Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association
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J Stroke Cerebrovasc Dis · Feb 2014
Initial experience with upfront arterial and perfusion imaging among ischemic stroke patients presenting within the 4.5-hour time window.
Although perfusion imaging is being evaluated as a tool to select acute ischemic stroke patients who are most likely to benefit from reperfusion therapies beyond the standard time windows, there are limited data on the utility of perfusion imaging within the intravenous (IV) thrombolytic time window. ⋯ An upfront CTA/CTP protocol aided stroke team decision-making in nearly half of cases. Implementation of a CTA/CTP protocol was associated with a learning curve of 6 months before door to needle time ≤60 minutes returned to similar rates as the pre-CTA/CTP protocol.
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J Stroke Cerebrovasc Dis · Feb 2014
Multicenter StudyQuality of acute ischemic stroke care in Thailand: a prospective multicenter countrywide cohort study.
Data concerning quality of acute stroke care and outcome are scarce in developing countries. ⋯ Limited access to acute ischemic stroke care interventions were observed in many domains especially thrombolysis and stroke unit admission. These findings emphasize an urgent need for strategies to improve standard acute stroke care among developing countries.
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J Stroke Cerebrovasc Dis · Feb 2014
Comparative StudyInsurance status and outcome after intracerebral hemorrhage: findings from Get With The Guidelines-stroke.
[corrected] Few studies have examined associations among insurance status, treatment, and outcomes in patients hospitalized for intracerebral hemorrhage (ICH). ⋯ GWTG-Stroke ICH patients demonstrated differences in mortality, functional status, discharge destination, and quality of care measures associated with insurance status.
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J Stroke Cerebrovasc Dis · Feb 2014
An emergency department intervention to increase warfarin use for atrial fibrillation.
Emergency department (ED) encounters represent lost opportunities to facilitate anticoagulation for stroke prevention in atrial fibrillation (AF). However, screening of warfarin eligibility in the ED may not be feasible. We evaluated whether a practical quality improvement initiative increased postdischarge warfarin use in ED patients with AF. ⋯ This practical stroke prevention quality improvement initiative was not associated with an increase in warfarin use among ED patients with AF.
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J Stroke Cerebrovasc Dis · Feb 2014
Prognostic value of high-sensitivity cardiac troponin T in acute ischemic stroke.
Cardiac troponins have been investigated as prognostic markers in the setting of ischemic stroke with diverging results. A new generation of highly sensitive troponin assays have recently been developed that allow for the detection of concentrations 5 to 10 times lower than those measureable with conventional assays. The aim of this study was to determine the association between high-sensitivity cardiac troponin T (hs-cTnT) elevation on admission and mortality after acute ischemic stroke. ⋯ Circulating hs-cTnT levels are closely associated with the risk of death in patients with acute ischemic stroke, and even levels below the upper reference limit appear to have prognostic value.