scholarly journals Embolic stroke of undetermined source (ESUS) cohort of Brazilian patients in a university hospital

2019 ◽  
Vol 77 (5) ◽  
pp. 315-320
Author(s):  
Gabriel Pinheiro Modolo ◽  
Juli Thomaz De Souza ◽  
Fernanda Cristina Winckler ◽  
Natalia Cristina Ferreira ◽  
Marcos Cristiano Lange ◽  
...  
Keyword(s):  
Risk Factors ◽  
Medical Records ◽  
Health Financing ◽  
National Institutes Of Health ◽  
Embolic Stroke ◽  
University Hospital ◽  
Stroke Patients ◽  
Important Group ◽  
Small Cohort ◽  
The Mean

ABSTRACT Embolic stroke of undetermined source (ESUS) is an important group of cryptogenic strokes that are in evidence due recent ongoing trials. We reviewed medical records at discharge from the stroke unit of all patients who met ESUS criteria and attended our institution between February 2016 and July 2017. Among 550 stroke patients, 51 had ESUS. We found that hypertension (60%), diabetes mellitus (34%), and smoking (36%) were the most prevalent risk factors. The mean National Institutes of Health Stroke Scale (NIHSS) scores were 7 at admission and 4 at discharge, while median scores on the modified Rankin scale were 0 and 2 at admission and discharge, respectively. Our sample had similar ages, risk factors prevalence and NIHSS scores at admission and discharge when compared with European and North American cohorts. Although a small cohort, our study suggests that the ESUS population is similar in countries with different health financing.

scholarly journals Statistical Data About Risk Factors and Pregnancy Outcome of Placenta Previa

2018 ◽  
Vol 14 (15) ◽  
pp. 27
Author(s):  
Kashami Arian ◽  
Troshani Amela ◽  
Shabani Zamira
Keyword(s):  
Risk Factors ◽  
Medical Records ◽  
Statistical Data ◽  
Placenta Previa ◽  
Economic Status ◽  
University Hospital ◽  
Uterine Surgery ◽  
Different Types ◽  
Maternal And Neonatal Outcomes ◽  
The Mean

Placenta previa is a placental location close to or over the internal cervical os. The aim of this study was to evaluate: risk factors, maternal and neonatal outcomes in patients with placenta previa. Material and methods: We conducted a retrospective cohort study of 38 women who have had a caesarean section for placenta previa at a tertiary referral University Hospital of Obstetrics and Gynecology “Koço Gliozheni” in Tirana, Albania. The period of this study was from January 2015 to March 2018. Maternal and neonatal data were obtained from medical records and the hospital database system. All cases of placenta previa were managed by medical team, obstetric consultants and all data were calculated with SPSS.20 program. Results: In total, 38 women with placenta previa were classified in three different types of placenta previa: Marginal placenta previa occurred in 16 women(42.1%), Complete placenta previa occurred in 19 women(50%) and with accreta placenta previa in 3 women(7.9%). The mean age of mothers was 30,61 years old, mode = 35, median = 30 and Std. deviation = 4.641 years. Conclusions: The prevalence rate of section caesarean and placenta previa is increased during the years. Several obstetrical factors have been found to be risk for placenta previa including: advancing maternal age, previous caesarean delivery, previous abortions, previous uterine surgery, multiparity, previous placenta previa, low socio-economic status, mother’s cigarette smoking /alcohol use. Placenta previa is associated with an increase in preterm birth and neonatal and maternal outcome. Other complications of pregnancy can be associated with placenta previa, but the majority of women deliver healthy babies.

scholarly journals Correlation of neutrophil-to-lymphocyte ratio and clinical outcome of acute thrombotic stroke in patients with COVID-19

