The Hallym Stroke Registry: A Web-Based Stroke Data Bank with an Analysis of 1,654 Consecutive Patients with Acute Stroke

New treatments for acute stroke require a rapid triage system, which minimizes treatment delays and maximizes selection of eligible patients. Our aim was to create a score for assessing the probability of brain hemorrhage among patients with acute stroke based upon clinical information. Of 1805 patients in the Stroke Data Bank, 1273 had infarction (INF) and 237 had parenchymatous hemorrhage (HEM) verified by CT. INF and HEM discriminators were determined by logistic regression and used to create a score. ROC curve was used to choose the cut-point for predicting HEM (score <= 2), with sensitivity of 76% and specificity of 83%. External validation was done using the NOMASS cohort. Although the use of a practical score by emergency personnel cannot replace the gold-standard brain image differentiation of HEM from INF for thrombolytic therapy, this score can help to select patients for stroke trials and pre-hospital treatments, alert CT scan technicians, and warn stroke teams of incoming patients to reduce treatment delays.

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Abstract TMP82: National Stroke Registry is Feasible and Improves Stroke Care and Training in Nigeria: A Pilot Experience

Stroke ◽

10.1161/str.48.suppl_1.tmp82 ◽

2017 ◽

Vol 48 (suppl_1) ◽

Author(s):

Rufus Akinyemi ◽

Philip Adebayo ◽

Lukman Owolabi ◽

Reginald Obiako ◽

Kolawole Wahab ◽

...

Keyword(s):

Job Satisfaction ◽

Acute Stroke ◽

Stroke Care ◽

World Federation ◽

Multidisciplinary Teams ◽

Case Report Form ◽

Web Based ◽

Stroke Registry ◽

The Impact ◽

And Training

Introduction: There is data - driven evidence showing that stroke registries improve tracking, documentation and the quality of care for acute stroke patients in centres across all continents except Africa where data is lacking. We report findings from a pilot multi - centre stroke registry in Nigeria. Methods: A World Federation of Neurology/World Stroke Organization (WFN/WSO) supported stroke training programme collaborated with NIH - funded Stroke Investigative Research and Education Network (SIREN) Project to develop a web-based multicenter acute stroke registry in 13 tertiary hospitals across Nigeria. All suspected cases of stroke were recorded in a Stroke Log and CT- confirmed cases were entered into a case report form and a web-based platform (RedCAP). A one hour focus group discussion (FGD) was conducted among 7 site neurologists to evaluate the impact of the pilot programme on stroke care and training. Results: Over a 21 month period (October 2014 - June 2016), 1686 suspected cases of stroke were logged into the stroke log while 1391 brain - CT confirmed cases of stroke were logged onto RedCAP. Across all sites; mean age(SD) was 60.1 (14.2) years, 57.1% male, 78.9% had at least primary education, 67.5%, 31.0% and 1.5% had ischemic, hemorrhagic and ischemic stroke with hemorrhagic transformation respectively, 51.8% were admitted with severe stroke, hypertension was the dominant risk factor (78.7% of cases) and 21.8% died within 7 days. An FGD to evaluate impact showed improved stroke awareness, better CT rate, reduced time to CT, reduced short term mortality, improved training and competence of interns and residents, development of stroke multidisciplinary teams and better job satisfaction among site neurologists. Conclusion: A pilot multicenter national stroke registry is feasible and improves stroke care, training and neurologist job satisfaction in Nigeria.

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Role of a Stroke Data Bank in Evaluating Cerebral Infarction Subtypes: Patterns and Outcome of 1,776 Consecutive Patients from the Besançon Stroke Registry

Cerebrovascular Diseases ◽

10.1159/000016068 ◽

2000 ◽

Vol 10 (4) ◽

pp. 261-271 ◽

Cited By ~ 82

Author(s):

Thierry Moulin ◽

Laurent Tatu ◽

Fabrice Vuillier ◽

Eric Berger ◽

Didier Chavot ◽

...

