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Palliative care in stroke

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https://www.readbyqxmd.com/read/29764435/use-of-hospital-palliative-care-according-to-the-place-of-death-and-disease-one-year-before-death-in-2013-a-french-national-observational-study
#1
Claire Poulalhon, Laureen Rotelli-Bihet, Sébastien Moine, Anne Fagot-Campagna, Régis Aubry, Philippe Tuppin
BACKGROUND: Only limited data are available concerning the diseases managed before death and hospital palliative care (HPC) use according to place of death in France. We therefore conducted an observational study based on administrative health data in a large population to identify the diseases treated one year before death in 2013, the place of stay with or without hospital palliative care, and the place of death. METHODS: French health insurance general scheme beneficiaries were identified in the National Health data Information System (Snds) with a selection of information...
May 16, 2018: BMC Palliative Care
https://www.readbyqxmd.com/read/29541545/thirty-day-readmission-after-spontaneous-intracerebral-hemorrhage
#2
Anna Therese Bjerkreim, Andrej Netland Khanevski, Solveig Bergliot Glad, Lars Thomassen, Halvor Naess, Nicola Logallo
Background: Intracerebral hemorrhage (ICH) is the most severe form of stroke, but data on readmission after ICH are sparse. We aimed to determine frequency, causes, and predictors of 30-day readmission after ICH. Materials and Methods: This retrospective cohort study includes all spontaneous ICH survivors admitted to the stroke unit at Haukeland University Hospital in Bergen in Norway from July 2007 to December 2013. Patients were followed by review of electronic medical charts, and the first unplanned readmission within 30 days after discharge was used as final outcome...
March 2018: Brain and Behavior
https://www.readbyqxmd.com/read/29507155/outcomes-experiences-and-palliative-care-in-major-stroke-a-multicentre-mixed-method-longitudinal-study
#3
Marilyn Kendall, Eileen Cowey, Gillian Mead, Mark Barber, Christine McAlpine, David J Stott, Kirsty Boyd, Scott A Murray
BACKGROUND: Case fatality after total anterior circulation stroke is high. Our objective was to describe the experiences and needs of patients and caregivers, and to explore whether, and how, palliative care should be integrated into stroke care. METHODS: From 3 stroke services in Scotland, we recruited a purposive sample of people with total anterior circulation stroke, and conducted serial, qualitative interviews with them and their informal and professional caregivers at 6 weeks, 6 months and 1 year...
March 5, 2018: CMAJ: Canadian Medical Association Journal, Journal de L'Association Medicale Canadienne
https://www.readbyqxmd.com/read/29468104/cerebellar-stroke-occupational-therapy-and-physical-therapy-management-from-intensive-care-unit-to-outpatient-a-case-report
#4
Christopher M Wilson, Christina L Mitchell, Katherine M Hebert
Cerebellar stroke increases the risk of extensive physical disability and long-term institutionalization. The purpose of this case report is to describe the 14-month longitudinal rehabilitation management and outcomes from the intensive care unit, inpatient rehabilitation unit and outpatient care of a patient after cerebellar stroke. A goal of this case report is to provide rehabilitation clinicians with a long-term perspective and understanding of the course of recovery for a patient after cerebellar cerebrovascular accident or related injury...
December 14, 2017: Curēus
https://www.readbyqxmd.com/read/29351343/minority-race-and-male-sex-as-risk-factors-for-non-beneficial-gastrostomy-tube-placements-after-stroke
#5
Roland Faigle, Joseph A Carrese, Lisa A Cooper, Victor C Urrutia, Rebecca F Gottesman
BACKGROUND: Percutaneous endoscopic gastrostomy (PEG) tubes are widely used for enteral feeding after stroke; however, PEG tubes placed in patients in whom death is imminent are considered non-beneficial. AIM: We sought to determine whether placement of non-beneficial PEG tubes differs by race and sex. DESIGN AND SETTING/PARTICIPANTS: In this retrospective cohort study, inpatient admissions for stroke patients who underwent palliative/withdrawal of care, were discharged to hospice, or died during the hospitalization, were identified from the Nationwide Inpatient Sample between 2007 and 2011...