Narra J ◽  
2021 ◽  
Vol 1 (3) ◽  
Author(s):  
Rizky Sarengat ◽  
Mohammad S. Islam ◽  
Mohammad S. Ardhi
Keyword(s):  
Ischemic Stroke ◽  
Clinical Outcome ◽  
Acute Ischemic Stroke ◽  
National Institutes Of Health ◽  
Neutrophil To Lymphocyte Ratio ◽  
Stroke Patients ◽  
Cross Sectional ◽  
Lymphocyte Ratio ◽  
Life Threatening ◽  
The Mean

The coronavirus disease 2019 (COVID-19) pandemic has caused millions of deaths worldwide. Acute ischemic stroke is a life-threatening risk factor for COVID-19 infection. Neutrophil-to-lymphocyte ratio (NLR) is one of the predictors of poor prognosis in acute ischemic stroke. The aim of this study was to assess the correlation between NLR values and the clinical outcome of acute thrombotic stroke patients with COVID-19 that was measured using the National Institutes of Health Stroke Scale (NIHSS). A cross-sectional hospital-based study was conducted in Dr. Soetomo General Hospital Surabaya, Indonesia. Patients with acute thrombotic stroke and COVID-19 admitted between 1 March 2020 and 31 May 2021 were recruited. The NLR values and the NIHSS scores were assessed during the admission and the correlation between NLR and NIHSS scores was calculated. This study included 21 patients with acute thrombotic stroke and COVID-19, consisting of 12 males and 9 females. The mean age was 57.6 years old. The mean NLR values was 8.33±6.7 and the NIHSS scores ranging from 1 to 33. Our data suggested a positive correlation between NLR values and NIHSS scores, r=0.45 with p=0.041. In conclusion, the NLR value is potentially to be used as a predictor of the clinical outcome in acute thrombotic stroke patients with COVID-19. However, further study is warranted to validate this finding.

Venous Thromboembolism in Patients With Thrombocytopenia: Risk Factors, Treatment, and Outcome

2015 ◽  
Vol 23 (4) ◽  
pp. 345-350 ◽  
Author(s):  
Jens Kristian Baelum ◽  
Espen Ellingsen Moe ◽  
Mads Nybo ◽  
Pernille Just Vinholt
Keyword(s):  
Risk Factors ◽  
Platelet Count ◽  
Venous Thromboembolism ◽  
Blood Cells ◽  
Medical Records ◽  
Odds Ratio ◽  
Conditional Logistic Regression ◽  
University Hospital ◽  
Hospital Department ◽  
Bleeding Episodes

Background: Venous thromboembolism (VTE) is a frequent and potentially lethal condition. Venous thrombi are mainly constituted of fibrin and red blood cells, but platelets also play an important role in VTE formation. Information about VTE in patients with thrombocytopenia is, however, missing. Objectives: To identify VTE risk factors and describe treatment and outcome (bleeding episodes and mortality) in patients with thrombocytopenia. Patients/Methods: Patients with thrombocytopenia (platelet count <100 × 109/L) admitted to Odense University Hospital, Denmark, between April 2000 and April 2012 were included. Fifty cases had experienced VTE. Controls without VTE were matched 3:1 with cases on sex and hospital department. Medical records were examined, and data were analyzed using conditional logistic regression. Results: In multivariate analysis, platelet count <50 × 109/L (odds ratio [OR] 0.22, P < .05) and chronic liver disease (OR 0.05, 95% confidence interval [CI] 0.01-0.58) reduced the risk of VTE. Surgery (OR 6.44, 95% CI 1.37-30.20) and previous thromboembolism (OR 6.16, 95% CI 1.21-31.41) were associated with an increased VTE risk. Ninety-two percent of cases were treated with anticoagulants. There was no difference in bleeding incidence between cases and controls. Conclusions: Several known VTE risk factors also seems to apply in patients with thrombocytopenia. Also, patients with thrombocytopenia may be VTE risk stratified based on platelet count and comorbidities. Finally, patients having thrombocytopenia with VTE seem to be safely treated with anticoagulants without increased occurrence of bleeding.

