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Rates of Adverse Events and Outcomes among Stroke Patients Admitted to Primary Stroke Centers
To identify the beneficial effects of primary stroke centers (PSCs) certification by Joint Commission (JC), we compared the rates of in-hospital adverse events and discharge outcomes among ischemic stroke patients admitted to PSCs and those admitted to non-PSC hospitals in the United States.
Source: Journal of Stroke and Cerebrovascular Diseases - May 17, 2016 Category: Neurology Authors: Saqib A. Chaudhry, Mohammad R. Afzal, Burhan Z. Chaudhry, Taqi T. Zafar, Adnan Safdar, Mounzer Y. Kassab, Syed I. Hussain, Adnan I. Qureshi Source Type: research

Trends and Regional Variation in Hospital Mortality, Length of Stay and Cost in Hospital of Ischemic Stroke Patients in Alberta Accompanying the Provincial Reorganization of Stroke Care
This study aimed to evaluate the trends and regional variation of stroke hospital care in 30-day in-hospital mortality, hospital length of stay (LOS), and 1-year total hospitalization cost after implementation of the Alberta Provincial Stroke Strategy.
Source: Journal of Stroke and Cerebrovascular Diseases - September 19, 2016 Category: Neurology Authors: Arto Ohinmaa, Yufei Zheng, Thomas Jeerakathil, Scott Klarenbach, Unto H äkkinen, Thanh Nguyen, Dan Friesen, Jane Ruseski, Padma Kaul, Ruolz Ariste, Philip Jacobs Source Type: research

Experience on Mechanical Thrombectomy for Acute Stroke Treatment in a Brazilian University Hospital
Brazil is a developing country struggling to reduce its extreme social inequality, which is reflected on shortage of health-care infrastructure, mainly to the low-income class, which depends exclusively on the public health system. In Brazil, less than 1% of stroke patients have access to intravenous thrombolysis in a stroke unit, and constraints to the development of mechanical thrombectomy in the public health system increase the social burden of stroke.
Source: Journal of Stroke and Cerebrovascular Diseases - January 4, 2017 Category: Neurology Authors: Guilherme S. Nakiri, Luis H. Castro-Afonso, Lucas M. Monsignore, Francisco A. Dias, Frederico F. Alessio-Alves, Soraia Ramos C. Fabio, Millene R. Camilo, Pedro T. Cougo-Pinto, Octavio M. Pontes-Neto, Jo ão Pereira Leite, Daniel G. Abud Source Type: research

Pitfalls of administrative database analysis are evident when assessing the 'weekend effect in stroke
Commentary on: Li L, Rothwell PM. Biases in detection of apparent "weekend effect" on outcome with administrative coding data: population based study of stroke. BMJ 2016;353:i2648 . Context Multiple studies attempt to clarify the role of weekend admissions in stroke.1 2 Recent studies have leveraged large populations in administrative databases to retrospectively evaluate hypotheses. While these studies disagree as to whether weekend admissions are associated with increased stroke mortality, concern exists regarding inherent limitations of administrative coding databases, including accuracy of patient and disease variables...
Source: Evidence-Based Medicine - January 23, 2017 Category: Internal Medicine Authors: Attenello, F. J., Mack, W. J. Tags: EBM Prognosis, Journalology, Epidemiologic studies, Stroke Source Type: research

Breakthrough of modern reperfusion therapies for acute stroke in Lithuania: The importance of integrated government support and national stroke care network
Incidence of ischemic stroke remains high in Lithuania (>10.000 new strokes every year) because of high prevalence and poor control of vascular risk factors. The intravenous thrombolysis (IVT) was started in 2002 in 2 Vilnius hospitals. Since 2007 IVT was recommended as first line treatment for acute ischemic stroke according to national guidelines. Nevertheless, the total annual number of IVTs remained low across the country (lessthan 100 procedures) until 2011. During 2012-2013 number of IVTs increased up to 160 and 207, respectively, however, only few centres in largest two cities were active, and access to IVT and mech...
Source: Journal of Stroke and Cerebrovascular Diseases - March 18, 2017 Category: Neurology Authors: Dalius Jatuzis, Aleksandras Vilionskis, Daiva Rastenyte Source Type: research

