischemic stroke.Methods—Using the Japanese Diagnosis Procedure Combination inpatient database, we retrospectively analyzed consecutive patients with ischemic stroke at admission who received rehabilitation (n=100 719) from April 2012 to March 2014. Early rehabilitation was defined as that starting within 3 days after admission. The average rehabilitation intensity per day was calculated as the total units of rehabilitation during hospitalization ...
Source: Stroke - February 26, 2017 Category: Neurology Authors: Maiko Yagi, Hideo Yasunaga, Hiroki Matsui, Kojiro Morita, Kiyohide Fushimi, Masashi Fujimoto, Teruyuki Koyama, Junko Fujitani Tags: Ischemic Stroke Original Contributions Source Type: research

Differences in Acute Ischemic Stroke Quality of Care and Outcomes by Primary Stroke Center Certification Organization Clinical Sciences
This study aimed to evaluate whether PSCs certified by different organizations have similar quality of care and in-hospital outcomes.Methods—The study population consisted of acute ischemic stroke patients who were admitted to PSCs participating in Get With The Guidelines-Stroke between January 1, 2010, and December 31, 2012. Measures of care quality and outcomes were compared among the 4 different PSC certifications.Results—A total of 477 297 acute ischemic stroke admissions were identified from 977 certified PSCs (73.8% JC, 3.7% Det Norske Veritas, 1.2% Healthcare Facilities Accreditation Program, and 21.3% State-b...
Source: Stroke - January 22, 2017 Category: Neurology Authors: Shumei Man, Margueritte Cox, Puja Patel, Eric E. Smith, Mathew J. Reeves, Jeffrey L. Saver, Deepak L. Bhatt, Ying Xian, Lee H. Schwamm, Gregg C. Fonarow Tags: Health Services, Quality and Outcomes, Ischemic Stroke Original Contributions Source Type: research

Timing of Percutaneous Endoscopic Gastrostomy for Acute Ischemic Stroke Clinical Sciences
Background and Purpose—Stroke guidelines recommend time-limited trials of nasogastric feeding prior to percutaneous endoscopic gastrostomy (PEG) tube placement. We sought to describe timing of PEG placement and identify factors associated with early PEG for acute ischemic stroke.Methods—We designed a retrospective observational study to examine time to PEG for ischemic stroke admissions in the Nationwide Inpatient Sample, 2001 to 2011. We defined early PEG placement as 1 to 7 days from admission. Using multivariable regression analysis, we identified the effects of patient and hospital characteristics on PEG timing.Res...
Source: Stroke - January 22, 2017 Category: Neurology Authors: Benjamin P. George, Adam G. Kelly, George P. Albert, David Y. Hwang, Robert G. Holloway Tags: Health Services, Ischemic Stroke Original Contributions Source Type: research

Changes in caregiver burden among informal caregivers of stroke patients in Mongolia.
This study aimed to define the changes in CGB in the first year of caregiving among the caregivers of stroke patients and to identify associated factors. METHODS: A prospective, multi-centered observational study was conducted in nine public hospitals in Mongolia. We used the Montgomery CGB Scale for assessing CGB, and repeated the assessment after 1 year. Stroke patient characteristics were included in the analyses. Multinomial logistic regressions were conducted to analyze changes in CGB. RESULTS: A paired t-test analysis revealed that demand burden increased (from 12.61 to 11.50, p = 0.034), whereas stress ...
Source: Topics in Stroke Rehabilitation - January 17, 2017 Category: Neurology Authors: Chuluunbaatar E, Pu C, Chou YJ Tags: Top Stroke Rehabil Source Type: research

Timing of Carotid Revascularization Procedures After Ischemic Stroke Brief Report
Background and Purpose—In 2006, the American Heart Association recommended that carotid revascularization generally occurs within 2 weeks of stroke based on data from 2 trials of carotid endarterectomy (CEA). We aimed to determine whether the time between stroke and CEA or carotid artery stenting (CAS) has decreased and whether the proportion of procedures occurring within 14 days has increased.Methods—Using validated International Classification of Diseases, Ninth Revision, Clinical Modification codes and administrative claims data from nonfederal hospitals in CA, FL, and NY, we identified patients with ischemic strok...
Source: Stroke - December 22, 2016 Category: Neurology Authors: Michael Reznik, Hooman Kamel, Gino Gialdini, Ankur Pandya, Babak B. Navi, Ajay Gupta Tags: Secondary Prevention, Quality and Outcomes, Cerebrovascular Disease/Stroke, Ischemic Stroke Brief Reports Source Type: research

