Pretreatment Blood–Brain Barrier Damage and Post-Treatment Intracranial Hemorrhage in Patients Receiving Intravenous Tissue-Type Plasminogen Activator

STROKEAHA: May 15, 2014 Background and Purpose—Early blood–brain barrier damage after acute ischemic stroke has previously been qualitatively linked to subsequent intracranial hemorrhage (ICH). In this quantitative study, it was investigated whether the amount of blood–brain barrier damage evident on pre–tissue-type plasminogen activator MRI scans was related to the degree of post–tissue-type plasminogen activator ICH in […]

Statins Improve Survival in Patients With Cardioembolic Stroke

STROKEAHA: May 6, 2014 Background and Purpose—The objective of this study was to investigate the potential benefits of statin therapy on mortality and stroke recurrence after cardioembolic stroke. Methods—In this retrospective observational study, we analyzed data from 535 patients with first-ever cardioembolic stroke. Patients were classified into nonstatin, low-potency statin, and high-potency statin groups. The primary […]

Guidelines for the Prevention of Stroke in Patients With Stroke and Transient Ischemic Attack

AHA: May 1, 2014 A Guideline for Healthcare Professionals From the American Heart Association/American Stroke Association   The aim of this updated guideline is to provide comprehensive and timely evidence-based recommendations on the prevention of future stroke among survivors of ischemic stroke or transient ischemic attack. The guideline is addressed to all clinicians who manage […]

Evolution of ”The Guideline Advantage”: Lessons Learned From the Front Lines of Outpatient Performance Measurement

AHA: 4/30/14 Heart disease, cancer, stroke, and diabetes mellitus collectively account for >1.37 million US deaths each year. Compounding the tragedy is the knowledge that many of those deaths could be avoided through better application of clinical guidelines related to primary and secondary prevention or dis- ease management. The combined control of blood pressure, lipids, and […]

Door‐to‐Puncture: A Practical Metric for Capturing and Enhancing System Processes Associated With Endovascular Stroke Care, Preliminary Results From the Rapid Reperfusion Registry

J Am Heart Assoc. 4/25/2014 Background In 2011, the Brain Attack Coalition proposed door‐to‐treatment times of 2 hours as a benchmark for patients undergoing intra‐arterial therapy (IAT). We designed the Rapid Reperfusion Registry to capture the percentage of stroke patients who meet the target and its impact on outcomes. Methods and Results This is a retrospective analysis of […]

Sex-Related Differences of Acute Stroke Unit Care

STROKEAHA: April 15, 2014 Background and Purpose—Sex-related differences in quality of acute stroke care are an important concern with limited data available, specifically regarding stroke unit (SU) setting. We used the prospective nationwide Austrian SU registry to address this issue. Methods—Our analysis covered an 8-year time period (January 2005 to December 2012) during which all patients […]

Compliance With Acute Stroke Care Quality Measures in Hospitals With and Without Primary Stroke Center Certification: The North Carolina Stroke Care Collaborative

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J Am Heart Assoc.: April 10, 2014 Background Organized stroke care is associated with improved outcomes. Data are limited on differences in changes in the quality of acute stroke care at The Joint Commission–certified Primary Stroke Centers (PSCs) versus non‐PSCs over time. Methods and Results We compared compliance with the Joint Commission’s 10 acute stroke care performance measures […]

Strategies Used by Hospitals to Improve Speed of Tissue-Type Plasminogen Activator Treatment in Acute Ischemic Stroke

STROKEAHA: April 8, 2014 Background and Purpose—The benefits of intravenous tissue-type plasminogen activator in acute ischemic stroke are time dependent, and several strategies have been reported to be associated with more rapid door-to-needle (DTN) times. However, the extent to which hospitals are using these strategies and their association with DTN times have not been well studied. […]

ACC/AHA to Assess Value in Practice Guidelines, Performance Measures

ACC: MARCH 27, 2014 Washington, D.C. (March 27, 2014) – Citing accelerating healthcare costs and finite resources, the American College of Cardiology and the American Heart Association announced they will begin incorporating value assessments into their clinical documents. The ACC and AHA elaborated on their decision, outlining the reasons for adding value assessments, reviewing the economic […]

End-of-life decisions in patients with severe acute brain injury

The Lancet Neurology: March 25, 2014 Most in-hospital deaths of patients with stroke, traumatic brain injury, or postanoxic encephalopathy after cardiac arrest occur after a decision to withhold or withdraw life-sustaining treatments. Decisions on treatment restrictions in these patients are generally complex and are based only in part on evidence from published work. Prognostic models to […]

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