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Thematic Analysis of Psychosocial Stressors and Adaptive Coping Strategies Among Informal Caregivers of Patients Surviving ICU Admission for Coma
ConclusionsIn response to substantial stressors, family caregivers of patients with SABI attempted to enact various psychological and behavioral coping strategies. They described avoidance and distraction as less helpful than other coping strategies but had difficulty engaging in alternative strategies because of their emotional distress. These findings can directly inform the development of additional resources to mitigate the long-term impact of acute psychological distress among this caregiver population.
Source: Neurocritical Care - July 31, 2023 Category: Neurology Source Type: research

Early vs Standard Approach to Tracheostomy and Functional Outcome After Severe Stroke
To the Editor In the subgroup analysis of the recently published Stroke-Related Early Tracheostomy vs Prolonged Orotracheal Intubation in Neurocritical Care Trial 2 (SETPOINT2), the enrolled patients were divided into 3 subgroups according to their pathology diagnosis: acute ischemic stroke, intracerebral hemorrhage, and subarachnoid hemorrhage. However, the type of stroke is not necessarily related to the need for tracheostomy. We believe it would be helpful to classify these patients based on the location of brain infarction, including distinct categories for brainstem or cerebellar stroke. The purpose of tracheostomy in...
Source: JAMA - September 13, 2022 Category: General Medicine Source Type: research

Long-term functional prognosis of patients with aneurysmal subarachnoid hemorrhage treated with rehabilitation combined with hyperbaric oxygen: Case-series study
The long-term prognosis of patients with aneurysmal subarachnoid hemorrhage (aSAH) has received increasing attention in recent years. Hyperbaric oxygen and rehabilitation are already used in clinical treatment of patients with aSAH, but it is unclear whether it can improve the long-term prognosis of patients postoperation. The purpose of this study was to evaluate the long-term prognosis and prognostic factors associated with combined rehabilitation and hyperbaric oxygen therapy for patients with aSAH. Information were retrospectively collected from patients with aSAH treated from October 2014 to July 2017, including demo...
Source: Medicine - January 1, 2020 Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research

Earlier tracheostomy and percutaneous endoscopic gastrostomy in patients with hemorrhagic stroke: associated factors and effects on hospitalization.
CONCLUSIONSThis study identified patient risk factors associated with increased likelihood of tracheostomy and PEG in patients with hemorrhagic stroke who were critically ill. Additionally, we found that the timing of tracheostomy was associated with length of ICU stay and overall hospital stay, and that the timing of PEG was associated with overall length of hospitalization. Complication rates related to tracheostomy and PEG in this population were minimal. This retrospective data set supports some benefit to earlier tracheostomy and PEG placement in this population and justifies the need for further prospective study. ...
Source: Journal of Neurosurgery - January 4, 2019 Category: Neurosurgery Authors: McCann MR, Hatton KW, Vsevolozhskaya OA, Fraser JF Tags: J Neurosurg Source Type: research

Predictors for Tracheostomy with External Validation of the Stroke-Related Early Tracheostomy Score (SETscore)
ConclusionsSETscore is a simple score with a moderate accuracy and with a fair AUC used to predict the need for TR after MV for IS, ICH, and SAH patients. Our study also demonstrates that early TR was associated with a lower ICU LOS and VD in our cohort. The utility of this score may be improved when including additional variables such as BMI, AA race, ICH, and positive sputum cultures.
Source: Neurocritical Care - August 30, 2018 Category: Neurology Source Type: research

Incidence and Risk Factors for Dysphagia Following Non-traumatic Subarachnoid Hemorrhage: A Retrospective Cohort Study
AbstractThe aim of the study is to investigate dysphagia incidence and establish factors which may reliably predict dysphagia risk in individuals presenting with non-traumatic subarachnoid hemorrhage (SAH). A retrospective chart audit of 250 patients (151 females and 99 males) consecutively admitted with non-traumatic SAH to a major, tertiary neurosurgery referral center in Australia was conducted. Demographics, medical, and surgical information, along with speech –language pathology (SLP) assessment data were collected. Differences between dysphagic and non-dysphagic groups were evaluated usingt tests,χ2, and Fisher â€...
Source: Dysphagia - August 7, 2018 Category: Speech-Language Pathology Source Type: research

Decannulation and Functional Outcome After Tracheostomy in Patients with Severe Stroke (DECAST): A Prospective Observational Study
ConclusionsDecannulation was achieved in 59.4% of stroke patients surviving the first 12  months after tracheostomy and was associated with better functional outcome compared to patients without decannulation. Further prospective studies with larger sample sizes are needed to confirm our results.
Source: Neurocritical Care - July 25, 2017 Category: Neurology Source Type: research