2018: PloS One
https://www.readbyqxmd.com/read/29191721/changes-in-the-use-of-intensive-and-supportive-procedures-for-patients-with-stroke-in-taiwan-in-the-last-month-of-life-between-2000-and-2010
#6
Pei-Yi Wang, Yen-Ni Hung, Robert Smith, Chia-Chin Lin
CONTEXT: Stroke is the second leading cause of death and the primary cause of disability worldwide. It is uncertain what care patients with stroke receive in their end of life and what trends in care are in recent years. OBJECTIVES: The objective of this study was to investigate the changes in the use of intensive and supportive procedures for Taiwanese patients with stroke in their last month of life during 2000-2010. METHODS: Analysis of claims data of 55,930 patients with stroke obtained from the National Health Insurance Research Database was performed to investigate the changes in the use of intensive and supportive procedures for Taiwanese patients with stroke in their last month of life during 2000-2010...
March 2018: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/29156917/advance-care-planning-for-patients-with-advanced-neurology-diseases
#7
Ka-Chi Cheung, Vikki Wai-Kee Lau, Ka-Chun Un, Man-Sheung Wong, Kwok-Ying Chan
BACKGROUND: Advanced neurology diseases including motor neuron disease (MND) are usually progressive life-limiting illness and could be devastating for patients, families and caregivers. Although medical technologies, such as enteral feeding and non-invasive ventilation, may prolong life expectancy of the patients, their utilization prompts important ethical questions in regard to their quality of life (QoL). Little attention had been paid on how ACP practice would practically help with patients suffering from different neurology diseases...
October 13, 2017: Annals of Palliative Medicine
https://www.readbyqxmd.com/read/29156908/enhanced-psychosocial-support-as-important-component-of-neuro-palliative-service
#8
Kwok-Ying Chan, Man-Lui Chan
There are unmet palliative care (PC) needs for psychosocial and spiritual distress of neurology patients such as bad stroke as well as in chronic neurodegenerative diseases. As such, psychosocial support to both patients and their caregivers should be enhanced in order to provide comprehensive neuro-PC. The first step in developing this type of support/program was to recognize the main psychosocial care needs of the population. Once these were determined, a program was specifically devised to meet those needs as efficiently and effectively as possible...
September 7, 2017: Annals of Palliative Medicine
https://www.readbyqxmd.com/read/29040110/racial-differences-in-palliative-care-use-after-stroke-in-majority-white-minority-serving-and-racially-integrated-u-s-hospitals
#9
Roland Faigle, Wendy C Ziai, Victor C Urrutia, Lisa A Cooper, Rebecca F Gottesman
OBJECTIVES: Racial/ethnic differences in palliative care resource use after stroke have been recognized, but it is unclear whether patient or hospital characteristics drive this disparity. We sought to determine whether palliative care use after intracerebral hemorrhage and ischemic stroke differs between hospitals serving varying proportions of minority patients. DESIGN: Population-based cross-sectional study. SETTING: Inpatient hospital admissions from the Nationwide Inpatient Sample between 2007 and 2011...
December 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28982489/palliative-care-in-neurology
#10
REVIEW
Maisha T Robinson, Robert G Holloway
Palliative medicine is a specialty that focuses on improving the quality of life for patients with serious or advanced medical conditions, and it is appropriate at any stage of disease, including at the time of diagnosis. Neurologic conditions tend to have high symptom burdens, variable disease courses, and poor prognoses that affect not only patients but also their families and caregivers. Patients with a variety of neurologic conditions such as Parkinson disease, dementia, amyotrophic lateral sclerosis, brain tumors, stroke, and acute neurologic illnesses have substantial unmet needs that can be addressed through a combination of primary and specialty palliative care...
