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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

Failing a Dysphagia Screening Test after Acute Ischemic Stroke: Baseline Patient Factors and Outcomes (P6.037)
CONCLUSIONS: Patients with ischemic stroke who failed a dysphagia screening test had worse pre-admission function and more severe strokes, and developed much higher rates of complications and death than those who passed. Multivariable analyses are pending to control for stroke severity and determine the strength of these associations.Disclosure: Dr. Joundi has nothing to disclose. Dr. Martino has nothing to disclose. Dr. Saposnik has nothing to disclose. Dr. Fang has nothing to disclose. Dr. Giannakeas has nothing to disclose. Dr. Kapral has nothing to disclose.
Source: Neurology - April 3, 2016 Category: Neurology Authors: Joundi, R., Martino, R., Saposnik, G., Fang, J., Giannakeas, V., Kapral, M. Tags: In-Hospital Stroke and Stroke Complications Source Type: research

Oral antiplatelet therapy for acute ischaemic stroke.
CONCLUSIONS: Antiplatelet therapy with aspirin 160 mg to 300 mg daily, given orally (or by nasogastric tube or per rectum in people who cannot swallow) and started within 48 hours of onset of presumed ischaemic stroke, reduced the risk of early recurrent ischaemic stroke without a major risk of early haemorrhagic complications; long-term outcomes were improved. PMID: 24668137 [PubMed - as supplied by publisher]
Source: Cochrane Database of Systematic Reviews - March 26, 2014 Category: Journals (General) Authors: Sandercock PA, Counsell C, Tseng MC, Cecconi E Tags: Cochrane Database Syst Rev Source Type: research

Prolonged impairment of deglutition in supratentorial ischaemic stroke: the predictive value of Parramatta Hospitals' Assessment of Dysphagia.
CONCLUSIONS: In a selected population at risk of aspiration, the PHAD with a threshold of 70 assessed in the second week after stroke onset may be a valuable tool to predict prolonged impairment of deglutition for another 4 weeks and to guide the decision about switching from NG to PEG tube feeding after supratentorial ischaemic stroke. PMID: 27684427 [PubMed - as supplied by publisher]
Source: Swiss Medical Weekly - October 1, 2016 Category: Journals (General) Authors: Kägi G, Leisi N, Galovic M, Müller-Baumberger M, Krammer W, Weder B Tags: Swiss Med Wkly Source Type: research

Oral antiplatelet therapy for acute ischaemic stroke
CONCLUSIONS: Antiplatelet therapy with aspirin 160 mg to 300 mg daily, given orally (or by nasogastric tube or per rectum in people who cannot swallow) and started within 48 hours of onset of presumed ischaemic stroke, significantly decreased death and dependency, and reduced the risk of early recurrent ischaemic stroke without a major risk of early haemorrhagic complications; long-term outcomes were improved.PMID:35028933 | DOI:10.1002/14651858.CD000029.pub4
Source: Cochrane Database of Systematic Reviews - January 14, 2022 Category: General Medicine Authors: Jatinder S Minhas Tamara Chithiramohan Xia Wang Sam C Barnes Rebecca H Clough Meeriam Kadicheeni Lucy C Beishon Thompson Robinson Source Type: research

The impact of aspiration pneumonia and nasogastric feeding on clinical outcomes in stroke patients: a retrospective cohort study
ConclusionHigh prevalence and cost of complications associated with stroke highlights the complexity of providing nursing and allied health care to this patient population. This provides a snap shot of dysphagia related complications experienced by stroke patients.This article is protected by copyright. All rights reserved.
Source: Journal of Clinical Nursing - June 15, 2017 Category: Nursing Authors: Maria Schwarz, Anne Coccetti, Allison Murdoch, Elizabeth Cardell Tags: Original Article Source Type: research

Dysphagia and Factors Associated with Respiratory Infections in the First Week Post Stroke
Conclusion: This study of a large cohort of acute stroke patients supports research indicating aspiration pneumonia is multifactorial in nature. NGT were associated with increased risk of respiratory infections and may contribute to infections by promoting oropharyngeal colonisation. Patients with severely impaired mobility were also at very high risk of respiratory infection.Neuroepidemiology 2014;43:140-144
Source: Neuroepidemiology - November 7, 2014 Category: Epidemiology Source Type: research

Disability and mortality after permanent feeding tube placement in patients with acute stroke (P3.107)
Conclusions:In our large cohort of patients with acute stroke and PEG tubes, nearly 9/10 had severe disability at discharge. From discharge to 1 year, there was no difference in mortality between PEG and NG patient cohorts. These results suggest that PEG tubes serve mainly to prolong survival in patients discharged with severe disability. Our study may help support guideline creation and facilitate discussions with patients and families regarding PEG tube placement after acute stroke.Disclosure: Dr. Joundi has nothing to disclose. Dr. Saposnik has nothing to disclose. Dr. Martino has nothing to disclose. Dr. Fang has nothi...
Source: Neurology - April 17, 2017 Category: Neurology Authors: Joundi, R., Saposnik, G., Martino, R., Fang, J., Giannakeas, V., Porter, J., Kapral, M. Tags: Cerebrovascular Disease and Interventional Neurology Poster Discussion Session Source Type: research

Prediction Model of Early Return to Hospital after Discharge Following Acute Ischemic Stroke.
CONCLUSIONS: Although CART analysis did not improve the prediction of an early return to hospital after stroke compared with logistic regression models, decision rules generated by CART can easily be interpreted and applied in clinical practice. PMID: 31544716 [PubMed - as supplied by publisher]
Source: Current Neurovascular Research - September 10, 2019 Category: Neurology Authors: Lee JD, Lee TH, Huang YC, Lee M, Kuo YW, Huang YC, Hu YH Tags: Curr Neurovasc Res Source Type: research

Network Mapping of Time to Antithrombotic Therapy Among Patients With Ischemic Stroke and Transient Ischemic Attack (TIA)
Conclusion: The proportion of patients receiving antithrombotics within 48 h was higher than previously reported in Australia but remained lower than the standard achieved in North American hospitals. Our process map and network analysis show avenues to shorten the time to antithrombotic.
Source: Frontiers in Neurology - June 7, 2021 Category: Neurology 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

E-008 Safety and efficacy of eptifibatide in acute ischemic stroke requiring extracranial carotid artery stenting
ConclusionsEptifibatide may have a role in the management of acute stroke requiring carotid stenting. Caution may be required in those with established infarct on presentation imaging.Disclosures M. Waters: None. J. Vargas: None. R. Turner: None. A. Turk: None. I. Chaudry: None.
Source: Journal of NeuroInterventional Surgery - July 30, 2023 Category: Neurosurgery Authors: Waters, M., Vargas, J., Turner, R., Turk, A., Chaudry, I. Tags: SNIS 20th annual meeting electronic poster abstracts Source Type: research

Safety and efficacy of eptifibatide in acute ischemic stroke requiring extracranial carotid artery stenting
CONCLUSIONS: Eptifibatide may have a role in the management of acute stroke requiring carotid stenting. Caution may be required in those with established infarct on presentation imaging.PMID:37574792 | DOI:10.1177/15910199231193928
Source: Interventional Neuroradiology - August 14, 2023 Category: Radiology Authors: Michael J Waters Jan Vargas Aquilla Turk Imran Chaudry Raymond D Turner Source Type: research

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