scholarly journals Clinical Characteristics of Acute Ischemic Stroke while Sleep and Awake

2011 ◽  
Vol 13 (2) ◽  
pp. 74
Author(s):  
Kyung-Mo Ku ◽  
Ki-Bong Song ◽  
Mi-Sun Oh ◽  
Kyung-Ho Yu ◽  
Ju-Hun Lee ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Clinical Characteristics

Abstract 45: Thrombolytic Treatment for In-Hospital Ischemic Strokes in United States

Stroke ◽  
2013 ◽  
Vol 44 (suppl_1) ◽  
Author(s):  
Tenbit Emiru ◽  
Malik M Adil ◽  
Adnan I Qureshi
Keyword(s):  
United States ◽  
Ischemic Stroke ◽  
Length Of Stay ◽  
Hospital Mortality ◽  
Acute Ischemic Stroke ◽  
Clinical Characteristics ◽  
The United States ◽  
Treated Group ◽  
Hospital Charges ◽  
Thrombolytic Treatment

BACKGROUND: Despite the recent emphasis on protocols for emergent triage and treatment of in-hospital acute ischemic stroke, there is little data on rates and outcomes of patients receiving thrombolytics for in-hospital ischemic strokes. OBJECTIVE: To determine the rates of in-hospital ischemic stroke treated with thrombolytics and to compare outcomes with patients treated with thrombolytics on admission. DESIGN/METHODS: We analyzed a seven-year data (2002-2009) from the National Inpatient Survey (NIS), a nationally representative inpatient database in the United States. We identified patients who had in-hospital ischemic strokes (defined by thrombolytic treatment after one day of hospitalization) and those who received thrombolytics on the admission day. We compared demographics, baseline clinical characteristics, in hospital complications, length of stay, hospitalization charges, and discharge disposition, between the two patient groups. RESULT: A total of 18036 (21.5%) and 65912 (78.5%) patients received thrombolytics for in-hospital and on admission acute ischemic stroke, respectively. In hospital complications such as pneumonia (5.0% vs. 3.4%, p=0.0006), deep venous thrombosis (1.9% vs. 0.6%, p<0.0001) and pulmonary embolism (0.8% vs. 0.4%, p=0.01) were significantly higher in the in-hospital group compared to on admission thrombolytic treated group. Hospital length of stay and mean hospital charges were not different between the two groups. Patients who had in-hospital strokes had had higher rates of in hospital mortality (12.1% vs. 10.6%, p=0.02). In a multivariate analysis, in-hospital thrombolytic treated group had higher in-hospital mortality after adjustment for age, gender and baseline clinical characteristics (odds ratio 0.84, 95% confidence interval 0.74-0.95, p=0.008). CONCLUSION/RELEVANCE: In current practice, one out of every five acute ischemic stroke patients treated with thrombolytics is receiving treatment for in-hospital strokes. The higher mortality and complicated hospitalization in such patients needs to be recognized.

scholarly journals Diagnosis of DWI-negative acute ischemic stroke

Neurology ◽  
2017 ◽  
Vol 89 (3) ◽  
pp. 256-262 ◽  
Author(s):  
Brian L. Edlow ◽  
Shelley Hurwitz ◽  
Jonathan A. Edlow
Keyword(s):  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Clinical Diagnosis ◽  
Clinical Characteristics ◽  
Meta Analysis ◽  
Reperfusion Therapy ◽  
Posterior Circulation ◽  
Anterior Circulation ◽  
Ovid Medline ◽  
Level Data

Objective:To determine the prevalence of diffusion-weighted imaging (DWI)–negative acute ischemic stroke (AIS) and to identify clinical characteristics of patients with DWI-negative AIS.Methods:We systematically searched PubMed and Ovid/MEDLINE for relevant studies between 1992, the year that the DWI sequence entered clinical practice, and 2016. Studies were included based upon enrollment of consecutive patients presenting with a clinical diagnosis of AIS prior to imaging. Meta-analysis was performed to synthesize study-level data, estimate DWI-negative stroke prevalence, and estimate the odds ratios (ORs) for clinical characteristics associated with DWI-negative stroke.Results:Twelve articles including 3,236 AIS patients were included. The meta-analytic synthesis yielded a pooled prevalence of DWI-negative AIS of 6.8%, 95% confidence interval (CI) 4.9–9.3. In the 5 studies that reported proportion data for DWI-negative and DWI-positive AIS based on the ischemic vascular territory (n = 1,023 AIS patients), DWI-negative stroke was strongly associated with posterior circulation ischemia, as determined by clinical diagnosis at hospital discharge or repeat imaging (OR 5.1, 95% CI 2.3–11.6, p < 0.001).Conclusions:A small but significant percentage of patients with AIS have a negative DWI scan. Patients with neurologic deficits consistent with posterior circulation ischemia have 5 times the odds of having a negative DWI scan compared to patients with anterior circulation ischemia. AIS remains a clinical diagnosis and urgent reperfusion therapy should be considered even when an initial DWI scan is negative.

