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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
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
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
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
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
Disparities in transitions of acute stroke care: The transitions of care stroke disparities study methodological report
Despite successful stroke therapies, women, minority, and other disadvantaged populations continue to experience a disproportionate burden of stroke and poor outcomes after stroke.1,2 Hospital based quality improvement stroke programs have demonstrated greater adherence to evidence-based stroke care recommendations. However, it is less evident if the implementation of these programs minimizes race-ethnic, sex and geographic disparities in stroke care post hospitalization. About 25% of discharged stroke patients are readmitted to the hospital within 30 days of initial event.
Source: Journal of Stroke and Cerebrovascular Diseases - July 12, 2023 Category: Neurology Authors: Karlon H. Johnson, Hannah Gardener, Carolina Gutierrez, Erika Marulanda, Iszet Campo-Bustillo, Gillian Gordon Perue, WayWay Hlaing, Ralph Sacco, Jose G. Romano, Tatjana Rundek, Transitions of Care Stroke Disparities Study (TCSD-S) Investigators 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
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
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
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
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
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
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
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
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
