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Stroke and predictive outcomes

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https://www.readbyqxmd.com/read/28634500/stroke-performance-measures-do-not-predict-functional-outcome
#1
Eric E Adelman, Lynda D Lisabeth, Melinda A Smith, Jonggyu Baek, Erin C Case, Brisa N Sánchez, James F Burke, Lesli E Skolarus, Darin B Zahuranec, William J Meurer, Devin L Brown, Kevin A Kerber, Deborah A Levine, Nelda M Garcia, Morgan S Campbell, Lewis B Morgenstern
BACKGROUND AND PURPOSE: Poststroke functional outcome is critical to stroke survivors. We sought to determine whether adherence to current stroke performance measures is associated with better functional outcome 90 days after an ischemic stroke. METHODS: Utilizing the Brain Attack Surveillance in Corpus Christi cohort, we examined adherence to 7 ischemic stroke performance measures from February 2009 to June 2012. Adherence to the measures was analyzed in aggregate using a binary defect-free score and an opportunity score, representing the proportion of eligible measures met...
July 2017: Neurohospitalist
https://www.readbyqxmd.com/read/28630233/motor-recovery-prediction-with-clinical-assessment-and-local-diffusion-homogeneity-after-acute-subcortical-infarction
#2
Gang Liu, Shuangquan Tan, Chao Dang, Kangqiang Peng, Chuanmiao Xie, Shihui Xing, Jinsheng Zeng
BACKGROUND AND PURPOSE: Initial clinical assessment or conventional diffusion tensor imaging parameters alone do not reliably predict poststroke recovery of motor function. Recently, local diffusion homogeneity (LDH) has been proposed to represent the local coherence of water molecule diffusion and can serve as a complementary marker for investigating white matter alterations of the brain. We aimed to determine whether a combination of initial clinical assessment and LDH could predict motor recovery after acute subcortical infarction...
June 19, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28628592/genetic-variation-and-neuroplasticity-role-in-rehabilitation-after-stroke
#3
Jill Campbell Stewart, Steven C Cramer
BACKGROUND AND PURPOSE: In many neurologic diagnoses, significant interindividual variability exists in the outcomes of rehabilitation. One factor that may impact response to rehabilitation interventions is genetic variation. Genetic variation refers to the presence of differences in the DNA sequence among individuals in a population. Genetic polymorphisms are variations that occur relatively commonly and, while not disease-causing, can impact the function of biological systems. The purpose of this article is to describe genetic polymorphisms that may impact neuroplasticity, motor learning, and recovery after stroke...
July 2017: Journal of Neurologic Physical Therapy: JNPT
https://www.readbyqxmd.com/read/28626160/effect-of-anemia-on-cardiovascular-hemodynamics-therapeutic-strategy-and-clinical-outcomes-in-patients-with-heart-failure-and-hemodynamic-congestion
#4
Muneyoshi Tanimura, Kaoru Dohi, Naoki Fujimoto, Keishi Moriwaki, Taku Omori, Yuichi Sato, Emiyo Sugiura, Naoto Kumagai, Shiro Nakamori, Tairo Kurita, Eitaro Fujii, Norikazu Yamada, Masaaki Ito
BACKGROUND: We investigated the effect of anemia on cardiovascular hemodynamics, therapeutic strategies and clinical outcomes in heart failure (HF) patients.Methods and Results:We divided 198 consecutive HF patients who underwent right heart catheterization before in-hospital HF treatment into 2 groups according to the presence or absence of hemodynamic congestion (HC: mean pulmonary capillary wedge pressure ≥15 mmHg and/or mean right atrial pressure ≥10 mmHg). The hemoglobin level correlated with the cardiac index (CI) and systemic vascular resistance index (SVRI) (r=-0...
June 17, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/28623943/does-metabolic-syndrome-predict-surgical-complications-a-protocol-for-a-systematic-review-and-meta-analysis
#5
Philip Norris, Nicholas Ralph, Clint Moloney
BACKGROUND: Metabolic syndrome (MetS) is defined by an accumulation of risk factors that include cardiovascular disease, diabetes, chronic high blood pressure, obesity, and hypercholesterolaemia which results in an increased risk of developing serious chronic diseases. MetS is widespread as it is estimated to affect up to 30% of the global population. For people with MetS who undergo surgery, an emerging body of literature points to significantly poorer postoperative outcomes compared with non-affected populations...