Risk Factors Associated With Pressure Ulcers in Patients With Traumatic Brain Injury Admitted to the Intensive Care Unit

2021 ◽  
pp. 105477382110504
Author(s):  
Jeong Eun Yoon ◽  
Ok-Hee Cho
Keyword(s):  
Risk Factors ◽  
Intensive Care Unit ◽  
Traumatic Brain Injury ◽  
Intensive Care ◽  
Brain Injury ◽  
Medical Records ◽  
Injury Severity ◽  
University Hospital ◽  
Factors Associated ◽  
Braden Scale

Pressure injuries (PIs) are one of the most important and frequent complications in patients admitted to the intensive care unit (ICU) or those with traumatic brain injury (TBI). The purpose of this study was to determine the incidence and risk factors of PIs in patients with TBI admitted to the ICU. In this retrospective study, the medical records of 237 patients with TBI admitted to the trauma ICU of a university hospital were examined. Demographic, trauma-related, and treatment-related characteristics of all the patients were evaluated from their records. The incidence of PIs was 13.9%, while the main risk factors were a higher injury severity score, use of mechanical ventilation, vasopressor infusion, lower Braden Scale score, fever, and period of enteral feeding. This study advances the nursing practice in the ICU by predicting the development of PIs and their characteristics in patients with TBI.

scholarly journals Clot composition of embolic strokes of undetermined source: a feasibility study

BMC Neurology ◽  
2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Amre Nouh ◽  
Tapan Mehta ◽  
Mohamed Hussain ◽  
Xianyuan Song ◽  
Martin Ollenschleger
Keyword(s):  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Mechanical Thrombectomy ◽  
National Institutes Of Health ◽  
Carotid Dissection ◽  
Stroke Patients ◽  
Stroke Etiology ◽  
The Mean ◽  
Undetermined Etiology ◽  
A Prospective Study

Abstract Background A number of emerging studies have evaluated clot composition in acute ischemic stroke. Studies of clot composition of embolic strokes of undetermined strokes are lacking. Objectives We sought to analyze the RBC to platelet ratios in clots and correlated our findings with stroke etiology. Methods This was a prospective study analyzing clots retrieved by mechanical thrombectomy in acute ischemic stroke patients at our institution. All clots were stained and scanned at 200x magnification by using a Scanscope XT digital scanner (Apergio, Vista, California). Image-J software (National Institutes of Health, Bethesda, Maryland) was used for semi quantitative analysis of percentage RBC’s and platelets. Unpaired t-test was used to compare means of RBC to Platelet ratios. Correlation of RBC to Platelet ratios with stroke etiology was performed. Results A total of 33 clots from 33 patients were analyzed. Stroke etiology was undetermined in 6 patients, cardioembolic in 14, large vessel atherosclerosis (LVA) in 9, and carotid dissection in 4. The mean RBC to platelet ratio was 0.78:1 (+/− 0.65) in cardioembolic clots, 1.73:1 (+/− 2.38) in LVA and 1.4:1(+/− 0.70) in carotid dissections. Although patients with undetermined etiology had a similar clot composition to cardioembolic stroke (0.36:1+/− 0.33), (p = 0.19), it differed significantly from LVA and dissections respectively (p = 0.037, p = 0.01). Conclusion In our study, a low RBC to Platelet ratio was found among patients with embolic strokes of undetermined source, however shared similar characteristics with cardioembolic thrombi. Ongoing collection and analysis is needed to confirm these findings and its significance in evaluating stroke etiology.

scholarly journals Costs of care provided in a university hospital for children exposed to or infected with the HIV/AIDS

