Improving Post-Stroke Dysphagia Outcomes Through a Standardized and Multidisciplinary Protocol: An Exploratory Cohort Study

Dysphagia ◽  
2014 ◽  
Vol 29 (6) ◽  
pp. 704-712 ◽  
Author(s):  
Marialuisa Gandolfi ◽  
Nicola Smania ◽  
Giulia Bisoffi ◽  
Teresa Squaquara ◽  
Paola Zuccher ◽  
...  
Keyword(s):  
Cohort Study ◽  
Post Stroke ◽  
Dysphagia Outcomes

scholarly journals Acupuncture Decreases the Incidence of Post-stroke Dementia: A Taiwan Nationwide Retrospective Cohort Study

2020 ◽  
Author(s):  
Shao-Ang Chu ◽  
Te-Yuan Chen ◽  
Po-Yuan Chen ◽  
Wei-Jie Tzeng ◽  
Cheng-Loong Liang ◽  
...  
Keyword(s):  
Cohort Study ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Acupuncture Treatment ◽  
Lower Probability ◽  
Control Group ◽  
Study Group ◽  
Research Database ◽  
Post Stroke ◽  
Incidence Of Dementia

Abstract BACKGROUND Stroke has been recognized as one of the major causes of adult disability worldwide, and post-stroke dementia may affect up to one-third of stroke survivors. This condition could be prevented if we could recognize and treat it earlier. Acupuncture as a complementary treatment for stroke has been shown to be beneficial for subsequent post-stroke rehabilitation. Our study investigated if acupuncture served additional advantages to decreasing the incidence of post-stroke dementia. METHODS We provide a retrospective cohort study from Taiwan National Health Insurance Research Database. This study compared the incidence of post-stroke dementia between cohorts with and without acupuncture treatment by calculating adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) of acupuncture associated with post-stroke dementia using Cox proportional hazard regressions. The study group was composed of 9,547 patients who received first hospitalization for the treatment of stroke between 2002 and 2004; of which, 47,735 comparison patients were defined as the control group. The two groups were followed-up until the diagnosis of dementia presented or until the end of 2007. RESULTS The adjusted HRs of developing dementia among patients with stroke was 4.705 times the average (range, 4.353–5.085), and the incidence of dementia was higher in males. The study group tended to have less incidence of all kinds of dementia after acupuncture treatment, and patients without stroke receiving acupuncture had a lower probability of dementia than those untreated during the follow-up period. CONCLUSIONS This study presents evidence that acupuncture serves as an effective and alternative procedure to lower the risk of post-stroke dementia and the overall incidence of dementia in Taiwanese population.

Predictors of Participation in Supervised Therapy by Post-Stroke Patients in The Singapore Community: A One-Year Cohort Study

2016 ◽  
Vol 97 (10) ◽  
pp. e8
Author(s):  
Gerald Choon-Huat Koh ◽  
Denise Yan-Yin Lim ◽  
Steven Liben Zhang ◽  
Cynthia Chen Huijun ◽  
Sanjiv Kishore Saxena ◽  
...  
Keyword(s):  
Cohort Study ◽  
Stroke Patients ◽  
Post Stroke ◽  
One Year

Risk of Stroke in Nasopharyngeal Cancer Survivors: A National Registry-Based Population Cohort Study

Neurology ◽  
2021 ◽  
pp. 10.1212/WNL.0000000000013058
Author(s):  
Teng Hwee Tan ◽  
Huili Zheng ◽  
Timothy Cheo ◽  
Jeremy Tey ◽  
Yu Yang Soon
Keyword(s):  
Cohort Study ◽  
General Population ◽  
Nasopharyngeal Cancer ◽  
Reference Population ◽  
National Registry ◽  
Age Group ◽  
Post Stroke ◽  
Risk Of Death ◽  
Increased Risk ◽  
Stage 1

BackgroundWe aim to determine the risk of stroke and death within 30 days post stroke in nasopharyngeal cancer (NPC) survivors.MethodsWe conducted a population-based cohort study of patients diagnosed with NPC from Jan 1, 2005 to Dec 31, 2017. Using the cancer and stroke disease registries and the Singapore general population as the reference population, we report the age-standardized incidence rate differences (SIRDs) ratios (SIRs) and the cumulative incidence of stroke and the standardized mortality rate differences (SMRDs) and ratios (SMRs) for all causes of death within 30 days post stroke for NPC survivors.FindingsAt a median follow up of 48.4 months (IQR 19.8 – 92.9) for 3849 patients diagnosed with NPC, 96 patients developed stroke. The overall SIRD and SIR for stroke was 3.12 (95% CI 2.09 – 4.15) and 2.54 (95% CI 2.08 – 3.10) respectively. The SIRD was highest for the age group 70 – 79 years old (8.84 cases per 1000 person-years (PY); 0.46 – 17.21) while the SIR was highest for the age group 30 – 39 years old (16.41; 6.01 – 35.82). The SIRD and SIR for stage 1 disease was (6.96 cases per 1000 PY; 2.16 – 11.77) and (4.15; 2.46 – 7.00) respectively. The SMRD and SMR for all cause deaths within 30 days of stroke was (3.20 cases per 100 persons; -3.87 – 10.28) and (1.34; 0.76 – 2.37) respectively.InterpretationThe overall risk of stroke was markedly elevated in survivors of NPC, especially in Stage 1 disease when compared to the general population. The risk of death within 30 days of stroke was not significantly higher for NPC survivors.Classification of EvidenceThis study provides Class II evidence of the increased risk of stroke in survivors of nasopharyngeal cancer compared to general population.

