Hyperglycemia predicts unfavorable outcomes in acute ischemic stroke patients treated with intravenous thrombolysis among a Chinese population: A prospective cohort study

2018 ◽  
Vol 388 ◽  
pp. 195-202 ◽  
Author(s):  
Sheng-Feng Lin ◽  
A-Ching Chao ◽  
Han-Hwa Hu ◽  
Ruey-Tay Lin ◽  
Chih-Hung Chen ◽  
...  
2020 ◽  
Vol 10 (12) ◽  
pp. 911
Author(s):  
Fabio Pilato ◽  
Serena Silva ◽  
Iacopo Valente ◽  
Marisa Distefano ◽  
Aldobrando Broccolini ◽  
...  

Although thrombectomy is beneficial for most stroke patients with large vessel occlusion (LVO), it has added new issues in acute management due to intensive care support. In this prospective cohort study, we described the patients admitted to our neuro-intensive care unit (NICU) after thrombectomy in order to assess factors linked to functional outcomes. The outcome was independency assessed for stroke patients consecutively admitted to NICU for an ischemic stroke due to LVO of the anterior cerebral circulation that underwent intra-arterial mechanical thrombectomy (IAMT), either in combination with intravenous thrombolysis (IVT) in eligible patients or alone in patients with contraindications for IVT. Overall, 158 patients were enrolled. IVT (odds ratio (OR), 3.78; 95% confidence interval (CI), 1.20–11.90; p = 0.023) and early naso-gastric tube removal (OR, 3.32; 95% CI, 1.04–10.59 p = 0.042) were associated with good outcomes, whereas a high baseline National Institutes of Health Stroke Scale (NIHSS) score (OR, 0.72 for each point of increase; 95% CI, 0.61–0.85; p < 0.001) was a predictor of poor outcomes at 3 months. Older age (OR, 0.95 for each year of increase; 95% CI, 0.92–0.99; p = 0.020) and hemorrhagic transformation (OR, 0.31; 95% CI, 0.11–0.84; p = 0.022) were predictors of poor outcomes after IAMT, whereas a modified Treatment in Cerebral Infarction (mTICI) score of 2b/3 was a predictor of good outcomes (OR, 7.86; 95% CI, 1.65–37.39; p = 0.010) at 6 months. Our results show that acute stroke patients with LVO who require NICU management soon after IAMT may show specific clinical factors influencing short- and long-term neurologic independency.


2021 ◽  
Vol 429 ◽  
pp. 119710
Author(s):  
Mojdeh Ghabaee ◽  
Ghasem Farahmand ◽  
Pargol Balali ◽  
Hana Magrouni ◽  
Fatemeh Alizadeh-Broujeni ◽  
...  

2021 ◽  
Author(s):  
Guangzong Li ◽  
Jie Li ◽  
Chen Zhu ◽  
Jing Ye ◽  
Bin Wang ◽  
...  

Abstract Background. Recent evidence suggest elevated periostin is associated with cardiovascular diseases. The aim of this study was to investigate the relationship between serum periostin and post-stroke cognitive impairment (PSCI) at 3 months. Methods. In this prospective cohort study, we enrolled patients with ischemic stroke and hospitalized within 7 days of symptoms onset from January 2019 to January 2020. Serum periostin levels were measured using enzyme-linked immunosorbent assay after admission. Cognitive function assessment was performed at 3-month follow-up visit using the Montreal Cognitive Assessment (MoCA). We defined the PSCI as total MoCA score < 25. Results. A total of 315 ischemic stroke patients were enrolled for the study. PSCI was observed in 173 patients, which accounted for 54.9% (95% confidence interval [CI] 52.1%–57.7%) of the cohort. Serum periostin levels were higher in patients with PSCI than in those without PSCI (median 19.6 vs 14.8 ng/mL; P = 0.001). In logistic regression analysis, the highest quartile of periostin levels were significantly correlated to PSCI (odds ratio [OR], 9.69; 95% CI, 5.06–25.61; P = 0.001), as compared with the lowest quartile. This association remained significant after adjustment for age, gender, educational years, stroke severity, and vascular risk factors. Subgroup analyses further confirmed these results. Furthermore, restricted cubic spline regression demonstrated a linear association between periostin levels and PSCI (P = 0.001 for linearity).Conclusions. This study found that higher serum periostin levels are associated with an increased risk of PSCI at 3 months after ischemic stroke onset.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
M. J. de Mooij ◽  
I. Ahayoun ◽  
J. Leferink ◽  
M. J. Kooij ◽  
F. Karapinar-Çarkit ◽  
...  

Abstract Introduction Approximately two-thirds of the patients admitted to the hospital with an ischemic stroke are discharged directly home. Discontinuity of care may result in avoidable patient harm, re-admissions and even death. We hypothesized that the transfer of information is most essential in this patient group since any future care for these patients relies solely on the information that is available to the care provider responsible at that time. Aim The objective of this study was to evaluate the continuity of transmural care in ischemic stroke patients by assessing 1) the transfer of clinical information through discharge letters to general practitioners (GPs), 2) subsequent documentation of this information and early follow-up by GPs and 3) the documentation of medication-related information in discharge letters, at GPs and community pharmacies (CPs). Methods This prospective cohort study was conducted from September 2019 through March 2020 in OLVG, Amsterdam, the Netherlands, in patients with a first stroke discharged directly home. Outcome measures were derived from national guidelines and regional agreements. Results were analyzed using descriptive analysis. Results A total of 33 patients were included. Discharge letters (n = 33) and outpatient clinic letters (n = 24) to GPs contained most of the essential items, but 16% (n = 9) of the letters were sent in time. GPs (n = 31) infrequently adhered to guidelines since 10% (n = 3) of the diagnoses were registered using the correct code and 55% (n = 17) of the patients received follow-up shortly after discharge. Medication overviews were inaccurately communicated to GPs since 62% (n = 150) of all prescriptions (n = 243) were correctly noted in the discharge letter. Further loss of information was seen as only 39% (n = 95) of all prescriptions were documented correctly in GP overviews. We found that 59% (n = 144) of the prescriptions were documented correctly in CP overviews. Conclusion In this study, we found that discontinuity of care occurred to a varying extent throughout transmural care in patients with a first stroke who were discharged home.


Sign in / Sign up

Export Citation Format

Share Document