Role of Early Supported Discharge in Acute Stroke Patients

2007 ◽  
Vol 49 (5) ◽  
pp. 693-695 ◽  
Author(s):  
Latha G. Stead ◽  
Lekshmi Vaidyanathan
Keyword(s):  
Acute Stroke ◽  
Stroke Patients ◽  
Early Supported Discharge

The role of nursing in the rehabilitation of acute stroke patients: Toward a unified theoretical perspective

Pflege ◽  
1999 ◽  
Vol 12 (1) ◽  
pp. 21-27
Author(s):  
Marit Kirkevold
Keyword(s):  
Acute Stroke ◽  
Theoretical Perspective ◽  
Stroke Patients ◽  
Role Of Nursing ◽  
Rolle Der Pflegenden

Eine Übersicht der bestehenden Literatur weist auf Unsicherheiten bezüglich der spezifischen Rolle der Pflegenden in der Rehabilitation von Hirnschlagpatientinnen und -patienten hin. Es existieren zwei unterschiedliche Begrifflichkeiten für die Rolle der Pflegenden, keine davon bezieht sich auf spezifische Rehabilitationsziele oder Patientenergebnisse. Ein anfänglicher theoretischer Beitrag der Rolle der Pflege in der Genesung vom Hirnschlag wird als Struktur unterbreitet, um die therapeutischen Aspekte der Pflege im Koordinieren, Erhalten und Üben zu vereinen. Bestehende Literatur untermauert diesen Beitrag. Weitere Forschung ist jedoch notwendig, um den spezifischen Inhalt und Fokus der Pflege in der Genesung bei Hirnschlag zu entwickeln.

scholarly journals Role of Renal Dysfunction as a Prognostic Factor in Acute Stroke Patients at a Tertiary Hospital in Northeastern Nigeria

2021 ◽  
Vol 32 (1) ◽  
pp. 199
Author(s):  
MohammadMaina Sulaiman ◽  
MusaMamman Watila ◽  
Jummai Shettima ◽  
Ibrahim Ummate ◽  
YakubuWilberforce Nyandaiti
Keyword(s):  
Prognostic Factor ◽  
Acute Stroke ◽  
Renal Dysfunction ◽  
Tertiary Hospital ◽  
Stroke Patients

scholarly journals Evaluating the Role of Oxidative Stress in Acute Ischemic Stroke

2020 ◽  
Vol 11 (01) ◽  
pp. 156-159
Author(s):  
Bindu Menon ◽  
Krishnan Ramalingam ◽  
Rajeev Kumar
Keyword(s):  
Oxidative Stress ◽  
Ischemic Stroke ◽  
Acute Stroke ◽  
Acute Ischemic Stroke ◽  
Lipid Membranes ◽  
Demographic Data ◽  
Stroke Severity ◽  
Stroke Patients ◽  
Antioxidant Power

Abstract Background The role of oxidative stress in neuronal injury due to ischemic stroke has been an interesting topic in stroke research. Malondialdehyde (MDA) has emerged as a sensitive oxidative stress biomarker owing to its ability to react with the lipid membranes. Total antioxidant power (TAP) is another biomarker to estimate the total oxidative stress in stroke patients. We aimed to determine the oxidative stress in acute stroke patients by measuring MDA and TAP. Materials and Methods MDA and TAP were determined in 100 patients with ischemic stroke and compared with that in 100 age- and sex-matched healthy adults. Demographic data, stroke severity measured by the National Institutes of Health Stroke Scale (NIHSS), and disability measured by the Barthel index (BI) were recorded. The association of MDA and TAP with other variables was analyzed by paired t-test. Results Of the whole sample, 74% represented males. The mean NIHSS score was 13.11 and BI was 38.87. MDA was significantly higher in stroke patients (7.11 ± 1.67) than in controls (1.64 ± 0.82; p = 0.00). TAP was significantly lower in stroke patients (5.72 ± 1.41) than in controls (8.53 ± 2.4; p = 0.00). The lipid profile and blood sugar levels were also significantly higher in stroke patients. There was no association of MDA and TAP with other variables. Conclusion We found that oxidative stress was associated with acute ischemic stroke. However, we could not establish an association between oxidative stress and the severity of acute stroke.