June 17, 2017: Systematic Reviews
https://www.readbyqxmd.com/read/28623739/high-density-lipoprotein-cholesterol-levels-are-associated-with-coronary-severity-but-not-with-outcomes-in-new-onset-patients-with%C3%A2-stable-coronary-artery-disease
#6
Hui-Hui Liu, Yuan-Lin Guo, Na-Qiong Wu, Cheng-Gang Zhu, Ying Gao, Ping Qing, Sha Li, Xi Zhao, Yan Zhang, Di Sun, Geng Liu, Qian Dong, Jian-Jun Li
BACKGROUND AND AIMS: The atheroprotective role of high-density lipoprotein cholesterol (HDL-C) levels in coronary artery disease (CAD) remains controversial. This study sought to reappraise the value of HDL-C in predicting the severity and outcomes of new-onset patients with stable CAD in Chinese populations. METHODS: A total of 4205 new-onset patients with stable CAD who received coronary angiography were enrolled to analyze the relation of HDL-C to coronary severity and major adverse cardiovascular events (MACEs)...
June 7, 2017: Atherosclerosis
https://www.readbyqxmd.com/read/28622175/predictors-prognosis-and-management-of-new-clinically-important-atrial-fibrillation-after-noncardiac-surgery-a-prospective-cohort-study
#7
Pablo Alonso-Coello, Deborah Cook, Shou Chun Xu, Alben Sigamani, Otavio Berwanger, Soori Sivakumaran, Homer Yang, Denis Xavier, Luz Ximena Martinez, Pedro Ibarra, Purnima Rao-Melacini, Janice Pogue, Kelly Zarnke, Pilar Paniagua, Jack Ostrander, Salim Yusuf, P J Devereaux
BACKGROUND: Despite the frequency of new clinically important atrial fibrillation (AF) after noncardiac surgery and its increased association with the risk of stroke at 30 days, there are limited data informing their prediction, association with outcomes, and management. METHODS: We used the data from the PeriOperative ISchemic Evaluation trial to determine, in patients undergoing noncardiac surgery, the association of new clinically important AF with 30-day outcomes, and to assess management of these patients...
July 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28622073/neighborhood-poverty-and-9-1-1-ambulance-contacts
#8
Josh Seim, Joshua English, Karl Sporer
BACKGROUND: Neighborhood poverty is positively associated with frequency of 9-1-1 ambulance utilization, but it is unclear whether this association remains significant when accounting for variations in the severities and types of ambulance contacts. METHODS: We merged EMS ambulance contact records in a single California county (n = 88,027) with data from the American Community Survey at the census tract level (n = 300). Using tract as a proxy for neighborhood and negative binomial regression as an analytical tool, we predicted 16 outcomes: any ambulance contacts, ambulance contacts stratified by three intervention severities, and ambulance contacts varied by 12 primary impression categories...
June 16, 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/28619833/ct-angiography-aspects-predicts-outcome-much-better-than-noncontrast-ct-in-patients-with-stroke-treated-endovascularly
#9
F Sallustio, C Motta, S Pizzuto, M Diomedi, B Rizzato, M Panella, F Alemseged, M Stefanini, S Fabiano, R Gandini, R Floris, P Stanzione, G Koch
BACKGROUND AND PURPOSE: Noncontrast CT ASPECTS has been investigated as a predictor of outcome in patients with acute ischemic stroke. Our purpose was to investigate whether CTA source images are a better predictor of clinical and radiologic outcomes than NCCT ASPECTS in candidates for endovascular stroke therapy. MATERIALS AND METHODS: CT scans of patients (n = 124) were independently evaluated by 2 readers for baseline NCCT and CTA source image ASPECTS and for follow-up ASPECTS...
June 15, 2017: AJNR. American Journal of Neuroradiology
https://www.readbyqxmd.com/read/28617815/impressive-predictive-value-of-ankle-brachial-index-for-very-long-term-outcomes-in-patients-with-cardiovascular-disease-impact-abi-study
#10
Takashi Miura, Masatoshi Minamisawa, Yasushi Ueki, Naoyuki Abe, Hitoshi Nishimura, Naoto Hashizume, Tomoaki Mochidome, Mikiko Harada, Yasutaka Oguchi, Koji Yoshie, Wataru Shoin, Tatsuya Saigusa, Soichiro Ebisawa, Hirohiko Motoki, Jun Koyama, Uichi Ikeda, Koichiro Kuwahara
BACKGROUND: The ankle-brachial index (ABI) is a marker of generalized atherosclerosis and is predictive of future cardiovascular events. However, few studies have assessed its relation to long-term future cardiovascular events, especially in patients with borderline ABI. We therefore evaluated the relationship between long-term future cardiovascular events and ABI. METHODS: In the IMPACT-ABI study, a single-center, retrospective cohort study, we enrolled 3131 consecutive patients (67 ± 13 years; 82% male) hospitalized for cardiovascular disease and measured ABI between January 2005 and December 2012...
