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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
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
Acute and Chronic Kidney Dysfunction and Outcome After Stroke Thrombectomy
AbstractData on the impact of kidney dysfunction on outcome in patients with stroke due to large vessel occlusion are scarce. The few available studies are limited by only considering single kidney parameters measured at one time point. We thus investigated the influence of both chronic kidney disease (CKD) and acute kidney injury (AKI) on outcome after mechanical thrombectomy. We included consecutive patients with anterior circulation large vessel occlusion stroke receiving mechanical thrombectomy at our center over an 8-year period. We extracted clinical data from a prospective registry and investigated kidney serum para...
Source: Translational Stroke Research - January 4, 2021 Category: Neurology Source Type: research
Analysis of Mechanical Thrombectomy for Acute Ischemic Stroke on Nights and Weekends Versus Weekdays at Comprehensive Stroke Centers
Treatment of patients outside of normal full-staffing hours has been associated with worse outcomes in multiple medical and surgical conditions [1-4]. Termed the “weekend effect,” such poorer outcomes are presumably due to fewer in-hospital personnel and resources during off-hours [2]. While poorer outcomes have been demonstrated in the treatment of patients presenting with acute ischemic stroke (AIS) on nights/weekends versus weekdays [5-9], the develop ment of comprehensive stroke centers (CSCs) with continuous coverage by stroke neurology, neurointerventional surgery, neurosurgery, and neurocritical care specialists...
Source: Journal of Stroke and Cerebrovascular Diseases - January 28, 2021 Category: Neurology Authors: Matthew B. Potts, Ramez N. Abdalla, Pedram Golnari, Madhav Sukumaran, Aaron H. Palmer, Michael C. Hurley, Ali Shaibani, Babak S. Jahromi, Sameer A. Ansari Source Type: research
Age-Related Disparities in the Quality of Stroke Care and Outcomes in Rehabilitation Hospitals: The Australian National Audit
Stroke is a life-changing event affecting survivors, their families, communities and workplaces. About 75% of strokes occur in people 65 years or older,1 but the incidence is increasing in those aged 20-64,2,3 during the most productive years of people's live. This contributes substantially to the social and economic burden of stroke to society.2,4 Specialist inpatient rehabilitation is cost effective in working age adults, even with complex neurological conditions such as stroke.5 The characteristics and rehabilitative needs often differ between younger and older survivors of stroke.
Source: Journal of Stroke and Cerebrovascular Diseases - March 16, 2021 Category: Neurology Authors: Tara Purvis, Isobel J Hubbard, Dominique A Cadilhac, Kelvin Hill, Justine Watkins, Natasha A. Lannin, Steven G Faux, Monique F Kilkenny Source Type: research
Understanding Coordinator Roles in Acute Stroke Care: A National Survey
Globally, stroke is a major contributor to death and disability.1 Evidence-based care in hospital after an acute stroke ensures improved survival and reduced disability, but care quality can vary.2,3 Clinical coordinators have an essential role in improving best-practice in trauma, cancer, diabetes, and heart failure conditions.4-7 Within stroke, coordinator roles are not new; in 1970, a study outlining the ‘Stroke Team’ model was published, which included a physician, nurse-coordinator and physical therapist.
Source: Journal of Stroke and Cerebrovascular Diseases - September 29, 2021 Category: Neurology Authors: Tara Purvis, Sandy Middleton, Anne W. Alexandrov, Monique F. Kilkenny, Skye Coote, Sarah Kuhle, Dominique A. Cadilhac Source Type: research
Managing post-stroke care during the COVID-19 pandemic at a tertiary care level hospital in Peru
Objectives: To understand the hospital-to-outpatient care transition and how the discharge process of stroke patients is managed; and to identify potential opportunities to improve these processes, while contrasting pre- and during COVID-19 experiences in Peru.Methods: A qualitative study was conducted between February and March 2021 consisting of in-depth interviews of patients with stroke, their caregivers and healthcare personnel regarding stroke care at a national tertiary referral center for stroke care in Lima, Peru.
Source: Journal of Stroke and Cerebrovascular Diseases - December 23, 2021 Category: Neurology Authors: Jessica Hanae Zafra-Tanaka, Jill Portocarrero, Carlos Abanto, Joseph R. Zunt, J. Jaime Miranda Source Type: research
Social distancing, stroke admissions and stroke mortality during the COVID-19 pandemic: a multicenter, longitudinal study
Objectives. We aimed to evaluate the relationship between social distancing, stroke admissions and stroke mortality during the COVID-19 pandemic, while accounting for the rate of COVID-19 admissions. Methods. We performed a longitudinal analysis of a multicenter, prospective, hospital-based registry of intensive care units from 19 hospitals from Brazil, comprising a 14-month period of the COVID-19 pandemic. We investigated whether the daily rate of admissions (DRAstroke) and daily mortality rate for stroke were associated with the social distancing index (SDI), taking into account the daily rate of admissions for COVID-19 ...
Source: Journal of Stroke and Cerebrovascular Diseases - February 20, 2022 Category: Neurology Authors: Pedro Cougo, Bruno Bessen, Daniel Bezerra, Rodrigo de Carvalho Moreira, Carlos Eduardo Brand ão, Emmanuel Salgueiro, Alex Balduino, Octávio Pontes-Neto, Victor Cravo Source Type: research
Delays in the Identification and Assessment of in-Hospital Stroke Patients
In ischemic stroke, the eligibility for stroke treatment and likelihood of good outcome after treatment are time dependent.1 Rapid identification of stroke is a priority. There have been numerous programs designed to inform rapid recognition of stroke symptoms in the community and to encourage patients to present to the Emergency Department expeditiously.2 Up to 17% of strokes occur in patients who are already hospitalized.3 In-hospital strokes are typically more severe than those that occur outside the hospital and are associated with reduced quality of care leading to dramatically increased cost, length of stay, morbidity, and mortality.
