The Carotid Surgery for Ischemic Stroke trial: A prospective observational study on carotid endarterectomy in the early period after ischemic stroke

The objective of this study is to assess the impact of recanalization (spontaneous and therapeutic) on upper limb functioning and general patient functioning after stroke. This is a prospective, observational study of patients hospitalized due to acute ischemic stroke in the territory of the middle cerebral artery (n = 98). Patients completed a comprehensive rehabilitation program and were followed-up for 24 weeks. The impact of recanalization on patient functioning was evaluated using the modified Rankin Scale (mRS) and Stroke Upper Limb Capacity Scale (SULCS). General and upper limb functioning improved markedly in the first three weeks after stroke. Age, gender, and National Institutes of Health Stroke Scale (NIHSS) score at admission were associated with general and upper limb functioning at 12 weeks. Successful recanalization was associated with better functioning. Among patients who underwent therapeutic recanalization, NIHSS scores ≥16.5 indicate lower general functioning at 12 weeks (sensibility = 72.4%; specificity = 78.6%) and NIHSS scores ≥13.5 indicate no hand functioning at 12 weeks (sensibility = 83.8%; specificity = 76.5%). Recanalization, either spontaneous or therapeutic, has a positive impact on patient functioning after acute ischemic stroke. Functional recovery occurs mostly within the first 12 weeks after stroke, with greater functional gains among patients with successful recanalization. Higher NIHSS scores at admission are associated with worse functional recovery.

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A prospective observational study on the clinical profile of ischemic stroke in a tertiary care centre in Thrissur, Kerala

International Journal of Medical Research and Review ◽

10.17511/ijmrr.2016.i08.15 ◽

2016 ◽

Vol 4 (8) ◽

pp. 1371-1375

Author(s):

Dr Mary Grace N C ◽

◽

Dr Shameer V K ◽

Dr Rajesh K R ◽

Dr Raju Raghavan ◽

...

Keyword(s):

Ischemic Stroke ◽

Observational Study ◽

Prospective Observational Study ◽

Tertiary Care ◽

Clinical Profile ◽

Care Centre ◽

Tertiary Care Centre

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Stroke in the Middle-East and North Africa: A 2-year prospective observational study of stroke characteristics in the region—Results from the Safe Implementation of Treatments in Stroke (SITS)–Middle-East and North African (MENA)

International Journal of Stroke ◽

10.1177/1747493019830331 ◽

2019 ◽

Vol 14 (7) ◽

pp. 715-722 ◽

Cited By ~ 5

Author(s):

Suhail Al Rukn ◽

Michael V Mazya ◽

Faycal Hentati ◽

Samia Ben Sassi ◽

Fatma Nabli ◽

...

Keyword(s):

Ischemic Stroke ◽

Middle East ◽

Observational Study ◽

Prospective Observational Study ◽

Large Artery ◽

North African ◽

Stroke Incidence ◽

Stroke Units ◽

Mena Countries ◽

Incidence And Mortality

Background and methods Stroke incidence and mortality are reported to have increased in the Middle-East and North African (MENA) countries during the last decade. This was a prospective observational study to examine the baseline characteristics of stroke patients in the MENA region and to compare the MENA vs. the non-MENA stroke cohort in the Safe Implementation of Treatments in Stroke (SITS) International Registry. Results Of the 13,822 patients with ischemic and hemorrhagic stroke enrolled in the SITS-All Patients Protocol between June 2014 and May 2016, 5897 patients (43%) were recruited in MENA. The median onset-to-door time was 5 h (IQR: 2:20–13:00), National Institutes of Health Stroke Scale (NIHSS) score was 8 (4–13) and age was 65 years (56–76). Hypertension (66%) and diabetes (38%) were the prevailing risk factors; large artery stenosis > 50% (25.3%) and lacunar strokes (24.1%) were the most common ischemic stroke etiologies. In comparison, non-MENA countries displayed an onset-to-door time of 5:50 h (2:00–18:45), a median of NIHSS 6 (3–14), and a median age of 66 (56–76), with other large vessel disease and cardiac embolism as the main ischemic stroke etiologies. Hemorrhagic strokes (10%) were less common compared to non-MENA countries (13.9%). In MENA, only a low proportion of patients (21%) was admitted to stroke units. Conclusions MENA patients are slightly younger, have a higher prevalence of diabetes and slightly more severe ischemic strokes, commonly of atherosclerotic or microvascular etiology. Admission into stroke units and long-term follow-up need to be improved. It is suspected that cardiac embolism and atrial fibrillation are currently underdiagnosed in MENA countries.

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Homeostasis model assessment of insulin resistance and outcome of ischemic stroke in non-diabetic patients - a prospective observational study

BMC Neurology ◽

10.1186/s12883-019-1406-3 ◽

2019 ◽

Vol 19 (1) ◽

Cited By ~ 2

Author(s):

Daniel Åberg ◽

N. David Åberg ◽

Katarina Jood ◽

Lukas Holmegaard ◽

Petra Redfors ◽

...

Keyword(s):

Insulin Resistance ◽

Ischemic Stroke ◽

Observational Study ◽

Prospective Observational Study ◽

Diabetic Patients ◽

Model Assessment ◽

Homeostasis Model Assessment

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Stroke in the Middle-East and North Africa: A 2-year prospective observational study of intravenous thrombolysis treatment in the region. Results from the SITS-MENA Registry

International Journal of Stroke ◽

10.1177/1747493019874729 ◽

2019 ◽

Vol 15 (9) ◽

pp. 980-987 ◽

Cited By ~ 1

Author(s):

S Al-Rukn ◽

M Mazya ◽

N Akhtar ◽

H Hashim ◽

B Mansouri ◽

...