2017: PloS One
https://www.readbyqxmd.com/read/28611609/transcranial-direct-current-stimulation-in-post-stroke-chronic-aphasia-the-impact-of-baseline-severity-and-task-specificity-in-a-pilot-sample
#11
Catherine Norise, Daniela Sacchetti, Roy Hamilton
Emerging evidence suggests that transcranial direct current stimulation (tDCS) can improve aspects of language production in persons with chronic non-fluent aphasia due to left hemisphere stroke. However, to date, studies exploring factors that predict response to tDCS in this or any patient population remain sparse, as are studies that investigate the specific aspects of language performance that are most responsive to stimulation. The current study explored factors that could predict recovery of language fluency and which aspects of language fluency could be expected to improve with the identified factor(s)...
2017: Frontiers in Human Neuroscience
https://www.readbyqxmd.com/read/28611087/acute-ischemic-stroke-after-moderate-to-severe-traumatic-brain-injury-incidence-and-impact-on-outcome
#12
Robert G Kowalski, Juliet K Haarbauer-Krupa, Jeneita M Bell, John D Corrigan, Flora M Hammond, Michel T Torbey, Melissa C Hofmann, Kristen Dams-O'Connor, A Cate Miller, Gale G Whiteneck
BACKGROUND AND PURPOSE: Traumatic brain injury (TBI) leads to nearly 300 000 annual US hospitalizations and increased lifetime risk of acute ischemic stroke (AIS). Occurrence of AIS immediately after TBI has not been well characterized. We evaluated AIS acutely after TBI and its impact on outcome. METHODS: A prospective database of moderate to severe TBI survivors, admitted to inpatient rehabilitation at 22 Traumatic Brain Injury Model Systems centers and their referring acute-care hospitals, was analyzed...
June 13, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28610884/outcomes-for-low-risk-surgical-aortic-valve-replacement-a-benchmark-for-aortic-valve-technology
#13
Lily E Johnston, Emily A Downs, Robert B Hawkins, Mohammed A Quader, Alan M Speir, Jeffrey B Rich, Ravi K Ghanta, Leora T Yarboro, Gorav Ailawadi
BACKGROUND: Two large, randomized trials are underway evaluating transcatheter aortic valve replacement (AVR) against conventional surgical AVR. We analyzed contemporary, real-world outcomes of surgical AVR in low-risk patients to provide a practical benchmark of outcomes and cost for evaluating current and future transapical AVR technology. METHODS: From 2010 to 2015, 2,505 isolated AVR operations were performed for severe aortic stenosis at 18 statewide cardiac institutions...
June 11, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28610565/the-influence-of-dehydration-on-the-prognosis-of-acute-ischemic-stroke-for-patients-treated-with-tissue-plasminogen-activator
#14
Fei-Fan Wu, Yen-Chu Hung, Y H Tsai, Jen-Tsung Yang, Tsong-Hai Lee, Chia-Wei Liow, Jiann-Der Lee, Chung-Jen Lin, Tsung-I Peng, Leng-Chieh Lin
BACKGROUND: Many studies have determined that dehydration is an independent predictor of outcome after ischemic stroke (IS); however, none have determined if the use of thrombolytic therapy modifies the negative impact of poor hydration. To inform the stroke registry established at our institution, we conducted a retrospective study to determine if dehydration remains a negative prognostic factor after IS patients treated with tissue plasminogen activator (tPA). METHODS: Between 2007 and 2012, we recruited 382 subjects; 346 had data available and were divided into 2 groups on the basis of their blood urea nitrogen/creatinine (BUN/Cr) ratio...
June 13, 2017: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/28608165/platelet-related-biomarkers-and-their-response-to-inhibition-with-aspirin-and-p2y12-receptor-antagonists-in-patients-with-acute-coronary-syndrome
#15
Angela Lowenstern, Robert F Storey, Megan Neely, Jie-Lena Sun, Dominick J Angiolillo, Christopher P Cannon, Anders Himmelmann, Kurt Huber, Stefan K James, Hugo A Katus, Joao Morais, Agneta Siegbahn, Phillippe Gabriel Steg, Lars Wallentin, Richard C Becker
The PLATelet inhibition and patient Outcomes (PLATO) trial showed that treatment with ticagrelor reduced the rate of death due to vascular causes, myocardial infarction and stroke when compared to clopidogrel in patients with ST-elevation or non-ST-elevation acute coronary syndrome (ACS). While the comparative benefit of ticagrelor over clopidogrel increased over time, event rates accrued in both groups during the study period. The purpose of our biomarker-based exploratory analysis was to determine whether long-term platelet inhibition may be associated with platelet adaptation...
