Rapid Risk Stratification of Acute Ischemic Stroke Patients in the Emergency Department: The Incremental Prognostic Role of Left Atrial Reservoir Strain

2021 ◽  
Vol 30 (11) ◽  
pp. 106100
Author(s):  
Andrea Sonaglioni ◽  
Marianna Di Cara ◽  
Gian Luigi Nicolosi ◽  
Alessandro Eusebio ◽  
Marco Bordonali ◽  
...  
2017 ◽  
Vol 136 (6) ◽  
pp. 672-679 ◽  
Author(s):  
H.-Z. Bei ◽  
S.-J. You ◽  
D. Zheng ◽  
C.-K. Zhong ◽  
H.-P. Du ◽  
...  

Stroke ◽  
2003 ◽  
Vol 34 (11) ◽  
pp. 2599-2603 ◽  
Author(s):  
Anna Cavallini ◽  
Giuseppe Micieli ◽  
Simona Marcheselli ◽  
Silvana Quaglini

Stroke ◽  
2021 ◽  
Vol 52 (Suppl_1) ◽  
Author(s):  
Nicolle W Davis ◽  
Meghan Bailey ◽  
Natalie Buchwald ◽  
Amreen Farooqui ◽  
Anna Khanna

Background/Objective: There is growing importance on discovering factors that delay time to intervention for acute ischemic stroke (AIS) patients, as rapid intervention remains essential for better patient outcomes. The management of these patients involves a multidisciplinary effort and quality improvement initiatives to safely increase treatment with intravenous thrombolytic (IV tPa). The objective of this pilot is to evaluate factors of acute stroke care in the emergency department (ED) and the impact they have on IV tPa administration. Methods: A sample of 89 acute ischemic stroke patients that received IV tPa from a single academic medical institution was selected for retrospective analysis. System characteristics (presence of a stroke nurse and time of day) and patient characteristics (mode of arrival and National Institutes of Health Stroke Scale score (NIHSS) on arrival) were analyzed using descriptive statistics and multiple regression to address the study question. Results: The mean door to needle time is 53.74 minutes ( + 38.06) with 74.2% of patients arriving to the ED via emergency medical services (EMS) and 25.8% having a stroke nurse present during IV tPa administration. Mode of arrival ( p = .001) and having a stroke nurse present ( p = .022) are significant predictors of door to needle time in the emergency department (ED). Conclusion: While many factors can influence door to needle times in the ED, we did not find NIHSS on arrival or time of day to be significant factors. Patients arriving to the ED by personal vehicle will have a significant delay in IV tPa administration, therefore emphasizing the importance of using EMS. Perhaps more importantly, collaborative efforts including the addition of a specialized stroke nurse significantly decreased time to IV tPa administration for AIS patients. With this dedicated role, accelerated triage and more effective management of AIS patients is accomplished, leading to decreased intervention times and potentially improving patient outcomes.


Author(s):  
Hye-Young Shin ◽  
In-Hye Jeong ◽  
Chang-Ki Kang ◽  
Dong-Jin Shin ◽  
Hyeon-Mi Park ◽  
...  

2020 ◽  
Vol 11 (01) ◽  
pp. 156-159
Author(s):  
Bindu Menon ◽  
Krishnan Ramalingam ◽  
Rajeev Kumar

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.


Neurosurgery ◽  
2019 ◽  
Vol 85 (suppl_1) ◽  
pp. S47-S51
Author(s):  
Kimberly P Kicielinski ◽  
Christopher S Ogilvy

Abstract As ischemic stroke care advances with more patients eligible for mechanical thrombectomy, so too does the role of the neurosurgeon in these patients. Neurosurgeons are an important member of the team from triage through the intensive care unit. This paper explores current research and insights on the contributions of neurosurgeons in care of acute ischemic stroke patients in the acute setting.


2019 ◽  
Vol 26 (3-4) ◽  
pp. 30-34
Author(s):  
Al Rasyid ◽  
Salim Harris ◽  
Mohammad Kurniawan ◽  
Taufik Mesiano ◽  
Rakhmad Hidayat

Background: To assess the role of risk factors of metabolic syndrome on blood viscosity and the prognosis of acute ischemic stroke in Indonesia based on the National Institute of Health Stroke Scale (NIHSS) and modified Rankin Scale (mRS). Methods: This study included 135 patients with acute ischemic stroke. Patients underwent measurements of viscosity and risk factor assessment. Analysis was performed to assess the role of these risk factors for blood viscosity and outcomes of acute ischemic stroke with NIHSS and mRS as indicators. NIHSS was assessed at <3 days after onset and 7 days after onset, while mRS was assessed 1 month post treatment. Bivariate analysis was performed using chi-square test, and variables with p < 0.25 were further analyzed in multivariate analysis using logistic regression. Results: Factors affecting blood viscosity are fibrinogen, low-density lipoprotein (LDL), and hematocrit. Factors affecting NIHSS and mRS are fibrinogen and LDL. Conclusion: Fibrinogen and LDL affect the viscosity of blood and outcomes in acute ischemic stroke patients, so it is necessary to treat in the primary and secondary prevention of ischemic stroke.


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