2007 ◽  
Vol 23 (suppl 3) ◽  
pp. S402-S413 ◽  
Author(s):  
Heloisa Helena de Sousa Marques ◽  
Bernard François Couttolenc ◽  
Maria do Rosário Dias de Oliveira Latorre ◽  
Maria Zilda de Aquino ◽  
Maria Ignez Garcia Aveiro ◽  
...  
Keyword(s):  
Medical Records ◽  
University Hospital ◽  
Accounting System ◽  
Cost Of Treatment ◽  
Costs Of Treatment ◽  
The Mean ◽  
Cost Accounting System ◽  
The Cost ◽  
Mean Cost ◽  
Hiv Aids

The objective of this study was to estimate and analyze the costs of treating children with HIV/AIDS at a university hospital in São Paulo, Brazil. The study collected and analyzed data from 291 medical records of children treated at the hospital as of March 2002. The costs of treatment were estimated for each category of patient (exposed and infected) and severity, based on the quantity of inputs and procedures used in treating each child, based on the cost accounting system used at the hospital. The total cost of treatment for children exposed to the HIV was R$ 956.41 and for those infected with HIV R$ 8,092.71 per year. The mean cost of ambulatory care was R$ 6,047.28 for children with severe conditions, R$ 3,714.45 for those with light/moderate conditions, and R$ 948.63 for the exposed. Hospitalized children had annual costs of R$ 19,353.34, R$ 18,823.16, and R$ 871.03, respectively. The medication was a major factor in the cost of treatment. Our estimates are comparable to the findings from other studies, but lower than corresponding findings from the international literature.

scholarly journals Impact of COVID-19 on stroke admissions, treatments, and outcomes at a comprehensive stroke centre in the United Kingdom

2020 ◽  
Author(s):  
Nishita Padmanabhan ◽  
Indira Natarajan ◽  
Rachel Gunston ◽  
Marko Raseta ◽  
Christine Roffe
Keyword(s):  
National Institutes Of Health ◽  
University Hospital ◽  
Stroke Severity ◽  
Stroke Patients ◽  
Stroke Treatment ◽  
Patient Demographics ◽  
The United Kingdom ◽  
Significant Difference ◽  
Ischaemic Attack ◽  
Provision Of Care

Abstract Introduction The coronavirus disease (COVID-19) pandemic has changed routine clinical practice worldwide with major impacts on the provision of care and treatment for stroke patients. Methods This retrospective observational study included all patients admitted to the Royal Stoke University Hospital in Stoke-on-Trent, UK, with a stroke or transient ischaemic attack between March 15th and April 14th, 2020 (COVID). Patient demographics, characteristics of the stroke, treatment details and logistics were compared with patients admitted in the corresponding weeks in the year before (2019). Results There was a 39.5% (n = 101 vs n = 167) reduction in admissions in the COVID cohort compared with 2019 with more severe strokes (median National Institutes of Health Stroke Scale (NIHSS) 7 vs 4, p = 0.02), and fewer strokes with no visible acute pathology (21.8 vs 37.1%, p = 0.01) on computed tomography. There was no statistically significant difference in the rates of thrombolysis (10.9 vs 13.2%, p = 0.72) and/or thrombectomy (5.9 vs 4.8%, p = 0.90) and no statistically significant difference in time from stroke onset to arrival at hospital (734 vs 576 min, p = 0.34), door-to-needle time for thrombolysis (54 vs 64 min, p = 0.43) and door-to-thrombectomy time (181 vs 445 min, p = 0.72). Thirty-day mortality was not significantly higher in the COVID year (10.9 vs 8.9%, p = 0.77). None of the 7 stroke patients infected with COVID-19 died. Conclusions During the COVID-19 pandemic, the number of stroke admissions fell, and stroke severity increased. There was no statistically significant change in the delivery of thrombolysis and mechanical thrombectomy and no increase in mortality.

scholarly journals The adaption and evaluation of a Latvian version of the National Institutes of Health Stroke Scale