Keyword(s):

Cerebral Infarction ◽

Data Bank ◽

Stroke Registry ◽

Stroke Data Bank

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THE IMPACT OF PRIOR USE OF ANTITHROMBOTIC AGENTS ON SEVERITY AND OUTCOME IN STROKE PATIENTS WITH ARTERIAL FIBRILLATION. THE JAPAN STROKE DATA BANK.

10.26226/morressier.5ab8f55cd462b8029238d4de ◽

2018 ◽

Author(s):

Kazutaka Sonoda

Keyword(s):

Data Bank ◽

Antithrombotic Agents ◽

Stroke Patients ◽

Prior Use ◽

Stroke Data Bank ◽

The Impact

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The Acute STroke Registry and Analysis of Lausanne (ASTRAL)

Stroke ◽

10.1161/strokeaha.110.596189 ◽

2010 ◽

Vol 41 (11) ◽

pp. 2491-2498 ◽

Cited By ~ 128

Author(s):

Patrik Michel ◽

Céline Odier ◽

Matthieu Rutgers ◽

Marc Reichhart ◽

Philippe Maeder ◽

...

Keyword(s):

Acute Stroke ◽

Stroke Registry

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Procedural Complications During Early Versus Late Endovascular Treatment in Acute Stroke

Stroke ◽

10.1161/strokeaha.120.031349 ◽

2021 ◽

Author(s):

Errikos Maslias ◽

Stefania Nannoni ◽

Federico Ricciardi ◽

Bruno Bartolini ◽

Davide Strambo ◽

...

Keyword(s):

Endovascular Treatment ◽

Acute Stroke ◽

Time Window ◽

National Institutes Of Health ◽

Late Time ◽

Short Term ◽

Term Outcome ◽

Stroke Registry ◽

Short Term Outcome ◽

Procedural Complications

Background and Purpose: Endovascular treatment (EVT) in acute ischemic stroke is effective in the late time window in selected patients. However, the frequency and clinical impact of procedural complications in the early versus late time window has received little attention. Methods: We retrospectively studied all acute ischemic strokes from 2015 to 2019 receiving EVT in the Acute Stroke Registry and Analysis of Lausanne. We compared the procedural EVT complications in the early (<6 hours) versus late (6–24 hours) window and correlated them with short-term clinical outcome. Results: Among 695 acute ischemic strokes receiving EVT (of which 202 were in the late window), 113 (16.3%) had at least one procedural complication. The frequency of each single, and for overall procedural complications was similar for early versus late EVT (16.2% versus 16.3%, P adj =0.90). Procedural complications lead to a significantly less favorable short-term outcome, reflected by the absence of National Institutes of Health Stroke Scale improvement in late EVT (delta-National Institutes of Health Stroke Scale-24 hours, −2.5 versus 2, P adj =0.01). Conclusions: In this retrospective analysis of consecutive EVT, the frequency of procedural complications was similar for early and late EVT patients but very short-term outcome seemed less favorable in late EVT patients with complications.

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Dysphagia screening after intracerebral hemorrhage

International Journal of Stroke ◽

10.1177/1747493017729265 ◽

2017 ◽

Vol 13 (5) ◽

pp. 503-510 ◽

Cited By ~ 1

Author(s):

Raed A Joundi ◽

Rosemary Martino ◽

Gustavo Saposnik ◽

Vasily Giannakeas ◽

Jiming Fang ◽

...

Keyword(s):