Source: Journal of Stroke and Cerebrovascular Diseases - February 3, 2022 Category: Neurology Authors: Stephanie Cummings, Scott E. Kasner, Michael Mullen, Andrew Olsen, Michael McGarvey, James Weimer, Ben Jackson, Nimesh Desai, Michael Acker, Steven R. Mess é Source Type: research
The Relationship Between Age Shock Index, and Severity of Stroke and In-Hospital Mortality in Patients with Acute Ischemic Stroke
Shock index (SI) has been reported to help us predict adverse prognosis in patients with acute ischemic stroke (AIS). However, the prognostic value of age SI and age modified shock index (MSI) in acute ischemic stroke is unknown. In our study, we aimed to examine the association between the severity of the stroke and in-hospital mortality, age SI and age MSI in patients with AIS.
Source: Journal of Stroke and Cerebrovascular Diseases - June 28, 2022 Category: Neurology Authors: Aysegul Demir, Fettah Eren Source Type: research
Can We Learn from Our Children About stroke? Effectiveness of a School-Based Educational Programme in Greece
Stroke is the second most common cause of death worldwide and the leading cause of chronic functional limitations.1 Without appropriate and timely care between the stroke symptom appearance and the treatment in acute stroke incidents, the ischemic brain ages 3.6 years for every hour of blood deprivation.2 Yet patients repeatedly arrive late to the hospital.3,4 The lack of public awareness about stroke symptoms has been reported in the literature as one of the main factors, causing this belated arrival to the hospital and hence the belated medical treatment.
Source: Journal of Stroke and Cerebrovascular Diseases - May 13, 2022 Category: Neurology Authors: Hariklia Proios, Maria Baskini, Christos Keramydas, Tatiana Pourliaka, Kalliopi Tsakpounidou Source Type: research
Elevated Serum Ninjurin-1 Is Associated with a High Risk of Large Artery Atherosclerotic Acute Ischemic Stroke
AbstractNinjurin-1 is a novel adhesion molecule which is involved in many inflammatory diseases. Functional blockage of Ninjurin-1 has exerted an atheroprotective effect. The aim of the study is to explore the association between serum Ninjurin-1 and the risk of large artery atherosclerotic acute ischemic stroke. From August 2020 through December 2021, patients with large artery atherosclerotic acute ischemic stroke (LAA-AIS) admitted to the First Hospital Affiliated to Soochow University, and age- and sex-matched controls free of ischemic stroke were recruited. Serum Ninj1 was measured with an enzyme-linked immunosorbent ...
Source: Translational Stroke Research - October 7, 2022 Category: Neurology Source Type: research
Organisational survey for acute stroke care in Vietnam: Regional Collaboration Programme
Low-middle income countries, such as Vietnam have a greater burden from stroke than high-income countries. Few health professionals have stroke specialist training, and the quality of care may vary between hospitals. To support improvements to stroke care, we aimed to gain a better understanding of the resources available in hospitals in Vietnam to manage acute stroke.
Source: Journal of Stroke and Cerebrovascular Diseases - September 26, 2022 Category: Neurology Authors: Hoang T Phan, Thang H Nguyen, Caroline Watkins, Elizabeth Lightbody, Elizabeth Boaden, Rachel Georgiou, Sandy Middleton, Simeon Dale, Monique F Kilkenny, Jeyaraj Pandian, Rohan S Grimley, Trung Q Nguyen, Dominique A Cadilhac Source Type: research
Determinants Of In-Hospital Muscle Loss In Acute Ischemic Stroke – Results Of The Muscle Assessment In Stroke Study (Mass)
There is a change in the mass and composition of paretic and non-paretic skeletal muscles in the chronic phase of stroke. The multi-center, prospective, and observational Muscle Assessment in Stroke Study (MASS) was performed to evaluate the degree of muscle loss during the in-hospital acute stroke setting and determine factors contributing to this loss.
Source: Clinical Nutrition - February 1, 2023 Category: Nutrition Authors: Levent Gungor, Ethem Murat Arsava, Ayse Guler, Canan Togay Isikay, Ozlem Aykac, Hale Zeynep Batur Caglayan, Hasan Huseyin Kozak, Ustun Aydingoz, Mehmet Akif Topcuoglu, the Muscle Assessment in Stroke Study (MASS) investigators Tags: Original article Source Type: research
Establishing the need for a stroke unit at Chris Hani Baragwanath Academic Hospital in South Africa
Stroke in Africa is a growing and neglected crisis with strokes more than doubling in low to middle income countries in the last four decades. Despite this growing threat to healthcare systems, implementation of stroke models of care in hospitals is lacking with most stroke patients being managed as part of a general medical service. Stroke units have shown to decrease mortality, reduce length of stay in hospital (LOS), and improve patient outcomes.
Source: Journal of Stroke and Cerebrovascular Diseases - March 30, 2023 Category: Neurology Authors: Stephanie Pillay, Azra Hoosen, Fiona Breytenbach, Roxann Redant, Nadia Umuneza, Sameera Haffejee, Zvifadzo Matsena-Zingoni, Kganetso Sekome Source Type: research
