Endovascular Interventions following Intravenous Thrombolysis May Improve Survival and Recovery in Patients with Acute Ischemic Stroke: A Case-Control Study

Background: The dysphagia screening in acute ischemic stroke plays an important role in patients with risk of dysphagia. The aim of this hospital-based case-control study is to explore if V-VST, as a new nurse-driven dysphagia screening tool for AIS patients, might help to reduce the rate of post-stroke pneumonia and early withdraw of feeding tube. Methods: 1598 acute ischemic stroke patients were enrolled in this study. The standard protocol in AIS patients were assessed by WST (before intervention and plus with V-VST after intervention). The V-VST assessment were be trained in two senior nurses and all AIS patients were assessed by V-VST during July 1and Dec 30 th , 2017. Among 299 AIS patients with suspected, all clinical data were analyzed. The comparison of their rate of pneumonia in hospital and withdraw rate of tubefeeding before discharge were performed between patients post-intervention (January 1, 2018-June 30, 2019)and those admitted before the intervention (January 1, 2016-June 30, 2017). Results: The baseline characteristics of the pre- and post- intervention AIS groups were similar in age, gender, NIHSS. The implementation of V-VST have a statistically significant reducing the risk of pneumonia with an adjusted HR (0.60, 95% CI 0.43-0.84, P=0.003). Additionally, follow-up V-VST were likely to be associated the withdraw rate of tube-feeding at discharge (29/168 vs 38/131 P=0.016).There is also a trend of length of tube-feeding decreasing (8.32±12.27 vs 6.84±8.61 P=0.241). Conclusion: In our study, the V-VST is a feasible bedside tool. The implemental might be associated with the reduction of post-stroke pneumonia. Therefore, it meets the requirements of a clinical screening test for dysphagia in acute stroke patients at bedside. Large prospective interventional study is needed to confirm our findings. V-VST: Volume-viscosity Swallow Test WST: Water Swallow Test AIS: Acute Ischemic Stroke HR: hazard ratio

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Diagnostic value of N-terminal pro B-type natriuretic peptide for nonvalvular atrial fibrillation in acute ischemic stroke patients: A retrospective multicenter case-control study

Journal of the Neurological Sciences ◽

10.1016/j.jns.2020.116822 ◽

2020 ◽

Vol 414 ◽

pp. 116822

Author(s):

Jingjing Zhao ◽

Yi Zhang ◽

Fang Yuan ◽

Changgeng Song ◽

Yongli Jiang ◽

...

Keyword(s):

Atrial Fibrillation ◽

Ischemic Stroke ◽

Acute Ischemic Stroke ◽

Natriuretic Peptide ◽

Case Control Study ◽

Diagnostic Value ◽

Case Control ◽

Stroke Patients ◽

Nonvalvular Atrial Fibrillation ◽

Control Study

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Free protein S deficiency in acute ischemic stroke. A case-control study.

Stroke ◽

10.1161/01.str.24.2.224 ◽

1993 ◽

Vol 24 (2) ◽

pp. 224-227 ◽

Cited By ~ 33

Author(s):

S A Mayer ◽

R L Sacco ◽

A Hurlet-Jensen ◽

T Shi ◽

J P Mohr

Keyword(s):

Ischemic Stroke ◽

Acute Ischemic Stroke ◽

Case Control Study ◽

Protein S ◽

Case Control ◽

Protein S Deficiency ◽

Free Protein ◽

S Deficiency ◽

Control Study

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PO04-MO-16 Estimation C-reactive protien (CRP) in acute ischemic stroke and correlation with risk factors: a case control study

Journal of the Neurological Sciences ◽

10.1016/s0022-510x(09)70664-1 ◽

2009 ◽

Vol 285 ◽

pp. S173-S174

Author(s):

T.N. Dubey ◽

V.K. Sharma ◽

B.N. Gouda ◽

R. Jain ◽

H.P.S. Chandel

Keyword(s):

Risk Factors ◽

Ischemic Stroke ◽

Acute Ischemic Stroke ◽

Case Control Study ◽

Case Control ◽

Control Study

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A Case-Control Study of Tissue Plasminogen Activator for Acute Ischemic Stroke

Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques ◽

10.1017/s0317167100007277 ◽

2007 ◽

Vol 34 (4) ◽

pp. 411-416 ◽

Cited By ~ 3

Author(s):

J M Reid ◽

S J Phillips ◽

G J Gubitz ◽

J Jarrett ◽

C Christian ◽

...