Ischemic Stroke ◽

Intracerebral Hemorrhage ◽

Acute Stroke ◽

Clinical Severity ◽

Stroke Severity ◽

Stroke Registry ◽

Patients At Risk ◽

Poor Outcomes ◽

Risk Of Aspiration ◽

To Receive

Background Dysphagia screening is recommended after acute stroke to identify patients at risk of aspiration and implement appropriate care. However, little is known about the frequency and outcomes of patients undergoing dysphagia screening after intracerebral hemorrhage (ICH). Methods We used the Ontario Stroke Registry from 1 April 2010 to 31 March 2013 to identify patients hospitalized with acute stroke and to compare dysphagia screening rates in those with ICH and ischemic stroke. In patients with ICH we assessed predictors of receiving dysphagia screening, predictors of failing screening, and outcomes after failing screening. Results Among 1091 eligible patients with ICH, 354 (32.4%) patients did not have documented dysphagia screening. Patients with mild ICH were less likely to receive screening (40.4% of patients were omitted, adjusted odds ratio (aOR) 0.40, 95% confidence interval (CI) 0.26–0.63). Older age, greater stroke severity, speech deficits, lower initial level of consciousness, and admission to intensive care unit were predictive of failing the screening test. Failing screening was associated with poor outcomes, including pneumonia (aOR 5.3, 95% CI 2.36–11.88), severe disability (aOR 4.78, 95% CI 3.08–7.41), and 1-year mortality (adjusted hazard ratio 2.1, 95% CI 1.38–3.17). When compared to patients with ischemic stroke, patients with ICH were less likely to receive dysphagia screening (aOR 0.64, 95% CI 0.54–0.76) and more likely to fail screening (aOR 1.98, 95% 1.62–2.42). Conclusion One-third of patients with ICH did not have documented dysphagia screening, increasing to 40% in patients with mild clinical severity. Failing screening was associated with poor outcomes. Patients with ICH were less like to receive screening and twice as likely to fail compared to patients with ischemic stroke, and thus efforts should be made to include ICH patients in dysphagia screening protocols whenever possible.

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Registration of acute stroke: validity in the Danish Stroke Registry and the Danish National Registry of Patients

Clinical Epidemiology ◽

10.2147/clep.s50449 ◽

2013 ◽

pp. 27 ◽

Cited By ~ 30

Author(s):

Cathrine Wildenschild ◽

Mehnert, Frank ◽

Reimar W. Thomsen ◽

Helle Iversen ◽

Karsten Vestergaard ◽

...

Keyword(s):

Acute Stroke ◽

National Registry ◽

Stroke Registry

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Abstract T P267: Development of an EMS Interfacility Ground Transport Protocol for Patients During/After IV tPA Administration for Acute Ischemic Stroke

Stroke ◽

10.1161/str.45.suppl_1.tp267 ◽

2014 ◽

Vol 45 (suppl_1) ◽

Author(s):

Kerrin Connelly ◽

Rishi Gupta ◽

Raul Nogueira ◽

Arthur Yancey ◽

Alexander Isakov ◽

...

Keyword(s):

Ischemic Stroke ◽

Acute Stroke ◽

Acute Ischemic Stroke ◽

Transport Protocol ◽

Stroke Patients ◽

Stroke Registry ◽

The Public ◽

State Office ◽

Stroke Center ◽

Iv Tpa

Purpose: To standardize the care of acute stroke patients who receive IV tPA being transported by ground EMS from a treating hospital to a stroke center. Background: National consensus guidelines exist for the hospital management of patients receiving IV tPA for acute ischemic stroke. Such patients require close monitoring and management to minimize risk of clinical deterioration. Although patients are often emergently transported from local hospitals to a stroke center, there are no treatment specific national guidelines for managing such patients enroute. As a result, there is a need to develop and implement a standardized approach to guide EMS personnel, particularly in states like Georgia where the public health burden of stroke is high. Methods: In 2012, the “Georgia EMS Interfacility Ground Transport Protocol for Patients during/after IV tPA Administration for Acute Ischemic Stroke” was developed in conjunction with the Georgia Coverdell Acute Stroke Registry, the Georgia State Office of EMS, a representative group of Georgia hospitals and EMS providers. Stakeholders were brought together with the goal of creating a unified statewide protocol. The intent was to create a streamlined protocol which could be readily implemented by pre-hospital care providers. Results: Stakeholders discussed challenges and opportunities to change the process of pre-hospital care. Challenges included recognition of the broad diversity of EMS providers representing over 250 agencies in the state. Opportunities included establishing the framework for greater collaboration across organizations and providers. The final protocol was endorsed by both the Georgia Coverdell Acute Stroke Registry and the State Office of EMS, and distributed to all EMS regions in Georgia. EMS agencies are currently implementing the protocol. Conclusion: Engaging a diverse group of statewide stakeholders to develop a new treatment protocol enhances success in implementation and serves to further the public health mission of improving care of acute stroke patients.

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