Hospital utilization, length stay and inhospital mortality in patients with subarachnoid hemorrhage among different racial groups (P2.300)
Conclusions:There are significant differences in hospital utilization, in hospital mortality, LOS and disposition among different racial groups. Interestingly minorities have higher utilization and lower inhospital mortality compared to Whites. Further studies needs to be warranted.Disclosure: Dr. Maud has nothing to disclose. Dr. Qureshi has nothing to disclose. Dr. Afzal has nothing to disclose. Dr. Qureshi has nothing to disclose. Dr. Piriyawat has nothing to disclose. Dr. Khatri has nothing to disclose. Dr. Rodriguez has nothing to disclose. Dr. Cruz-Flores has nothing to disclose.
Source: Neurology - April 17, 2017 Category: Neurology Authors: Maud, A., Qureshi, M., Afzal, M.-R., Qureshi, I., Piriyawat, P., Khatri, R., Rodriguez, G., Cruz-Flores, S. Tags: Subarachnoid Hemorrhage, Intracranial Aneurysm, and Other Cerebrovascular Malformations Source Type: research

"I believe in miracles": Implications for the Neuro-ICU (P3.181)
Conclusions:Preliminary data lack robustness to make definitive conclusions, however suggest possibility of shorter hospital LOS in those who don’t believe in miracles. Involvement of spiritual care early in the ICU may assist in important decision making with patients and family members.Disclosure: Dr. Ramineni has nothing to disclose. Dr. Dangayach has nothing to disclose. Dr. Griffiths has nothing to disclose. Dr. Keogh has nothing to disclose. Dr. Wheelwright has nothing to disclose. Dr. Sharma has nothing to disclose. Dr. Gidwani has nothing to disclose. Dr. Ahmad has nothing to disclose. Dr. Bederson has nothin...
Source: Neurology - April 17, 2017 Category: Neurology Authors: Ramineni, A., Dangayach, N., Griffiths, S., Keogh, M., Wheelwright, D., Sharma, V., Gidwani, U., Ahmad, J., Bederson, J., Mocco, J., Mayer, S. Tags: Neurocritical Care: NICU Issues Source Type: research

Hospital Readmission Rates Among Mechanically Ventilated Patients With Stroke Brief Reports
Conclusions— Approximately one quarter of mechanically ventilated patients with stroke who survive to discharge are readmitted to the hospital within 30 days. Readmission rates are significantly higher in patients with stroke who undergo tracheostomy, but the difference is not clinically meaningful. Thirty-day readmission rates among mechanically ventilated patients with stroke are similar to Medicare beneficiaries hospitalized with major medical diseases such as pneumonia.
Source: Stroke - September 28, 2015 Category: Neurology Authors: Lahiri, S., Navi, B. B., Mayer, S. A., Rosengart, A., Merkler, A. E., Claassen, J., Kamel, H. Tags: Acute Cerebral Hemorrhage, Acute Cerebral Infarction, Emergency treatment of Stroke, Other Stroke Treatment - Medical Brief Reports Source Type: research

Mechanical Ventilation for Acute Stroke: A Multi-state Population-Based Study
Conclusions In this large population-based sample, over half of mechanically ventilated stroke patients died in the hospital despite the fact that younger patients were more likely to receive mechanical ventilation. Future studies are indicated to elucidate mechanical ventilation strategies to optimize long-term outcomes after severe stroke.
Source: Neurocritical Care - December 9, 2014 Category: Neurology Source Type: research

Stroke-Related Early Tracheostomy Versus Prolonged Orotracheal Intubation in Neurocritical Care Trial (SETPOINT): A Randomized Pilot Trial Original Contributions
Conclusions— Early tracheostomy in ventilated intensive care stroke patients is feasible, and safe, and presumably reduces sedation need. Whether the suggested benefits in mortality and outcome truly exist has to be determined by a larger multicenter trial. Clinical Trial Registration— http://www.clinicaltrials.gov. Unique identifier: NCT01261091.
Source: Stroke - December 24, 2012 Category: Neurology Authors: Bosel, J., Schiller, P., Hook, Y., Andes, M., Neumann, J.-O., Poli, S., Amiri, H., Schonenberger, S., Peng, Z., Unterberg, A., Hacke, W., Steiner, T. Tags: Other Treatment, Acute Cerebral Hemorrhage, Acute Cerebral Infarction, Cerebral Aneurysm, AVM, & Subarachnoid hemorrhage, Other Stroke Treatment - Surgical Original Contributions Source Type: research