A study on relationship of Hounsfield Units value on non-contrast computer tomography and recanalization of intravenous thrombolysis

2021 ◽  
Vol 18 ◽  
Author(s):  
Zhen Wang ◽  
Kangping Song ◽  
Wei Xu ◽  
Guohua He ◽  
Tieqiao Feng ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Clinical Characteristics ◽  
Intravenous Thrombolysis ◽  
Imaging Features ◽  
Hounsfield Units ◽  
Vessel Occlusion ◽  
Mean Values ◽  
Intravenous Alteplase ◽  
Relationship Of

Objective: To determine whether the administration of intravenous alteplase would be beneficial or futile to patients with acute ischemic stroke caused by large vessel occlusion (LVO) before endovascular treatment (EVT), we conducted this study to determine the relationship between Hounsfield units (HU) in non-contrast computed tomography (NCCT) and recanalization by alteplase. Methods: We performed a retrospective analysis of patients with acute ischemic stroke caused by LVO received intravenous thrombolysis (IVT) or followed by EVT at our center during November 2016 and October 2020. The clinical characteristics and imaging features of patients who achieved recanalization after IVT, and those who did not, were compared. Results: Forty-three eligible patients were enrolled; 12 achieved recanalization by IVT. Baseline clinical characteristics did not differ between patients of the recanalization and non-recanalization groups. HU in the NCCT were estimated and statistically significant maximum and mean values of the ipsilateral middle cerebral artery (MCA) were found between the groups (P< 0.05). The results hint that patients in the non-recanalization group have a higher rHU and δHU value of the ipsilateral MCA compared with recanalization group (P< 0.05). With regards the receiver operator characteristic (ROC) curve, we demonstrated that a high HU value of the ipsilateral MCA could be a predictor for non-recanalization by IVT. Conclusion: Patients suffering LVO stroke are less likely to obtain recanalization by IVT with a high HU value of the ipsilateral MCA. It is feasible to screen patients with LVO using HU for direct EVT.

Abstract TP304: Use, Time Delay and Outcomes of the Drip-and-Ship Thrombolysis Paradigm for Patients With Acute Ischemic Stroke

Stroke ◽  
2016 ◽  
Vol 47 (suppl_1) ◽  
Author(s):  
Jay Chol Choi ◽  
Man-Seok Park ◽  
Ji Sung Lee ◽  
Tai Hwan Park ◽  
Yong-Jin Cho ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Functional Outcomes ◽  
Clinical Characteristics ◽  
Multivariable Analysis ◽  
Stroke Care ◽  
Modified Rankin Scale ◽  
Significant Delay ◽  
Stroke Registry ◽  
Endovascular Recanalization

Introduction: The utilization of drip-and-ship thrombolysis paradigm, clinical characteristics and outcomes of patients treated with the paradigm could vary with regional stroke care system. Hypothesis: We hypothesized that clinical characteristics and functional outcomes of patients treated with drip-and-ship paradigm would be different from those of patients treated via direct visit. Methods: From a multicenter stroke registry, we identified acute ischemic stroke patients treated with tPA who arrived hospital within 6 hours from the symptom onset. Functional outcomes at three months after the stroke were classified as favorable (modified Rankin Scale score [mRS] 0 to 1) or unfavorable (mRS 2-6). Using multivariable analysis, we compared the modified Rankin scale (mRS) score at 3 months and symptomatic intracranial hemorrhages (SICH) between patients treated with drip-and-ship paradigm and those treated via direct visit. Results: Among 1,843 patients who met the eligible criteria, 244 patients (13.2%; 95% CI, 11.7-14.9) were treated using drip-and-ship paradigm. Patients treated with drip-and-ship paradigm had shorter onset to needle time compared with patients treated via direct visit (median[IQR], 110 minutes[79-150] vs 126 minutes[90-173], p<0.001). After multivariable analysis, patients treated with drip-and-ship paradigm had significantly greater risk of unfavorable functional outcome (mRS 2-6) at 3 months after the stroke compared with patients treated via direct visit (OR 2.15; 95% CI, 1.50-3.08; p < 0.001). SICH also occurred more frequently in patients treated with drip-and-ship paradigm (OR 1.78; 95% CI, 1.02-3.12; p =0.04). Of 1,843 patients, 509 patients (27.6%, 71 patients with drip-and-ship paradigm and 438 patients via direct visit) received subsequent endovascular recanalization therapy. The use of drip-and-ship paradigm caused approximately 105 minute delay in onset to groin puncture time compared with those treated via direct visit (305 minutes[260-345] vs 200 minutes[155-245], p<0.001). Conclusions: Drip-and-ship thrombolysis paradigm was used in less than 15% of patients treated with tPA, and use of the paradigm caused a significant delay in onset to groin puncture time for endovascular therapy.

scholarly journals Nationwide trends of clinical characteristics and economic burden of emergency department visits due to acute ischemic stroke

2017 ◽  
Vol Volume 9 ◽  
pp. 89-96 ◽  
Author(s):  
Mark Stuntz ◽  
Katsiaryna Busko ◽  
Shumaila Irshad ◽  
Taylor Paige ◽  
Veranika Razhkova ◽  
...  
Keyword(s):  
Emergency Department ◽  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Economic Burden ◽  
Clinical Characteristics ◽  
Emergency Department Visits

scholarly journals Clinical Characteristics of Elderly Acute Ischemic Stroke Patients Calling Emergency Medical Services

2017 ◽  
Vol 21 (4) ◽  
pp. 164-167
Author(s):  
In Hwan Lim ◽  
Hyung Jong Park ◽  
Hyun Young Park ◽  
Kyeong Ho Yun ◽  
Dae-Han Wi ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Emergency Medical Services ◽  
Clinical Characteristics ◽  
Medical Services ◽  
Stroke Patients ◽  
Emergency Medical
Sign in / Sign up

Export Citation Format

Share Document