AHA Stroke: August 27, 2013 Intracerebral hemorrhage (ICH) is the deadliest stroke subtype, with 30-day mortality rates of ≈40% and significant morbidity among survivors.1 Progress has proven difficult for this disease state. Unlike ischemic stroke, where incidence seems to be declining in high-wealth countries,2and subarachnoid hemorrhage, where case fatality has improved,3 there is little evidence that ICH has […]
Neurology: August 14, 2013 Objective: We hypothesized that low rates of tissue plasminogen activator (tPA) use are only partially explained by medical considerations, and that biases, beliefs, systems, and uncertainty affect acute stroke decision-making. Methods: We generated a list of factors potentially influential in acute stroke decision-making: uncertainty, patient demographics that may predispose to bias (age, sex, comorbidities), […]
STROKEAHA: September 19, 2013 Background and Purpose—There is evidence that high-volume hospitals may produce better patient outcomes. We aimed to identify whether there were any associations between hospital thrombolysis volume and speed of thrombolysis (tissue-type plasminogen activator [tPA]) administration in patients with ischemic stroke. Read more
NeuroIntervent Surg: 9/19/13 Outcomes from endovascular therapy for acute stroke are time dependent. Delays in the administration of this therapy have not been extensively studied and no performance benchmarks have been established. There are limited data on the complex factors that can affect these delays. In this review, we discuss the existing literature on the […]
J Am Heart Assoc.: 9/17/13 Background Intravenous tissue plasminogen activator (tPA) is an effective treatment for acute ischemic stroke if administered within a few hours of stroke onset. Because of this time restriction, tPA administration remains infrequent. Ambulance use is an effective strategy for increasing tPA administration but may be influenced by geographical factors. The objectives […]
AHA: 9/16/13 Regionalization, systems of care design, and quality improvement (QI) registry participation all promote the widespread dissemination of guideline-based evidence into actual practice. As a result, policy statements from the American Heart Association/American Stroke Association (AHA/ASA) advocate the creation of regional systems of care for various timecritical diagnoses, including ST-elevation myocardial infarction (STEMI), out-of-hospital cardiac arrest resuscitation, and acute stroke. Read more
JNS: 9/10/13 OBJECT The goal of this study was to determine racial/ethnic differences in inpatient mortality rates and the use of institutional postacute care following subarachnoid hemorrhage (SAH) in the US. METHODS A cross-sectional study of hospital discharges for SAH was conducted using the Nationwide Inpatient Sample for the years 2005–2010. Discharges with a principal […]
STROKEAHA: September 10, 2013 Background and Purpose—Many patients are transferred to comprehensive stroke centers for advanced acute ischemic stroke care, especially after intravenous tissue plasminogen activator. We sought to determine differences in the baseline characteristics and outcomes between patients with acute ischemic stroke presenting directly to our academic stroke center’s front door versus transfers-in from another […]
AHA: 9/16/13 Regionalization, systems of care design, and quality improvement (QI) registry participation all promote the widespread dissemination of guideline-based evidence into actual practice. As a result, policy statements from the American Heart Association/American Stroke Association (AHA/ASA) advocate the creation of regional systems of care for various timecritical diagnoses, including ST-elevation myocardial infarction (STEMI), out-of-hospital cardiac arrest resuscitation, and acute stroke. Read more
AHA: August 9, 2013 Background—Limited long-term follow-up data exist on the impact of appropriate secondary prevention therapies on cognitive function in patients after first-ever stroke. The aim of this study is to determine the effect of secondary prevention of vascular events on cognitive function after stroke. Methods and Results—Data were collected between 1995 and 2011 (n=4413) […]