scholarly journals Korean Model for Post-acute Comprehensive rehabilitation (KOMPACT): The Study Protocol for a Pragmatic Multicenter Randomized Controlled Study on Early Supported Discharge

2021 ◽  
Vol 12 ◽  
Author(s):  
Won Kee Chang ◽  
Won-Seok Kim ◽  
Min Kyun Sohn ◽  
Sungju Jee ◽  
Yong-Il Shin ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Acute Stroke ◽  
Study Protocol ◽  
Transitional Care ◽  
Controlled Trial ◽  
Controlled Study ◽  
Care Model ◽  
Stroke Patients ◽  
Randomized Controlled ◽  
Early Supported Discharge

Introduction: Early supported discharge (ESD) is a transitional care model aimed at facilitating post-acute stroke patients' discharge to home. Previous studies have demonstrated that ESD provides equivalent patient and caregiver outcomes with superior cost-effectiveness compared to conventional rehabilitation (CR). This study intends to examine the feasibility of ESD in Korea.Methods and Analysis: This study is designed as a multicenter assessor-blinded, randomized controlled trial. Ninety post-acute stroke patients with mild to moderate disability (modified Rankin Scale 1–3) will be recruited from three university hospitals (30 patients per hospital) in Korea and allocated to either the ESD group or the CR group in a 1:1 ratio. Patients in the ESD group will receive individualized discharge planning and goal setting, a 4-week home-based rehabilitation program, and liaison service to community-based resources by a multidisciplinary team. Patients in the CR group will receive rehabilitation practices according to their current hospital policy.Outcomes: The primary outcome is the Korean version of the modified Barthel Index, and the primary endpoint was post-onset 3 months. Clinical outcomes, patient/caregiver reported outcomes, and socioeconomic outcomes will be measured at baseline, 1 month after discharge, 2 months after discharge, and 3 months after onset.Discussion: The efficacy and cost-effectiveness of ESD can vary according to the healthcare system and sociocultural aspects. To establish ESD as an alternative transitional care model for post-acute stroke patients in Korea, its feasibility needs to be examined in prior. This study will add evidence on the applicability of ESD in Korea.Ethical Considerations: The study protocol was reviewed and approved by the Institutional Review Board of Seoul National University Bundang Hospital (IRB number B-2012/654-308). The study protocol was registered at ClinicalTrials.gov (Identifier NCT04720820). Disseminations will include submission to peer-reviewed journals and presentations at conferences.

scholarly journals Role of Diffusion Weighted Imaging in Enhancing MR Imaging in Recent Is-chemic Stroke Patients

2020 ◽  
Vol 35 (2) ◽  
pp. 104-115
Author(s):  
Hajer A. Alfadeel
Keyword(s):  
Acute Stroke ◽  
Spin Echo ◽  
Haemorrhagic Stroke ◽  
P Value ◽  
Consecutive Series ◽  
Stroke Patients ◽  
First Line ◽  
Diffusion Weighted ◽  
Significant Difference

Stroke is a common cause of admission to hospitals, and imaging in acute stroke is necessary to differentiate ischemic from haemorrhagic stroke and to exclude other diagnoses. This study aimed to evaluate the role of diffusion-weighted magnetic resonance imaging (DW MRI) in the diagnosis of recent cerebral ischemic infarction in a consecutive series of patients with symptoms of acute stroke and its feasibility as first-line imaging for those patients. We report our results with DWI and apparent diffusion coefficient (ADC) mapping comparing the sensitivity of DWI with that of conventional T2 weighted and fluid-attenuated inversion recovery (FLAIR) MRI. A Prospective audit of 87 patients with clinically suspected recent stroke referred for imaging over a consecutive 20-week period was done. The data collected included patient age, time from onset of symptoms, and clinical presentation. DWI echo planar, FLAIR, and turbo spin-echo T2-weighted MRI were performed, and ADC maps were generated. Conventional MR images were assessed before DW images. DWI was considered positive for the diagnosis of new arterial stroke whenever hyperintensities with reduced ADC values were observed, and the site of infarct detected on the images was included in patients’ data. The results were 47 patients had a final diagnosis of recent ischemic cerebral infarct. With DWI, 98% of the ischemic lesions were detected, whereas with FLAIR, only 70% were detected, and with T2-weighted images, 66% of lesions were found. There was a significant difference between the results of ischemic infarcts’ detection on DWI and T2-w/FLAIR in relation to time from onset (P value = .012). In this study, I was able to image 68% (60 of 87) of the referred suspected stroke patients with DW MRI within 48 hours and 39 patients (45%) within 24 hours of the onset of symptoms. DW MRI showed high sensitivity and superiority over conventional T2 and FLAIR imaging for the detection of acute ischemic lesions in stroke patients; it also proved quite feasible as a first-line of neuroimaging.  