The development of visual management web system for acute ischemic stroke therapy
【Background and Purpose】The benefits of intravenous tissue-plasminogen activator and endovascular therapy in acute ischemic stroke are highly time-dependent. However, there are so many cross-departmental tasks to eligible patent that many stroke centers have difficulty achieving the guideline re commended 1-hour Door-to-Needle time. We developed a visual management web system named “Task Calc. Stroke” to support in-hospital task processing for acute stroke treatment efficacy. We aim to introduce the system and the results of the initial evaluation survey.
Source: Journal of Stroke and Cerebrovascular Diseases - March 18, 2017 Category: Neurology Authors: Shoji Matsumoto, Hiroshi Koyama, Taketo Hatano, Nobutake Sadamasa, Yasutoshi Kai, Makoto Saka, Tetsuya Hashimoto, Ichiro Nakahara, Izumi Nagata, Jun-ichi Kira Source Type: research

Long-Term Impact of Implementation of a Stroke Protocol on Door-to-Needle Time in the Administration of Intravenous Tissue Plasminogen Activator
This study aims to evaluate the effectiveness of implementing a stroke protocol (SP) in improving door-to-needle time (DTNT) and door-to-computed tomography (DTCT) time from 2010 to 2014. Published data from the Get With The Guidelines-Stroke (GWTGS) participating hospitals showed that median DTNT  = 75 minutes with 26.6% of the patients achieving the recommended DTNT of 60 minutes or less. Implementation of an SP, which specifies the role of nurses, physicians, and technicians during acute stroke evaluation, can improve DTNT.
Source: Journal of Stroke and Cerebrovascular Diseases - April 11, 2017 Category: Neurology Authors: Machteld E. Hillen, Wenzhuan He, Zaid Al-Qudah, Weizhen Wang, Andrea Hidalgo, Jessy Walia Source Type: research

Differentiating Stroke and Seizure in Acute Setting —Perfusion Computed Tomography?
Perfusion computed tomography (PCT) is part of acute stroke protocol in many hospitals; however, its clinical utility is still being disputed. Beyond its use in core and penumbra estimation, there is also a question about PCT role in stroke mimics diagnosis. Case series or small, retrospective studies showed equivocal results. This is the first published prospective, comparative study on PCT in differentiating stroke and seizure in acute setting.
Source: Journal of Stroke and Cerebrovascular Diseases - April 13, 2017 Category: Neurology Authors: Katarzyna Kubiak-Balcerewicz, Urszula Fiszer, Ewa Naga ńska, Cezary Siemianowski, Aleksander Sobieszek, Agnieszka Witak-Grzybowska, Aldona Kosińska-Szot Source Type: research

Streamlining Workflow for Endovascular Mechanical Thrombectomy: Lessons Learned from a Comprehensive Stroke Center
Recently, 5 randomized controlled trials confirmed the superiority of endovascular mechanical thrombectomy (EMT) to intravenous thrombolysis in acute ischemic stroke with large-vessel occlusion. The implication is that our health systems would witness an increasing number of patients treated with EMT. However, in-hospital delays, leading to increased time to reperfusion, are associated with poor clinical outcomes. This review outlines the in-hospital workflow of the treatment of acute ischemic stroke at a comprehensive stroke center and the lessons learned in reduction of in-hospital delays.
Source: Journal of Stroke and Cerebrovascular Diseases - June 1, 2017 Category: Neurology Authors: Hongjin Wang, Arthur Thevathasan, Richard Dowling, Steven Bush, Peter Mitchell, Bernard Yan Tags: Review Article Source Type: research