Stroke Thrombolysis in a Centralized and a Decentralized System (Helsinki and Telemedical Project for Integrative Stroke Care Network) Clinical Sciences
Background and Purpose—Intravenous thrombolysis with tissue-type plasminogen activator (tPA) for acute ischemic stroke is more effective when delivered early. Timely delivery is challenging particularly in rural areas with long distances. We compared delays and treatment rates of a large, decentralized telemedicine-based system and a well-organized, large, centralized single-hospital system.Methods—We analyzed the centralized system of the Helsinki University Central Hospital (Helsinki and Province of Uusimaa, Finland, 1.56 million inhabitants, 9096 km2) and the decentralized TeleStroke Unit network in a predominantly ...
Source: Stroke - November 27, 2016 Category: Neurology Authors: Gordian J. Hubert, Atte Meretoȷa, Heinrich J. Audebert, Turgut Tatlisumak, Florian Zeman, Sandra Boy, Roman L. Haberl, Markku Kaste, Peter Muller–Barna Tags: Revascularization, Treatment, Health Services, Ischemic Stroke Original Contributions Source Type: research

Rheumatic Mitral Valve Disease Is Associated With Worse Outcomes in Stroke Clinical Sciences
We examined the association between RMVD and both serious and common cardiovascular and noncardiovascular (respiratory and infective) complications in a cohort of hospitalized stroke patients based in Thailand. Factors associated with in-hospital mortality were also explored. Data were obtained from a National Insurance Database. All hospitalized strokes between October 1, 2004, and January 31, 2013, were included in the current study. Characteristics and outcomes were compared for RMVD and non-RMVD patients. Logistic regression, propensity score matching, and multivariate models were used to assess study outcomes.Results...
Source: Stroke - October 23, 2016 Category: Neurology Authors: Wood, A. D., Mannu, G. S., Clark, A. B., Tiamkao, S., Kongbunkiat, K., Bettencourt-Silva, J. H., Sawanyawisuth, K., Kasemsap, N., Barlas, R. S., Mamas, M., Myint, P. K. Tags: Rheumatic Heart Disease, Valvular Heart Disease, Complications, Mortality/Survival, Cerebrovascular Disease/Stroke Original Contributions Source Type: research

Psychological and emotional needs, assessment, and support post-stroke: a multi-perspective qualitative study.
DISCUSSION: Stroke patients need better access to psychological support, including information, advice, and peer or social support. More research is required to establish the effectiveness of alternative options to formal psychological support. PMID: 27309492 [PubMed - as supplied by publisher]
Source: Topics in Stroke Rehabilitation - June 15, 2016 Category: Neurology Authors: Harrison M, Ryan T, Gardiner C, Jones A Tags: Top Stroke Rehabil Source Type: research

Profile and 1-Year Outcome of Ischemic Stroke in East China: Nanjing First Hospital Stroke Registry
This study aimed to investigate the profile and outcome after 1-year follow-up of AIS in East China.
Source: Journal of Stroke and Cerebrovascular Diseases - September 22, 2015 Category: Neurology Authors: Guo-mei Shi, Ying-dong Zhang, Cong Geng, Yu-qiao Zhang, Xi-ding Pan, Yu-kai Liu, Jie Yang, Jun-shan Zhou, Nanjing First Hospital Stroke Registry Investigators Source Type: research

Endovascular Clot Retrieval Therapy: Implications for the Organization of Stroke Systems of Care in North America Understanding and Applying the Endovascular Trials
Endovascular acute ischemic stroke therapy is now proven by randomized controlled trials to produce large, clinically meaningful benefits. In response, stroke systems of care must change to increase timely and equitable access to this therapy. In this review, we provide a North American perspective on implications for stroke systems, focusing on the United States and Canada, accompanied by initial recommendations for changes. Most urgently, every community must create access to a hospital that can safely and quickly provide intravenous tissue-type plasminogen activator and immediately transfer appropriate patients onward t...
Source: Stroke - May 22, 2015 Category: Neurology Authors: Smith, E. E., Schwamm, L. H. Tags: Health policy and outcome research, Acute Cerebral Infarction, Acute Stroke Syndromes, Angioplasty and Stenting Understanding and Applying the Endovascular Trials Source Type: research

Letter by Uchino et al Regarding Article, "Art of Expertise in Stroke Telemedicine: Imaging and the Collaterome" Letters to the Editor
Source: Stroke - May 22, 2015 Category: Neurology Authors: Uchino, K., Rasmussen, P. A., Hussain, M. S., on behalf of Cleveland Pre-Hospital Acute Stroke Treatment Study Group Tags: Emergency treatment of Stroke Letters to the Editor Source Type: research

Academic Year-end Changeover and Stroke Outcomes
Lower quality of care and poorer outcomes are suspected when new trainees (eg, residents) start in July in teaching hospitals, the so-called “the July effect.” We evaluated outcomes and processes of care among patients with an acute ischemic stroke (AIS) admitted in July versus other 11 months of the year.
Source: Journal of Stroke and Cerebrovascular Diseases - December 23, 2014 Category: Neurology Authors: Tai Hwan Park, Donald A. Redelmeier, Shudong Li, Jitphapa Pongmoragot, Gustavo Saposnik, Investigators of the Registry of the Canadian Stroke network (RCSN) for the Stroke Outcomes Research (SORCan) Working Group Source Type: research