October 2017: Mayo Clinic Proceedings
https://www.readbyqxmd.com/read/28923988/contemporary-management-of-cardiogenic-shock-a-scientific-statement-from-the-american-heart-association
#11
REVIEW
Sean van Diepen, Jason N Katz, Nancy M Albert, Timothy D Henry, Alice K Jacobs, Navin K Kapur, Ahmet Kilic, Venu Menon, E Magnus Ohman, Nancy K Sweitzer, Holger Thiele, Jeffrey B Washam, Mauricio G Cohen
Cardiogenic shock is a high-acuity, potentially complex, and hemodynamically diverse state of end-organ hypoperfusion that is frequently associated with multisystem organ failure. Despite improving survival in recent years, patient morbidity and mortality remain high, and there are few evidence-based therapeutic interventions known to clearly improve patient outcomes. This scientific statement on cardiogenic shock summarizes the epidemiology, pathophysiology, causes, and outcomes of cardiogenic shock; reviews contemporary best medical, surgical, mechanical circulatory support, and palliative care practices; advocates for the development of regionalized systems of care; and outlines future research priorities...
October 17, 2017: Circulation
https://www.readbyqxmd.com/read/28892278/reflection-on-stroke-deaths-and-end-of-life-stroke-care
#12
Syed Z Quadri, Thang Huynh, Cecilia Cappelen-Smith, Nirupama Wijesuriya, Abul Mamun, Roy G Beran, Alan J McDougall, Dennis Cordato
BACKGROUND: The benefit of palliative care referral for severe stroke patients on end-of-life care pathway (EOLCP) is increasingly recognised. Palliative care provides assistance with symptom management and transition to end-of-life care. Advance care planning (ACP) may help accommodate patient/family expectations and guide management. METHODS: This is a retrospective study of all stroke deaths (2014-2015) at Liverpool Hospital, Sydney, Australia. Data examined included age, comorbidities, living arrangements, pre-existing ACP, palliative care referral rates and 'survival time'...
March 2018: Internal Medicine Journal
https://www.readbyqxmd.com/read/28846483/palliative-care-needs-in-an-acute-internal-medicine-ward-in-mexico
#13
Tania Zertuche-Maldonado, Rodrigo Tellez-Villarreal, Antonio Pascual, Salvador B Valdovinos-Chavez, Abel Jesus Barragan-Berlanga, Maria Teresa Sanchez-Avila, Leonardo Bracho-Vela, Adria Tinoco-Aranda, Eduardo Bruera
BACKGROUND: Palliative care is an evolving but underdeveloped practice in Mexico. OBJECTIVE: The primary end point of this prospective observational study was to identify internal medicine inpatients fulfilling advanced criteria within a second-level hospital. Secondary end points were symptom burden, treatment, resource utilization, and one-year survival. DESIGN AND MEASUREMENTS: The 390-sample size calculation was based on previous studies where 15% of inpatients fulfilled palliative care needs...
February 2018: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28818864/palliative-care-for-hospitalized-patients-with-stroke-results-from-the-2010-to-2012-national-inpatient-sample
#14
Tarvinder Singh, Steven R Peters, David L Tirschwell, Claire J Creutzfeldt
BACKGROUND AND PURPOSE: Substantial variability exists in the use of life-prolonging treatments for patients with stroke, especially near the end of life. This study explores patterns of palliative care utilization and death in hospitalized patients with stroke across the United States. METHODS: Using the 2010 to 2012 nationwide inpatient sample databases, we included all patients discharged with stroke identified by International Classification of Diseases-Ninth Revision codes...
September 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28768356/-singultus-diagnostic-workup-and-therapy
#15
Ohlrich Marcus, Georg Royl
A hiccup is a reflex movement with diffusely distributed afferents and efferents in the thorax; its functional relevance is controversial. In its physiological form, it is mostly a minor complaint that stops spontaneously and rarely leads to medical consultation. However, prolonged agonizing hiccups represent serious deterioration of quality of life. Chronic hiccups by definition last for more than 48 h, with gastroesophageal reflux being the frequent underlying disease. Various other causes affect multiple organ systems, some with serious underlying diseases...