2016 ◽  
Vol 45 (6) ◽  
pp. 1861-1869 ◽  
Author(s):  
Kristaps Jurjāns ◽  
Iļja Noviks ◽  
Diāna Volčeka ◽  
Linda Zandersone ◽  
Kristīne Meilerte ◽  
...  
Keyword(s):  
National Institutes Of Health ◽  
Assessment Tools ◽  
Rater Agreement ◽  
Validity And Reliability ◽  
Stroke Patients ◽  
Intra Class Correlation ◽  
Scale Validity ◽  
Study Population ◽  
The Mean ◽  
Intra Class Correlation Coefficient

Objectives To determine the validity and reliability of a Latvian version of the National Institutes of Health Stroke Scale (LV-NIHSS) for evaluating Latvian stroke patients. Methods The adaption of the LV-NIHSS followed standard methods used for the adaption and validation of clinical assessment tools. The scale validity was tested by comparison with the Glasgow Coma Scale (GCS) and the modified Rankin scale (mRs). The reliability of the LV-NIHSS was evaluated by intra-rater and inter-rater agreement using intra-class correlation coefficient (ICC) analysis. Results A total of 296 stroke patients and 101 control subjects were evaluated. The mean age of the overall study population was 73.6 years (range, 37 – 94 years; 227 [57.2%] were female). The mean LV-NIHSS score of the patients with stroke was 8.4 ± 6.2. In terms of construct validity of the LV-NIHSS, it correlated with the GCS ( r = −0.571) and mRs ( r = 0.755). In terms of the reliability of the LV-NIHSS, the inter-rater agreement had an ICC of 0.99 and the intra-rater agreement had an ICC of 0.99. Conclusion The adaption of LV-NIHSS was successful and the evaluation showed that the scale was valid and reliable for evaluating Latvian stroke patients.

scholarly journals Trends in the seeking of emergency service for ischemic stroke and its risk factors during the COVID-19 pandemic, a study from Taiwan

2021 ◽  
Vol 26 (3) ◽  
pp. 441-447
Author(s):  
Yi Te Tsai ◽  
Yachung Jeng ◽  
Hsiu-Hsi Chen ◽  
Kai-Chieh Chang
Keyword(s):  
Risk Factors ◽  
Ischemic Stroke ◽  
Emergency Services ◽  
Stroke Care ◽  
University Hospital ◽  
Minor Stroke ◽  
Stroke Severity ◽  
Health Seeking ◽  
Stroke Patients ◽  
Ich Score

Background & Objectives: COVID-19 may influence the health seeking behavior of acute ischemic stroke patients. This study aimed to determine the characteristics of the patients who visited the emergency room in a centre designated for stroke care in Taiwan. Methods: This was a retrospective database-based study comparing the severity of ischemic stroke, intracerebral hemorrhage (ICH), and risk factors of patients seen between 2019 and 2020 in the National Taiwan University Hospital Yunlin Branch. Patients with or without thrombolysis therapy were analysed. Results: The median NIHSS of ischemic stroke patients were lower in 2019 than in 2020 (p = 0.015). The difference was seen in non-thrombolysis patients (2019: 3[1-6] vs. 4 [2-7.5], p = 0.012) but not in thrombolysis patients. The frequency of minor stroke was higher in 2019 (45.1%) than in 2020 (37.9%, p = 0.038). The discharge mRS was lower overall (p = 0.004) and in non-thrombolysis patients (0.003), but not in thrombolysis patients in 2019. As for the ICH patients, the severity of ICH score (p = 0.021) and discharge mRS (p = 0.001) were also lower in 2019. The frequencies of risk factors of stroke were higher in 2019 than in 2020, including smoking (24% vs. 18.2%, p = 0.046), alcohol (11.9% vs. 7.5%, p = 0.039), hypertension (72.9% vs. 66.2%, p = 0.039), history of stroke (16.5% vs. 11.6%, p = 0.047), and atrial fibrillation (11.9% vs. 7.5%, p = 0.039). Conclusions: This study in Taiwan revealed a decline in the willingness to seek emergency services under the influence of COVID-19 among patients with lower stroke severity, especially those with more risk factors.

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