scholarly journals Derivation and Validation of a Novel Prognostic Scale (Modified–Stroke Subtype, Oxfordshire Community Stroke Project Classification, Age, and Prestroke Modified Rankin) to Predict Early Mortality in Acute Stroke

Stroke ◽  
2016 ◽  
Vol 47 (1) ◽  
pp. 74-79 ◽  
Author(s):  
Azmil H. Abdul-Rahim ◽  
Terence J. Quinn ◽  
Sarah Alder ◽  
Allan B. Clark ◽  
Stanley D. Musgrave ◽  
...  
Keyword(s):  
Acute Stroke ◽  
Early Mortality ◽  
Stroke Subtype ◽  
Oxfordshire Community Stroke Project

Abstract NS6: To Rest or Mobilize... When to Start Early Mobilization in Acute Stroke: a Systematic Review

Stroke ◽  
2016 ◽  
Vol 47 (suppl_1) ◽  
Author(s):  
Michelle Whaley ◽  
Wendy Dusenbury ◽  
Andrei V Alexandrov ◽  
Georgios Tsivgoulis ◽  
Anne W Alexandrov
Keyword(s):  
Systematic Review ◽  
Ischemic Stroke ◽  
Acute Stroke ◽  
Early Mobilization ◽  
Future Research ◽  
Cochrane Central Register ◽  
Large Artery ◽  
Stroke Subtype ◽  
Vascular Insufficiency ◽  
The Impact

Background: Recent nursing initiatives encourage early mobilization of neurocritical care patients, but whether this intervention can be safely generalized to acute stroke is debatable. We performed a systematic review of findings from recent studies to provide direction for patient management and future research. Methods: An exhaustive literature search was performed in Medline, SCOPUS and the Cochrane Central Register of Controlled Trials to identify published clinical trial research using a very early mobility intervention (within 24 hours) in acute ischemic stroke patients. The primary efficacy outcome supporting the search was neurologic disability reduction or improved functional outcomes, and the primary safety outcome was neurologic deterioration. Studies were critically reviewed for inclusion by 3 separate investigators, findings were synthesized, and an overall recommendation for very early mobilization use in acute stroke was assigned according to GRADE criteria. Results: We initially identified 12 papers focused on early mobilization in acute stroke; of these, 6 observational studies were excluded, 1 study was excluded due to an ambiguous population, and 3 studies were excluded due to first initial mobilization out of bed occurring greater than 24 hours after admission. Two prospective randomized outcome blinded evaluation (PROBE) studies were retained, consisting of a total 2160 patients; ischemic stroke subtype was not disclosed in either study, limiting an understanding of the impact of very early mobilization on small versus large artery occlusion. Slower mobilization occurring beyond the first 24 hours was associated with higher rates of favorable outcome (mRS 0-2) at 90 days, whereas very early mobilization within the first 24 hours was associated with a number needed to harm of 25. Conclusions: In acute stroke, evidence supports a rested approach to care within the first 24 hours of hospitalization (GRADE: Strong recommendation, high quality of evidence). Similar to acute myocardial infarction, vascular insufficiency experienced in stroke likely warrants a more guarded approach to mobility. Additional studies exploring timing beyond 24 hours and dose of mobility interventions are warranted in discreet populations.

Efficacy of IV tissue plasminogen activator in acute stroke: Does stroke subtype really matter?

Neurology ◽  
2003 ◽  
Vol 61 (1) ◽  
pp. 71-75 ◽  
Author(s):  
A. W. Hsia ◽  
H. S. Sachdev ◽  
J. Tomlinson ◽  
S. A. Hamilton ◽  
D. C. Tong
Keyword(s):  
Acute Stroke ◽  
Plasminogen Activator ◽  
Tissue Plasminogen Activator ◽  
Stroke Subtype ◽  
Tissue Plasminogen

Prediction of early mortality after acute stroke

2002 ◽  
Vol 11 (1) ◽  
pp. 15-22 ◽  
Author(s):  
Patricia Braga ◽  
Alicia Ibarra ◽  
Isabel Rega ◽  
Carlos Ketzoian ◽  
Matías Pebet ◽  
...  
Keyword(s):  
Acute Stroke ◽  
Early Mortality

scholarly journals Prevalence of the Frank’s sign by aetiopathogenic stroke subtype: A prospective analysis

PLoS ONE ◽  
2021 ◽  
Vol 16 (12) ◽  
pp. e0261080
Author(s):  
Laura Sánchez-Cirera ◽  
Saima Bashir ◽  
Adina Ciscar ◽  
Carla Marco ◽  
Verónica Cruz ◽  
...  
Keyword(s):  
Risk Factors ◽  
Ischaemic Stroke ◽  
Acute Stroke ◽  
Haemorrhagic Stroke ◽  
Vascular Risk Factors ◽  
Vascular Risk ◽  
Stroke Subtype ◽  
Cross Sectional ◽  
Stroke Subtypes ◽  
Artery Disease