scholarly journals Association of Prior Atherosclerotic Cardiovascular Disease with Dementia After Stroke: A Retrospective Cohort Study

2020 ◽  
Vol 77 (3) ◽  
pp. 1157-1167
Author(s):  
Zhirong Yang ◽  
Duncan Edwards ◽  
Stephen Burgess ◽  
Carol Brayne ◽  
Jonathan Mant
Keyword(s):  
Cardiovascular Disease ◽  
Cohort Study ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Clinical Practice Research Datalink ◽  
Atherosclerotic Cardiovascular Disease ◽  
Stroke Patients ◽  
Post Stroke ◽  
Increased Risk ◽  
The Impact

Background: Prior atherosclerotic cardiovascular disease (ASCVD), including coronary heart disease (CHD) and peripheral artery disease (PAD), are common among patients with stroke, a known risk factor for dementia. However, whether these conditions further increase the risk of post-stroke dementia remains uncertain. Objective: To examine whether prior ASCVD is associated with increased risk of dementia among stroke patients. Methods: A retrospective cohort study was conducted using the Clinical Practice Research Datalink with linkage to hospital data. Patients with first-ever stroke between 2006 and 2017 were followed up to 10 years. We used multi-variable Cox regression models to examine the associations of prior ASCVD with dementia and the impact of prior ASCVD onset and duration. Results: Among 63,959 patients, 7,265 cases (11.4%) developed post-stroke dementia during a median of 3.6-year follow-up. The hazard ratio (HR) of dementia adjusted for demographics and lifestyle was 1.18 (95% CI: 1.12–1.25) for ASCVD, 1.16 (1.10–1.23) for CHD, and 1.25 (1.13–1.37) for PAD. The HRs additionally adjusted for multimorbidity and medications were 1.07 (1.00–1.13), 1.04 (0.98–1.11), and 1.11 (1.00–1.22), respectively. Based on the fully adjusted estimates, there was no linear relationship between the age of ASCVD onset and post-stroke dementia (all p-trend >0.05). The adjusted risk of dementia was not increased with the duration of pre-stroke ASCVD (all p-trend >0.05). Conclusion: Stroke patients with prior ASCVD are more likely to develop subsequent dementia. After full adjustment for confounding, however, the risk of post-stroke dementia is attenuated, with only a slight increase with prior ASCVD.

scholarly journals Quality of Life during the First Two Years Post Stroke: The Restore4Stroke Cohort Study

2015 ◽  
Vol 41 (1-2) ◽  
pp. 19-26 ◽  
Author(s):  
Maria L. van Mierlo ◽  
Caroline M. van Heugten ◽  
Marcel W.M. Post ◽  
Tibor R.S. Hajós ◽  
L. Jaap Kappelle ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Life Satisfaction ◽  
Cohort Study ◽  
Marital Status ◽  
Discharge Destination ◽  
Confounding Effect ◽  
Level Of Education ◽  
Post Stroke ◽  
Status Level

Background: Little information is available about the course of quality of life (QoL) post stroke and how dependency on activities of daily living (ADL) influences this course. The aim of this study was therefore to describe the course of QoL from 2 months up to 2 years post stroke and to study the influence of ADL dependency in the first week post stroke. Methods: This is a multicenter prospective longitudinal cohort study in which 368 stroke patients were included and data were collected at 1 week, 2 months, 6 months, 12 months and 24 months post stroke. QoL assessment included measures of health-related quality of life (HRQoL) (short stroke-specific Quality of Life Scale), emotional functioning (Hospital Anxiety and Depression Scale), participation (Utrecht Scale for Evaluation of Rehabilitation-Participation), and life satisfaction (2LS). Dependency on ADL was defined as having a Barthel Index score ≤17 four days post stroke. Generalized Estimating Equations analyses were performed to examine the course of the 4 domains of QoL. Furthermore, the possible confounding effect of age, gender, marital status, level of education and discharge destination was examined. Results: Results showed that HRQoL, participation and life satisfaction improved during the first year post stroke, with most changes occurring in the first 6 months. Furthermore, patients dependent in ADL scored consistently lower on all 4 QoL domains and test occasions compared to ADL-independent patients. In both patient groups separately, no changes over time were found in emotional functioning. ADL-independent patients improved in HRQoL (p = 0.002), participation (p < 0.001) and life satisfaction (p = 0.020) between 2 and 6 months and in life satisfaction (p = 0.003) between 6 and 12 months also. ADL-dependent patients improved in HRQoL (p = 0.009) between 2 and 6 months and in participation between 2 and 6 months (p = 0.001) and between 6 and 12 months (p = 0.031). Furthermore, they experienced no changes in life satisfaction. No confounding effect was found after adding age, gender, marital status, level of education and discharge destination. Conclusions: Most improvement in QoL occurred up to 6 months post stroke and showed different patterns for specific domains of QoL and for patients with and without dependency in ADL in the first week post stroke. It is therefore important to differentiate between these different domains of QoL when the long-term perspective is considered. Furthermore, patients dependent in ADL consistently scored lower on all QoL domains and did not reach the level of QoL of patients independent of QoL.