July 2017: Laryngo- Rhino- Otologie
https://www.readbyqxmd.com/read/28711755/palliative-care-clinicians-caring-for-patients-before-and-after-continuous-flow-left-ventricular-assist-device
#16
Sara E Wordingham, Colleen K McIlvennan, Timothy J Fendler, Amy L Behnken, Shannon M Dunlay, James N Kirkpatrick, Keith M Swetz
Left ventricular assist devices (LVADs) are an available treatment option for carefully selected patients with advanced heart failure. Initially developed as a bridge to transplantation, LVADs are now also offered to patients ineligible for transplantation as destination therapy (DT). Individuals with a DT-LVAD will live the remainder of their lives with the device in place. Although survival and quality of life improve with LVADs compared with medical therapy, complications persist including bleeding, infection, and stroke...
July 13, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28699144/palliative-care-needs-assessment-in-the-neuro-icu-effect-on-family
#17
Claire J Creutzfeldt, Marina G Hanna, C Sherry Cheever, Abhijit V Lele, Charles Spiekerman, Ruth A Engelberg, J Randall Curtis
BACKGROUND: Examine the association of a daily palliative care needs checklist on outcomes for family members of patients discharged from the neurosciences intensive care unit (neuro-ICU). METHODS: We conducted a prospective, longitudinal cohort study in a single, thirty-bed neuro-ICU in a regional comprehensive stroke and level 1 trauma center. One of two neuro-ICU services that admit patients to the same ICU on alternating days used a palliative care needs checklist during morning work rounds...
October 2017: Neurocritical Care
https://www.readbyqxmd.com/read/28674685/risk-factors-prophylaxis-and-treatment-of-venous-thromboembolism-in-congenital-heart-disease-patients
#18
REVIEW
Michael Silvey, Leonardo R Brandão
Congenital heart disease (CHD) is a common condition in the pediatric population, affecting up to 1% of all live births (i.e., around 40,000 newborns/year in the United States). Although CHD does have a wide range of severity, by the age of 5 years approximately 80% of patients will require at least one surgical intervention to achieve a complete/palliative cardiac repair. Today, in light of their much-improved surgical survival, the care of these patients focuses on morbidity prevention and/or treatment...
2017: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/28659419/aggressiveness-of-care-following-intracerebral-hemorrhage-in-women-and-men
#19
MULTICENTER STUDY
Rahul Guha, Amelia Boehme, Stacie L Demel, Janet J Li, Xuemei Cai, Michael L James, Sebastian Koch, Carl D Langefeld, Charles J Moomaw, Jennifer Osborne, Padmini Sekar, Kevin N Sheth, E Woodrich, Bradford B Worrall, Daniel Woo, Seemant Chaturvedi
OBJECTIVE: To compare comorbidities and use of surgery and palliative care between men and women with intracerebral hemorrhage (ICH). METHODS: The Ethnic/Racial Variations of Intracerebral Hemorrhage (ERICH) study is a prospective, multicenter, case-control study of ICH risk factors and outcomes. We compared comorbidities, treatments, and use of do-not-resuscitate (DNR) orders in men vs women. Multivariate analysis was used to assess the likelihood of ICH surgery and palliative care after adjustment for variables that were p < 0...
July 25, 2017: Neurology
https://www.readbyqxmd.com/read/28590159/which-patients-die-in-their-preferred-place-a-secondary-analysis-of-questionnaire-data-from-bereaved-relatives
#20
Natasja Jh Raijmakers, Anke Je de Veer, Rosanne Zwaan, Jolien M Hofstede, Anneke L Francke
BACKGROUND: Previous studies on factors influencing the place of death have focused on cancer patients dying at home. However, home is not always the preferred place. AIM: To provide insight into the extent to which patients with various diseases die in their preferred place and into factors associated with dying in the preferred place. DESIGN: A secondary analysis of the data set of the evaluation study of the National Quality Improvement Programme for Palliative Care was undertaken to explore factors related to 'dying in the preferred place'...
February 2018: Palliative Medicine
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