scholarly journals Comparative evaluation of risk factors, outcome and biomarker levels in young and old acute ischemic stroke patients

2015 ◽  
Vol 22 (2) ◽  
Author(s):  
Anuja P Kawle ◽  
Amit R Nayak ◽  
Neha H Lande ◽  
Dinesh P Kabra ◽  
Nitin H Chandak ◽  
...  
Stroke ◽  
2017 ◽  
Vol 48 (suppl_1) ◽  
Author(s):  
Robynn S Cox ◽  
Cheryl Bradas ◽  
Victoria Bowden ◽  
Beth Buckholz ◽  
Kathleen Kerber ◽  
...  

Fall Risk Factors among Hospitalized Acute Post-Ischemic Stroke Patients in an Urban Public Healthcare System Background: Falls remain an important benchmarking indicator for hospitals. The incidence of falls is a nursing-sensitive indicator, amenable to preventable measures. Research indicates factors associated with falls, but few studies specifically identify factors among hospitalized patients with acute ischemic stroke (AIS). Purpose: Identify prevalence and risk factors for falls among acute, hospitalized AIS patients within an urban safety net hospital. Methods: Retrospective cohort study. Data abstracted from stroke and fall registries, and medical records from 2013-2015 among all adult patients admitted for AIS. Variables included traditional risk factors for falls, as well as stroke-specific factors (NIHSS score, functional status, stroke location and vessel, administration of tPA). Results: N=683 AIS stroke patients, with 1.6% fall rate. Falls among AIS patients accounted for 6% of all hospital falls. AIS patients who experienced an inpatient fall had a mean age of 67 (range 46-86), were mostly male (82%), and ambulating independently prior to arrival (91%). Mean NIHSS scores upon admission were higher among those who experienced a fall, when compared to AIS patients who did not fall (mean=8.73, 7.01, respectively). Most patients who experienced a fall demonstrated weakness and/or paresis upon initial exam (90%), with 64% experiencing small vessel ischemic changes, and 36% MCA strokes. Administration of tPA was not associated with increased falls. LOS was significantly increased among AIS patients who experienced a fall (7.7 vs. 4.8, respectively, p <0.01). Conclusions: Fall rates among hospitalized AIS patients may be lower than earlier reports, reflecting increased vigilance among providers and widespread integration of fall prevention strategies. Elevated NIHSS scores and weakness/paresis upon initial exam may be important predictors of falls among newly diagnosed AIS patients who had previously been able to ambulate independently. Consistent with fall literature among other populations, the occurrence of a fall in the inpatient setting can substantially increase length of stay.


2020 ◽  
Vol 26 (1) ◽  
pp. 2926-2930
Author(s):  
Georgi Tz. Dimitrov ◽  
◽  
Maya P. Danovska ◽  
Yoana I. Simeonova ◽  
Irena I. Gencheva ◽  
...  

2020 ◽  
Author(s):  
Xiaohua Yang ◽  
Huijuan Chen ◽  
Wanling Yang ◽  
Bin Deng ◽  
Jialing Zheng ◽  
...  

Abstract Background: Stroke-associated pneumonia (SAP) is a major complication after stroke, oral microorganisms are important contributors to SAP. Here, we aimed to investigate whether the oral hygiene was associated with SAP and related risk factors of them in patients with acute ischemic stroke. Methods: We performed a cross-sectional study that recruited 331 patients with acute ischemic stroke from two medical centers. A series of assessments were performed to evaluate the neurological status and habits of oral hygiene. According to whether the oral hygiene was abnormal and SAP occurred, univariate analyses were performed in cohort 1 (normal / abnormal oral hygiene groups) and cohort 2 (SAP / non-SAP groups). Multiple logistic regression analyses were conducted to confirm risk factors of oral cleanliness and SAP in stroke patients. Results: A total of 12 and 8 independent variables were included in the model 1 and 2 analysis. After adjusting for confounders, multivariable logistic regression analysis showed that oral cleanliness was not only closely related to SAP (OR=2.219, P=0.026), dental caries (OR=1.292, P=0.005) and age (OR=1.030, P=0.006) in model 1, but also an independent risk factor for predicting SAP (OR=1.678, P=0.001) in model 2. Barthel index was a protective factor for oral cleanliness (OR=0.986, P=0.019) and SAP (OR=0.977, P=0.002) in ischemic stroke patients. Conclusions: Mutually primary risk roles of abnormal oral cleanliness and SAP exist in patients with acute ischemic stroke. Dental caries and aging are important risk factors for oral health disorders. Improving the activities of daily living would have protective effects on both oral hygiene and SAP prevention in stroke patients.