Keyword(s):

Ischemic Stroke ◽

Middle East ◽

Observational Study ◽

Prospective Observational Study ◽

Treatment Time ◽

Intravenous Thrombolysis ◽

Functional Independence ◽

Stroke Severity ◽

University Hospitals ◽

Mena Region

Background and methods Intravenous thrombolysis for acute ischemic stroke in the Middle-East and North African (MENA) countries is still confined to the main urban and university hospitals. This was a prospective observational study to examine outcomes of intravenous thrombolysis-treated stroke patients in the MENA region compared to the non-MENA stroke cohort in the SITS International Registry. Results Of 32,160 patients with ischemic stroke registered using the SITS intravenous thrombolysis protocol between June 2014 and May 2016, 500 (1.6%) were recruited in MENA. Compared to non-MENA (all p < 0.001), median age in MENA was 55 versus 73 years, NIH Stroke Scale score 12 versus 9, onset-to-treatment time 138 versus 155 min and door-to-needle time 54 min versus 64 min. Hypertension was the most reported risk factor, but lower in MENA (51.7 vs. 69.7%). Diabetes was more frequent in MENA (28.5 vs. 20.8%) as well as smoking (20.8 vs. 15.9%). Hyperlipidemia was less observed in MENA (17.6 vs. 29.3%). Functional independence (mRS 0–2) at seven days or discharge was similar (53% vs. 52% in non-MENA), with mortality slightly lower in MENA (2.3% vs. 4.8%). SICH rates by SITS-MOST definition were low (<1.4%) in both groups. Conclusions Intravenous thrombolysis patients in MENA were younger, had more severe strokes and more often diabetes. Although stroke severity was higher in MENA, short-term functional independency and mortality were not worse compared to non-MENA, which could partly be explained by younger age and shorter OTT in MENA. Decreasing the burden of stroke in this young population should be prioritized.

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Plasma C-Reactive Protein and Clinical Outcomes after Acute Ischemic Stroke: A Prospective Observational Study

PLoS ONE ◽

10.1371/journal.pone.0156790 ◽

2016 ◽

Vol 11 (6) ◽

pp. e0156790 ◽

Cited By ~ 22

Author(s):

Ryu Matsuo ◽

Tetsuro Ago ◽

Jun Hata ◽

Yoshinobu Wakisaka ◽

Junya Kuroda ◽

...

Keyword(s):

Ischemic Stroke ◽

Observational Study ◽

Acute Ischemic Stroke ◽

Clinical Outcomes ◽

Prospective Observational Study ◽

C Reactive Protein ◽

Reactive Protein

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Preoperative anxiety as predictor of perioperative clinical events following carotid surgery: a prospective observational study

Perioperative Medicine ◽

10.1186/s13741-021-00223-2 ◽

2021 ◽

Vol 10 (1) ◽

Author(s):

Manuela Aspalter ◽

Florian K. Enzmann ◽

Thomas J. Hölzenbein ◽

Wolfgang Hitzl ◽

Florian Primavesi ◽

...

Keyword(s):

Observational Study ◽

Vascular Surgery ◽

Prospective Observational Study ◽

Depression Scale ◽

Composite Endpoint ◽

Preoperative Anxiety ◽

Anxiety And Depression ◽

Published Data ◽

Carotid Surgery ◽

Asymptomatic Patients

Abstract Background Psychological factors like anxiety and depression are recognised to play a causal role in the development of cardiovascular disease and they may also influence outcome after vascular surgery procedures. The aim of this study was to investigate the association of anxiety and depression with postoperative outcome following elective carotid surgery. Methods Single centre prospective observational study of patients treated for asymptomatic carotid artery stenosis at an academic vascular surgery centre. Preoperative anxiety and depression were evaluated using self-reporting questionnaires: Spielberger State-Trait Anxiety Inventory (STAI-S/-T) and Hospital Anxiety and Depression Scale (HADS-A/-D). Postoperative morbidity and mortality were assessed with the primary composite endpoint of stroke, myocardial infarction (MI) and death. Standard reporting guidelines for carotid disease were applied. Results From June 2012 to November 2015, 393 carotid endarterectomies (CEA) were performed at our institution. Out of those, 98 asymptomatic patients were available for analysis (78% male; median age, 71.1 years). Median scores of self-reporting questionnaires did not differ from published data of the general population (STAI-T, trait component, median, 36; IQR, 31-42.75; STAI-S, state component, median, 38; IQR, 32-43; HADS-A median, 6; IQR, 3-8; HADS-D median, 4; IQR, 2-7). Cardiovascular risk factors were similar in anxious and non-anxious patients. The composite endpoint of stroke, MI and death occurred significantly more often in patients presenting with a preoperative HADS-A score higher than 6 (10.5%, 95% CI, 3-25; p =.020). Conclusions The present study indicates that preoperative anxiety is associated with the occurrence of intra- and postoperative neurological events in patients undergoing CEA. Patients who had a preoperative HADS-A score of 6 or less had a very low probability of experiencing these complications.

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