Keyword(s):

Ischemic Stroke ◽

Acute Ischemic Stroke ◽

Plasminogen Activator ◽

Randomized Trials ◽

Case Control Study ◽

Case Control ◽

Term Survival ◽

Tissue Plasminogen ◽

Control Study

Background:Randomized trials demonstrate that intravenous tissue plasminogen activator (tPA) improves outcome in acute ischemic stroke (AIS). To assess translation of this efficacy into effectiveness in routine clinical practice we performed a case-control study of tPA treatment for AIS in a single hospital.Methods:151 tPA-treated AIS patients (1996-2005) were matched 1:1 with blinding to outcome to controls from a prospective registry based on age, gender, pre-stroke Oxford handicap scale (OHS), stroke severity, and subtype. The outcomes were in-hospital death, symptomatic intracranial hemorrhage (SICH), length-of-stay (LOS), discharge OHS and long-term survival.Results:In-hospital mortality (23% vs. 24%) or long-term survival (median follow-up of 2 years) was not different between cases and controls (p=0.83). SICH occurred in 7.8% (95% CI 4.2-13.5%) of tPA-treated patients. Median LOS was non-significantly shorter for cases (13 [7-29] vs. 16 [8-32] days, p=0.14) but significantly shorter in tPA-treated vs. non-treated women (14 [7-28] vs. 20 [11-34] days, p=0.04). At discharge 6.6% (95% CI 1.1-12.0%) more tPA-treated patients than controls had no disability (OHS ≤1, p=0.02). However, there was no difference in discharge independence rates or proportion discharged home.Conclusion:We demonstrate minor improvements in early recovery after stroke with tPA but the impact is less dramatic than that reported in randomized trials. This may relate to timing of treatment and the type of patients treated.

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High Risk Features Contributing to 30-Day Readmission After Acute Ischemic Stroke: A Single Center Retrospective Case-Control Study

The Neurohospitalist ◽

10.1177/19418744211027746 ◽

2021 ◽

pp. 194187442110277

Author(s):

Emma M. Loebel ◽

Mary Rojas ◽

Danielle Wheelwright ◽

Connor Mensching ◽

Laura K. Stein

Keyword(s):

Ischemic Stroke ◽

Acute Ischemic Stroke ◽

Case Control Study ◽

Case Control ◽

Retrospective Case ◽

Medical Comorbidities ◽

Care Plans ◽

History Of ◽

Prior Stroke ◽

Control Study

Background and Purpose: Risk of 30-day stroke readmission has been attributed to medical comorbidities, stroke severity, and hospitalization metrics. The leading etiologies appear to vary across institutions and remain a moving target. We hypothesized that patients with increased medical complexity have higher odds of 30-day readmission and the immediate time after discharge may be most vulnerable. We aimed to characterize patients with 30-day readmission after acute ischemic stroke (IS) and identify predictors of post-IS readmission. Methods: We performed a retrospective case-control study analyzing post-IS 30-day readmission between January 2016-December 2019 using data from Mount Sinai Hospital’s Get With The Guidelines database. We performed chi square analyses and multivariate adjusted logistic regression model including age, sex, coronary artery disease (CAD), renal insufficiency (RI), history of prior stroke or TIA, length of stay (LOS) > 7, and NIHSS ≥ 5. Results: 6.7% (n = 115) of 1,706 IS encounters had 30-day readmission. The 115 cases were compared to 1,591 controls without 30-day readmission. In our adjusted model, CAD (OR = 1.7, p = 0.01), history of prior stroke or TIA (OR = 1.6, p = 0.01), LOS >7 (OR = 1.7, p = 0.02), and NIHSS ≥ 5 (OR = 4.5, p < 0.001) predicted 30-day readmission. 65% (n = 75) of readmitted patients had readmission within 14 days post-discharge. Conclusions: Patients with post-IS 30-day readmission were more likely to have complex medical comorbidities and history of stroke or TIA compared to controls. Patients with more severe stroke and longer LOS may benefit from individualized transition of care plans and closer follow up during the vulnerable 30-day post-stroke period.

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