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.


Stroke ◽  
2014 ◽  
Vol 45 (suppl_1) ◽  
Author(s):  
Maria C Zurru ◽  
Claudia Alonzo ◽  
Laura Brescacin ◽  
Santiago Pigretti ◽  
Ariel Luzzi ◽  
...  

Background and purpose: similarities in renal and vascular beds could explain the relationship between impaired glomerular filtration rate (iGFR) and leukoaraiosis, white matter hiperintensities (WMH), and lacunar infarcts. We evaluated the association between microbleeds (MB) and impaired kidney function in patients with acute ischemic stroke. Methods: acute ischemic stroke patients were prospectively included. Pre-stroke vascular risk factors were obtained and the presence of MB and WMH were evaluated on admission MRI and analyzed as dichotomous variables. Results: MB were present in 128 (19%) of the 663 patients evaluated.. Table shows risk factors and comorbidities associated with MB in the univariate analysis. Only leukoaraiosis (OR 3.3; CI 95% 1.5-3.3; p 0.0001), age older than 80 years (OR 1.90; CI 95% 1.10-2.8; p 0.01), WMH (OR 9.4; CI 95% 5.6-15.6; p 0.0001) and iGFR (OR 2.2; CI 95% 1.3-3.3; p 0.01) were associated with the presence of MB in the multivariate analysis. Conclusion: Besides age and WMH, well-known risk factors for MB, impaired kidney function doubles the risk these lesions in a cohort of ischemic stroke patients, reassuring the hypothesis of a common pathophysiological pathway for renal and cerebral microvascular damage.


2020 ◽  
pp. 174749302097937
Author(s):  
Xin Tong ◽  
Quanhe Yang ◽  
Mary G George ◽  
Cathleen Gillespie ◽  
Robert K Merritt

Background Recent studies reported increasing trends in hospitalization of stroke patients aged 35–64 years. Aim To examine changes in risk factor profiles among patients aged 35–64 years hospitalized with acute ischemic stroke between 2006 and 2017 in the United States. Methods We used data from the National Inpatient Sample of the Healthcare Cost and Utilization Project from 2006 through 2017. Principal ICD-9-CM/ICD-10-CM codes were used to identify acute ischemic stroke hospitalizations, and secondary codes were used to identify the presence of four major stroke risk factors: hypertension, diabetes, lipid disorders, and tobacco use. We used the relative percent change to assess the changes in the prevalence of risk profile between 2006–2007 and 2016–2017 and linear regression models to obtain the p values for the overall trends across six time periods. Results Approximately 1.5 million acute ischemic stroke hospitalizations occurred during 2006–2017. The prevalence of having all four risk factors increased from 4.1% in 2006–2007 to 9.1% in 2016–2017 (relative percent change 122.0%, p < 0.001 for trend), prevalence of any three risk factors increased from 24.5% to 33.8% (relative percent change 38.0%, p < 0.001). Prevalence of only two risk factors decreased from 36.1% to 32.7% (p < 0.001), only one risk factor decreased from 25.2% to 18.1% (p < 0.001), and absence of risk factors decreased from 10.1% to 6.2% (p < 0.001). The most prevalent triad of risk factors was hypertension, diabetes, and lipid disorders (14.3% in 2006–2007 and 19.8% in 2016–2017), and the most common dyad risk factors was hypertension and lipid disorders (12.6% in 2006–2007 and 11.9% in 2016–2017). Conclusions The prevalence of hospitalized acute ischemic stroke patients aged 35–64 years with all four or any three of four major stroke risk factors increased by 122% and 38%, while those with only one risk factor or no risk factor has declined by 28% and 39%, respectively, from 2006 to 2017. Younger adults are increasingly at higher risk for stroke from preventable and treatable risk factors. This growing public health problem will require clinicians, healthcare systems, and public health efforts to implement more effective prevention strategies among this population.


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