Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association
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J Stroke Cerebrovasc Dis · Nov 2020
Predictors of Extended Length of Stay Following Treatment of Unruptured Adult Cerebral Aneurysms: A Study of The National Inpatient Sample.
In an unprecedented era of soaring healthcare costs, payers and providers alike have started to place increased importance on measuring the quality of surgical procedures as a surrogate for operative success. One metric used is the length of hospital stay (LOS) during index admission. For the treatment of unruptured cerebral aneurysms, the determinants of extended length of stay are relatively unknown. The aim of this study was to identify the patient- and hospital-level factors associated with extended LOS following treatment for unruptured cerebral aneurysms. ⋯ Our study demonstrates that extended LOS after treatment of unruptured aneurysms is influenced by a number of patient-level factors including demographics, preadmission comorbidities, type of aneurysm treatment (open surgical versus endovascular), and, importantly, inpatient complications. A better understanding of these independent predictors of prolonged length of hospital stay may help to improve patient outcomes and decrease overall healthcare costs.
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J Stroke Cerebrovasc Dis · Oct 2020
Comparative StudyA Comparison of Probabilistic and Deterministic Match Strategies for Linking Prehospital and in-Hospital Stroke Registry Data.
Understanding and improving EMS stroke care requires linking data from both the prehospital and hospital settings. In the US, such data is collected in separate de-identified registries that cannot be directly linked due to lack of a common, unique patient identifier. In the absence of unique patient identifiers two common approaches to linking databases are deterministic matching, which uses combinations of non-unique matching variables to define matches, and probabilistic matching, which generates estimates of match probability based on the degree of similarity between records. This analysis seeks to compare these two approaches for matching EMS and stroke registry data. ⋯ Probabilistic matching resulted in higher match rates and a more representative sample of EMS transported strokes, suggesting it may be superior in assessing EMS stroke care compared to a deterministic approach.
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J Stroke Cerebrovasc Dis · Oct 2020
Multicenter Study Comparative Study Observational StudyClinical Characteristics and Clinical Course of Body Lateropulsion in 47 Patients with Brainstem Infarctions.
In patients with lower lateral medullary infarction (LMI) located under the vestibular nucleus, proprioceptive impairment due to dorsal spinocerebellar tract (DSCT) is considered a pathological condition for body lateropulsion. In patients with brainstem infarction located at or above the level of the vestibular nucleus, other pathways, such as the crossed vestibulothalamic tract (CVTT), are considered responsible. ⋯ Lower LMI primarily affected body lateropulsion in gait. DSCT damage could affect ipsilateral hip joint or leg coordination, causing body lateropulsion in dynamic situation.
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J Stroke Cerebrovasc Dis · Oct 2020
Review Case ReportsA Rare Clinical Antity; Pure Gerstmann Syndrome.
Gerstmann syndrome is defined as a tetrad including agraphia, acalculia, finger agnosia, and right-left disorientation. In the case studies presented in the literature, it has been reported that Gerstmann syndrome usually appears as an incomplete tetrad of symptoms or accompanied by cognitive deficits including aphasia, alexia, apraxia and some perceptual disorders. ⋯ In addition to the symptoms mentioned above, the patient had alexia and anomic aphasia as well. We discussed the clinic appearance and reviewed the current literature.