scholarly journals When Does Return of Voluntary Finger Extension Occur Post-Stroke? A Prospective Cohort Study

PLoS ONE ◽  
2016 ◽  
Vol 11 (8) ◽  
pp. e0160528 ◽  
Author(s):  
Caroline Winters ◽  
Gert Kwakkel ◽  
Rinske Nijland ◽  
Erwin van Wegen ◽  
Keyword(s):  
Cohort Study ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Post Stroke ◽  
Finger Extension

A prospective cohort study of lesion location and its relation to post-stroke depression among Chinese patients

2012 ◽  
Vol 136 (1-2) ◽  
pp. e83-e87 ◽  
Author(s):  
Tong Zhang ◽  
Xue Jing ◽  
Xingquan Zhao ◽  
Chunxue Wang ◽  
Zhaorui Liu ◽  
...  
Keyword(s):  
Cohort Study ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Chinese Patients ◽  
Lesion Location ◽  
Post Stroke ◽  
Post Stroke Depression

scholarly journals Correction: Metabolic Syndrome and Fatal Outcomes in the Post-Stroke Event: A 5-Year Cohort Study in Cameroon

PLoS ONE ◽  
2013 ◽  
Vol 8 (12) ◽  
Author(s):  
Eric Vounsia Balti ◽  
André Pascal Kengne ◽  
Jean Valentin Fogha Fokouo ◽  
Brice Enid Nouthé ◽  
Eugene Sobngwi
Keyword(s):  
Metabolic Syndrome ◽  
Cohort Study ◽  
Stroke Event ◽  
Post Stroke

scholarly journals Post-stroke Hyperglycemia in Non-diabetic Ischemic Stroke is Related With Worse Functional Outcome: A Cohort Study

2021 ◽  
Vol 45 (5) ◽  
pp. 359-367
Author(s):  
Jin A Yoon ◽  
Yong-Il Shin ◽  
Deog Young Kim ◽  
Min Kyun Sohn ◽  
Jongmin Lee ◽  
...  
Keyword(s):  
Cohort Study ◽  
Ischemic Stroke ◽  
Glucose Level ◽  
Functional Outcomes ◽  
Stroke Patients ◽  
Nihss Score ◽  
Post Stroke ◽  
Significant Difference ◽  
Functional Assessments

Objective To investigate long-term and serial functional outcomes in ischemic stroke patients without diabetes with post-stroke hyperglycemia.Methods The Korean Stroke Cohort for Functioning and Rehabilitation (KOSCO) is a large, multi-center, prospective cohort study of stroke patients admitted to participating hospitals in nine areas of Korea. From KOSCO, ischemic stroke patients without diabetes were recruited and divided into two groups: patients without diabetes without (n=779) and with post-stroke hyperglycemia (n=223). Post-stroke hyperglycemia was defined as a glucose level >8 mmol/L. Functional assessments were performed 7 days and 3, 6, and 12 months after stroke onset.Results There were no significant differences in baseline characteristics between the groups, except in the age of onset and smoking. Analysis of the linear correlation between the initial National Institutes of Health Stroke Scale (NIHSS) score and glucose level showed no significant difference. Among our functional assessments, NIHSS, Fugl-Meyer Assessment (affected side), Functional Ambulatory Category, modified Rankin Scale, and Korean Mini-Mental State Examination (K-MMSE) showed statistically significant improvements in each group. All functional improvements except K-MMSE were significantly higher in patients without post-stroke hyperglycemia at 7 days and 3, 6, and 12 months.Conclusion The glucose level of ischemic stroke patients without diabetes had no significant correlation with the initial NIHSS score. The long-term effects of stress hyperglycemia showed worse functional outcomes in ischemic stroke patients without diabetes with post-stroke hyperglycemia.

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