Background and purpose The Frank’s sign is a diagonal earlobe crease running from the tragus to the edge of the auricle at an angle of 45°. Many studies have associated this sign with coronary artery disease and some with cerebrovascular disease. The objective of this study was to analyse the prevalence of the Frank’s sign in patients suffering from acute stroke with a particular focus on its prevalence in each of the five aetiopathogenic stroke subtypes. Special interest is given to embolic stroke of undetermined source (ESUS), correlating the sign with clinical and radiological markers that support an underlying causal profile in this subgroup. Methods Cross-sectional descriptive study including 124 patients admitted consecutively to a stroke unit after suffering an acute stroke. The Frank’s sign was evaluated by the same blinded member of the research team from photographs taken of the patients. The stroke subtype was classified following SSS-TOAST criteria and the aetiological study was performed following the ESO guidelines. Results The Frank’s sign was present in 75 patients and was more prevalent in patients with an ischaemic stroke in comparison with haemorrhagic stroke (63.9 vs. 37.5, p<0.05). A similar prevalence was found in the different ischaemic stroke subtypes. The Frank’s sign was significantly associated with age, particularly in patients older than 70 who had vascular risk factors. Atherosclerotic plaques found in carotid ultrasonography were significantly more frequent in patients with the Frank’s sign (63.6%, p<0.05). Analysing the ESUS, we also found an association with age and a higher prevalence of the Frank’s sign in patients with vascular risk factors and a tendency to a high prevalence of atherosclerosis markers. Conclusion The Frank’s sign is prevalent in all aetiopathogenic ischaemic stroke subtypes, including ESUS, where it could be helpful in suspecting the underlying cardioembolic or atherothrombotic origin and guiding the investigation of atherosclerosis in patients with ESUS and the Frank’s sign.

scholarly journals Validation of the mSOAR and SOAR scores to predict early mortality in Chinese acute stroke patients

PLoS ONE ◽  
2017 ◽  
Vol 12 (7) ◽  
pp. e0180444 ◽  
Author(s):  
Hui Wang ◽  
Yuesong Pan ◽  
Xia Meng ◽  
Chunjuan Wang ◽  
Xiaoling Liao ◽  
...  
Keyword(s):  
Acute Stroke ◽  
Early Mortality ◽  
Stroke Patients

Abstract TP180: Markedly Elevated High-sensitive C-reactive protein (hsCRP) Predicts Early Mortality Among Stroke Patients

Stroke ◽  
2013 ◽  
Vol 44 (suppl_1) ◽  
Author(s):  
Ahmed Itrat ◽  
Shazia Alam ◽  
Esteban Walker ◽  
Irene Katzan
Keyword(s):  
Acute Stroke ◽  
Early Mortality ◽  
Mortality Data ◽  
C Reactive Protein ◽  
Stroke Patients ◽  
Reactive Protein ◽  
Risk Of Death ◽  
Social Security Death Index ◽  
All Cause Mortality ◽  
Very High

Background: High-sensitive C-Reactive Protein (hsCRP) levels are correlated with risk of vascular disease and cardiovascular mortality. The clinical implications of markedly elevated hsCRP levels in the setting of acute stroke are less understood as they are often excluded from studies. Objective: To determine the association of very high admission hsCRP levels (> 10mg/L) on all-cause mortality in patients with acute stroke Methods: We performed a retrospective cohort study of patients admitted to our institution with acute stroke (8/2003- 11/2011) who had at least one hsCRP assay drawn < 7 days of stroke diagnosis. Mortality data was obtained using Social Security Death Index. Differences in survival were determined using Kaplan-Meier curves. Cox proportional analysis was used to determine hazard ratios of death among patients with hsCRP values > 10 mg/L after adjusting for age, sex, race and the following co-morbid conditions: cancer, atrial fibrillation, diabetes, hypertension, myocardial infarction Results: There were 293 stroke patients identified with hsCRP levels drawn < 7 days of stroke admission. Median age was 65.7 years (SD 15.3), and 55% were male. All-cause mortality was 18% (n=53) with a median follow-up of 2.2 years. Median hsCRP level was 5.5 mg/L, [IQR 1.8 - 14.6] with 31.7% patients having hsCRP > 10 mg/L. Patients with hsCRP > 10 mg/L had a 2.7 times higher risk of mortality than those with hsCRP < 10 mg/L (p=0.004). The increased risk was steepest in the first months after stroke (Figure). The only other significant variable affecting hazard for death was age; each year increased the hazard ratio by 3.3%. Of the cases in which cause of death was known (n=31), stroke was the most common cause (71%) Conclusion: Very high level of hsCRP (>10 mg/L) at the time of admission is associated with increased early mortality among patients presenting with acute strokes. This finding may help stratify risk of death in stroke.