June 12, 2017: Journal of Thrombosis and Thrombolysis
https://www.readbyqxmd.com/read/28605738/spatial-neglect-predicts-upper-limb-use-in-the-activities-of-daily-living
#16
Tim Vanbellingen, Beatrice Ottiger, Noortje Maaijwee, Tobias Pflugshaupt, Stephan Bohlhalter, René M Müri, Tobias Nef, Dario Cazzoli, Thomas Nyffeler
BACKGROUND AND PURPOSE: Motor tests performed at stroke onset have been shown to predict the recovery of upper limb motor impairment. Less is known about upper limb recovery at the level of functional activity or of participation and how spatial neglect may influence the integration of the upper limb in the activities of daily living (ADL). Our objective was to investigate whether the initial severity of spatial neglect may predict upper limb use in ADL. METHODS: Eighty-two patients with a right-hemispheric stroke (RHS) were prospectively included in the study...
June 13, 2017: Cerebrovascular Diseases
https://www.readbyqxmd.com/read/28603141/time-course-of-evolution-of-disability-and-cause-specific-mortality-after-ischemic-stroke-implications-for-trial-design
#17
Aravind Ganesh, Ramon Luengo-Fernandez, Rose M Wharton, Sergei A Gutnikov, Louise E Silver, Ziyah Mehta, Peter M Rothwell
BACKGROUND: Outcome in stroke trials is often based on a 3-month modified Rankin scale (mRS). How 3-month mRS relates to longer-term outcomes will depend on late recovery, delayed stroke-related deaths, recurrent strokes, and nonstroke deaths. We evaluated 3-month mRS and death/disability at 1 and 5 years in a population-based cohort study. METHODS AND RESULTS: In 3-month survivors of ischemic stroke (Oxford Vascular Study; 2002-2014), we related 3-month mRS to disability (defined as mRS >2) at 1 and 5 years and/or death rates (age/sex adjusted)...
June 11, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28602376/left-ventricular-assist-device-in-older-adults
#18
REVIEW
Chris Caraang, Gregg M Lanier, Alan Gass, Wilbert S Aronow, Chhaya Aggarwal Gupta
Left ventricular assist devices (LVADs) are an effective therapy for a growing and aging population in the background of limited donor supply. Selecting the proper patient involves assessment of indications, risk factors, scores for overall outcomes, assessment for right ventricular failure, and optimal timing of implantation. LVAD complications have a 5% to 10% perioperative mortality and complications of bleeding, thrombosis, stroke, infection, right ventricular failure, and device failure. As LVAD engineering technology evolves, so will the risk-prediction scores...
July 2017: Heart Failure Clinics
https://www.readbyqxmd.com/read/28601908/urinary-liver-type-fatty-acid-binding-protein-is-an-independent-predictor-of-stroke-and-mortality-in-individuals-with-type-1-diabetes
#19
Nicolae M Panduru, Carol Forsblom, Markku Saraheimo, Lena M Thorn, Daniel Gordin, Nina Elonen, Valma Harjusalo, Angelika Bierhaus, Per M Humpert, Per-Henrik Groop
AIMS/HYPOTHESIS: In type 1 diabetes, cardiovascular disease (CVD) and diabetic nephropathy progress in parallel, thereby potentiating the risk of premature death during their development. Since urinary liver-type fatty acid binding protein (L-FABP) predicts the progression of diabetic nephropathy, the aim of this study was to investigate whether urinary L-FABP also predicts cardiovascular outcomes and mortality. METHODS: We tested our hypothesis in a Finnish cohort of 2329 individuals with type 1 diabetes and a median follow-up of 14...
June 10, 2017: Diabetologia
https://www.readbyqxmd.com/read/28601329/predictors-of-readmission-in-nonagenarians-analysis-of-the-american-college-of-surgeons-national-surgical-quality-improvement-project-dataset
#20
Zachary Hothem, Dustin Baker, Christina S Jenkins, Jason Douglas, Rose E Callahan, Catherine C Shuell, Graham W Long, Robert J Welsh
BACKGROUND: Increased longevity has led to more nonagenarians undergoing elective surgery. Development of predictive models for hospital readmission may identify patients who benefit from preoperative optimization and postoperative transition of care intervention. Our goal was to identify significant predictors of 30-d readmission in nonagenarians undergoing elective surgery. METHODS: Nonagenarians undergoing elective surgery from January 2011 to December 2012 were identified using the American College of Surgeons National Surgical Quality Improvement Project participant use data files...
June 1, 2017: Journal of Surgical Research
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