Abstract TMP78: Tick Tock we Don't Stop - 24/7 Stroke Nurse Clinician Response Improves Care in the Stroke Patient

Stroke ◽  
2016 ◽  
Vol 47 (suppl_1) ◽  
Author(s):  
Mary Zimmermann
Keyword(s):  
Acute Stroke ◽  
Patient Outcomes ◽  
Stroke Patients ◽  
Stroke Treatment ◽  
Core Measure ◽  
Nurse Clinician ◽  
Multiple Challenges ◽  
Core Measures ◽  
Iv Tpa

Background: Large community hospitals often face multiple challenges in the emergent care of acute stroke patients. Some of these challenges include decreasing door to IV tPA (activase) time and consistently meeting core measures. The 24/7 utilization of specialized nurses (Stroke Clinicians) trained to respond to acute stroke patients in the ED and inpatient areas improves the outcomes for stroke patients. Utilizing the Stroke Clinician role for 24/7 response to all acute strokes improves each patient’s ability to access complex stroke treatment. Purpose: The purpose of implementing 24/7 Stroke Clinician coverage for the ED and all inpatient units was to reduce door to needle times for patients receiving tpa, to increase stroke core measure compliance, and to improve patient outcomes. In addition to responding to acute strokes, the Stroke Clinicians also provide concurrent chart review and patient education. Methods The role of the Stroke Clinician was expanded to provide acute stroke response coverage on a continual, 24/7 basis in the first quarter of 2015. Stroke Program administration discussed options for the expanded coverage and subsequently trained the Cardiovascular Clinicians to cover stroke call from 11pm to 7am. These clinicians were already in-house, thus no additional cost was associated with the coverage. Results: The door to needle times have consistently decreased from an average of 70 minutes to an average of 50 minutes. There has been a steady improvement in patient outcomes evidenced by doubling the number of stroke patients who have received endovascular therapy since the prior year. Conclusion: The implementation of 24 hours per day/7 days per week stroke clinician coverage improved IV tPA door to needle times, improved the utilization of endovascular stroke treatment, and improved compliance with the stroke core measures.

scholarly journals Newly Detected Atrial Fibrillation after Acute Stroke: A Narrative Review of Causes and Implications

Cardiology ◽  
2019 ◽  
Vol 144 (3-4) ◽  
pp. 112-121 ◽  
Author(s):  
Youcheng Wang ◽  
Yongsheng Qian ◽  
Daniel Smerin ◽  
Shujuan Zhang ◽  
Qingyan Zhao ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Ischemic Stroke ◽  
Acute Stroke ◽  
Adverse Outcomes ◽  
Stroke Recurrence ◽  
Stroke Patients ◽  
Increased Risk ◽  
Definition Of ◽  
Humoral Regulation

Cardiac arrhythmias occur frequently in patients with acute stroke, with atrial fibrillation (AF) being the most common. Newly detected AF may lead to increased risk of ischemic stroke, which in turn generates stroke recurrence and adverse outcomes. Currently, most studies are focusing on the role of AF in ischemic stroke and attributing cryptogenic ischemic stroke to previously undetected AF. However, in these studies, subjects used to have neither symptoms of palpitation nor evidence of AF. A better understanding of this association will contribute to the management and therapy for patients after clinical decisions regarding stroke patients. Currently, the definition of newly detected AF has not come to an agreement, and the pathophysiology remains incompletely understood, possibly involving complex alterations in both the autonomic network and humoral regulation. Therefore, this review aims to introduce the definition and epidemiology of newly detected AF after stroke with updated information and elucidate the potential pathophysi­ology, such as autonomic imbalance, catecholamine surge, poststroke systematic inflammation, and microvesicles and microRNAs.

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