Validation of the Oxfordshire Community Stroke Project syndrome diagnosis derived from a standard symptom list in acute stroke

2004 ◽  
Vol 220 (1-2) ◽  
pp. 55-58 ◽  
Author(s):  
Leo Aerden ◽  
Gert-Jan Luijckx ◽  
Stefano Ricci ◽  
Anne Hilton ◽  
Fons Kessels ◽  
...  
Keyword(s):  
Acute Stroke ◽  
Syndrome Diagnosis ◽  
Oxfordshire Community Stroke Project ◽  
Symptom List

Matrix metalloproteinases and their inhibitors in different acute stroke subtypes

2006 ◽  
Vol 44 (4) ◽  
Author(s):  
Ines Vukasovic ◽  
Andrea Tesija-Kuna ◽  
Elizabeta Topic ◽  
Visnja Supanc ◽  
Vida Demarin ◽  
...  
Keyword(s):  
Matrix Metalloproteinases ◽  
Acute Stroke ◽  
Serum Levels ◽  
Characteristic Analysis ◽  
Anterior Circulation ◽  
Stroke Subtypes ◽  
Discriminating Power ◽  
Oxfordshire Community Stroke Project ◽  
Stroke Group ◽  
Natural Inhibitors

AbstractThe aim of the study was to determine serum levels of selected matrix metalloproteinases (MMPs) and their natural inhibitors (TIMPs) in the acute phase of different stroke types subdivided according to the Oxfordshire Community Stroke Project (OCSP) classification and the possibility of discriminating stroke types according to their levels. The study included 126 patients with acute stroke within the first 24h of symptom onset, and 124 healthy volunteers. The stroke group had lower MMP-2 concentrations and MMP-2/TIMP-2 ratios (p<0.001) but higher TIMP-2 (p<0.001) than controls. The level of MMP-9 and the MMP-9/TIMP-1 ratio were higher in patients with total anterior circulation infarct (TACI) than in patients with other stroke subtypes according to OCSP classification (p=0.0019, p=0.0065, respectively) or in controls (p<0.0001, p=0.0024, respectively). A negative correlation of MMP-2 levels with MMP-9 and MMP-9/TIMP-1 ratio was recorded in all stroke subtypes except for TACI. Receiver operating characteristic analysis showed similar discriminating power for MMP-9 levels and Barthel index in the differential diagnosis of TACI. High MMP-9/TIMP-1 ratio (odds ratio 3.263) was associated with TACI. Our results demonstrate that the MMP-9/TIMP-1 ratio may provide information to help in assessing stroke patients in the future as a baseline biomarker of infarct extent.

Retinal Microvascular Signs: A Key to Understanding the Underlying Pathophysiology of Different Stroke Subtypes?

2008 ◽  
Vol 3 (4) ◽  
pp. 297-305 ◽  
Author(s):  
Richard I. Lindley ◽  
Keyword(s):  
Acute Stroke ◽  
Small Vessel Disease ◽  
New Technology ◽  
Retinal Vessel ◽  
Small Vessel ◽  
Stroke Subtype ◽  
Vessel Disease ◽  
Underlying Mechanisms ◽  
New Treatments ◽  
Retinal Microvascular Signs

Background The heterogeneity of the pathology of stroke has been a major difficulty in assessing new treatments for acute stroke, and contributes to the complexity of stroke medicine. Some underlying mechanisms are poorly understood, such as small vessel (lacunar) disease. New technology such as advanced brain imaging has transformed our knowledge of large vessel disease and we suggest that other new technology such as detailed analysis of retinal vessels may provide new insights into the pathology of small vessel (lacunar) stroke disease. We hypothesise that retinal microvascular signs differ by pathological stroke subtype, and we plan to test this hypothesis in over 1000 acute stroke patients. Summary Eligible patients undergo a standardised neurological assessment followed by digital retinal photography. At a consensus meeting, an anatomical and aetiological classification is determined. Retinal photographs will be assessed qualitatively (e.g. retinal emboli, arteriovenous nicking) and quantitatively (arteriolar/venule ratio). Six-month vascular event rates together with disability and vital status are collected. Conclusion Retinal vessel appearances may provide a ‘window’ to the brain and help determine the important underlying pathophysiological mechanisms of small vessel disease stroke.

Sign in / Sign up

Export Citation Format

Share Document