Patterns of Care and Temporal Trends in Ischemic Stroke Management: A Brazilian Perspective
Demonstration of an improvement process of quality indicators in stroke care is essential to obtain certification as a primary stroke center (PSC). Our aim was to evaluate factors that influence temporal trends in quality indicators of ischemic stroke (IS) in a Brazilian hospital.
Source: Journal of Stroke and Cerebrovascular Diseases - June 20, 2017 Category: Neurology Authors: Monique Bueno Alves, Gisele Sampaio Silva, Renata Carolina Acri Miranda, Rodrigo Meireles Massaud, Andreia Maria Heins Vaccari, Miguel Cendoroglo-Neto, Solange Diccini Source Type: research

Hospital-Based Study of the Frequency and Risk Factors of Stroke Recurrence in Two Years in China
Stroke causes death and disability throughout the world and recurrent stroke events are more likely to be disabling or fatal. We conducted a hospital-based study to investigate the frequency and influence factors of stroke recurrence in China.
Source: Journal of Stroke and Cerebrovascular Diseases - September 19, 2017 Category: Neurology Authors: Qian He, Cheng Wu, Wei Guo, Zhi-Yong Wang, Yan-Fang Zhao, Jian Lu, Ying-Yi Qin, Yi-Bin Guo, Yu-Chen Qin, Chuan-Di Pan, Jia He Source Type: research

Discrepant relationships between admission blood pressure and mortality in different stroke subtypes
The relationship between blood pressure(BP) and clinical outcome in patients with acute stroke is still controversial. The present study aimed to elucidate the impact of admission blood pressure on mortality in patients with acute stroke of different subtypes. Data were from ChinaQUEST (QUality Evaluation of Stroke Care and Treatment), a multicenter, prospective hospital registry study in 37 cities across China. A total of 6427 patients were admitted within 24h of onset and after following up for 12months, 5501 were included in the final analysis.
Source: Journal of the Neurological Sciences - September 22, 2017 Category: Neurology Authors: Yuanyuan Liu, Yide Yang, Haiqiang Jin, Chenghe Fan, Pu Lv, Wei Sun, Qing Peng, Mingming Zhao, David K. Jin, Jiguang Wang, Lawrence K.S. Wong, Craig S. Anderson, Lemin Zheng, Yining Huang, ChinaQUEST (Quality Evaluation of Stroke Care and Treatment) Invest Source Type: research

Influence of Penumbral Reperfusion on Clinical Outcome Depends on Baseline Ischemic Core Volume Clinical Sciences
This study included 1507 patients. Reperfused penumbral volume had moderate ability to predict 90-day mRS 0 to 1 (area under the curve, 0.77; R2, 0.28; P
Source: Stroke - September 25, 2017 Category: Neurology Authors: Chushuang Chen, Mark W. Parsons, Matthew Clapham, Christopher Oldmeadow, Christopher R. Levi, Longting Lin, Xin Cheng, Min Lou, Timothy J. Kleinig, Kenneth S. Butcher, Qiang Dong, Andrew Bivard Tags: Ischemic Stroke Original Contributions Source Type: research

Transitioning from a single-site pilot project to a state-wide regional telehealth service: The experience from the Victorian Stroke Telemedicine programme.
Abstract Scaling of projects from inception to establishment within the healthcare system is rarely formally reported. The Victorian Stroke Telemedicine (VST) programme provided a very useful opportunity to describe how rural hospitals in Victoria were able to access a network of Melbourne-based neurologists via telemedicine. The VST programme was initially piloted at one site in 2010 and has gradually expanded as a state-wide regional service operating with 16 hospitals in 2017. The aim of this paper is to summarise the factors that facilitated the state-wide transition of the VST programme. A naturalistic case-s...
Source: Rural Remote Health - October 31, 2017 Category: Rural Health Authors: Bagot KL, Cadilhac DA, Kim J, Vu M, Savage M, Bolitho L, Howlett G, Rabl J, Dewey HM, Hand PJ, Denisenko S, Donnan GA, Bladin CF, Victorian Stroke Telemedicine Programme Consortium Tags: J Telemed Telecare Source Type: research