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Keywords Stroke and primary admitting p...

Stroke and primary admitting physician

https://read.qxmd.com/read/33145511/lack-of-benefit-from-hospitalization-in-patients-with-syncope-a-propensity-analysis
#21
JOURNAL ARTICLE
Padma Kaul, Dat T Tran, Roopinder K Sandhu, Monica Solbiati, Giorgio Costantino, Robert S Sheldon
Study Objective: Patients with syncope are frequently admitted to the hospital, but whether this improves outcome is unknown. We tested whether hospitalization reduced mortality in patients who presented to emergency departments (EDs) with syncope. Methods: We conducted a propensity analysis of the outcomes of patients ≥18 years old presenting to EDs with a primary diagnosis of syncope in April 2004-March 2013. The model used 1:1 nearest-neighbor matching to predicted admission using age, sex, urban residence, household income, and 14 significant comorbidities from 4 administrative databases of the province of Alberta...
October 2020: Journal of the American College of Emergency Physicians open
https://read.qxmd.com/read/32667718/increased-mortality-in-patients-with-secondary-diagnosis-of-atrial-fibrillation-report-from-chinese-af-registry
#22
JOURNAL ARTICLE
Xing-Hui Shao, Yan-Min Yang, Jun Zhu, Li-Tian Yu, Li-Sheng Liu
BACKGROUND: The relationship between mortality and the primary diagnosis in AF patients is poorly recognized. The purpose of the study is to compare the differences on mortality in patients with a primary or secondary diagnosis of AF and to identify risk factors amenable to treatment. METHODS: This was a prospective cohort study using data from the Chinese AF registry. For admitted patients, a follow-up was completed to obtain the outcomes during 1 year. RESULTS: A total of 2015 patients with confirmed AF were included...
July 15, 2020: Annals of Noninvasive Electrocardiology
https://read.qxmd.com/read/32623107/diagnosis-and-management-of-silent-coronary-ischemia-in-patients-undergoing-carotid-endarterectomy
#23
JOURNAL ARTICLE
Dainis Krievins, Edgars Zellans, Gustavs Latkovskis, Sanda Jegere, Indulis Kumsars, Karlis Kaufmanis, Andrejs Erglis, Christopher K Zarins
INTRODUCTION: Coronary artery disease (CAD) is the primary cause of death in patients with carotid artery disease and silent ischemia is a marker for adverse coronary events. A new non-invasive cardiac diagnostic test, coronary CT-derived fractional flow reserve (FFRCT ) can reliably identify ischemia-producing coronary stenosis in patients with CAD and help select patients for coronary revascularization. The purpose of this study is to determine the prevalence of silent coronary ischemia in patients undergoing carotid endarterectomy (CEA) and to evaluate the usefulness of FFRCT in selecting patients for coronary revascularization in order to reduce cardiac events and improve survival...
July 2, 2020: Journal of Vascular Surgery
https://read.qxmd.com/read/32572113/nationwide-patterns-of-hemorrhagic-stroke-among-patients-hospitalized-with-brain-metastases-influence-of-primary-cancer-diagnosis-and-anticoagulation
#24
JOURNAL ARTICLE
Victor Lee, Vikram Jairam, James B Yu, Henry S Park
Brain metastases can contribute to a decreased quality of life for patients with cancer, often leading to malaise, neurologic dysfunction, or death. Intracerebral hemorrhage (ICH) is an especially feared complication in patients with brain metastases given the potential for significant morbidity and mortality. We aim to characterize patients with cancer and brain metastases admitted to hospitals nationwide and identify factors associated with ICH. The 2016 Healthcare Cost and Utilization Project Nationwide Inpatient Sample (HCUP-NIS) was queried for all patients with cancer hospitalized with a diagnosis of brain metastases...
June 22, 2020: Scientific Reports
https://read.qxmd.com/read/32066601/risk-factors-and-clinical-outcomes-of-functional-decline-during-hospitalisation-in-very-old-patients-with-acute-decompensated-heart-failure-an-observational-study
#25
JOURNAL ARTICLE
Hidenori Yaku, Takao Kato, Takeshi Morimoto, Yasutaka Inuzuka, Yodo Tamaki, Neiko Ozasa, Erika Yamamoto, Yusuke Yoshikawa, Takeshi Kitai, Masashi Kato, Tomoyuki Ikeda, Yutaka Furukawa, Yoshihisa Nakagawa, Yukihito Sato, Koichiro Kuwahara, Takeshi Kimura
OBJECTIVE: To investigate the prevalence and risk factors of functional decline during hospitalisation and its relationship with postdischarge outcomes in very old patients with acute decompensated heart failure (ADHF) hospitalisation. DESIGN: Prospective cohort study between 1 October 2014 and 31 March 2016. SETTING: A physician-initiated, multicentre study of consecutive patients admitted for ADHF in 19 hospitals throughout Japan. PARTICIPANTS: Among 3555 patients hospitalised for ADHF (median age (IQR), 80 (71-86) years; 1572 (44%) women), functional decline during the index hospitalisation occurred in 528 patients (15%)...
February 16, 2020: BMJ Open
https://read.qxmd.com/read/32001107/the-use-of-oral-anticoagulants-in-patients-with-atrial-fibrillation-in-the-emergency-department
#26
JOURNAL ARTICLE
Hope Hua, Nicole Sur, Jungwon Choi, Sai Polineni, Lilly Lee, Seemant Chaturvedi
BACKGROUND AND AIM: Atrial Fibrillation is the leading cause of embolic stroke, yet less than half of high-risk patients with atrial fibrillation are on adequate stroke prevention with oral anticoagulants. Guidelines for the primary prevention of stroke recognize the emergency department as a location for physicians to identify atrial fibrillation and initiate anticoagulants. We sought to compare anticoagulant prescription rates in patients with atrial fibrillation in various provider settings to identify opportunities for improvement in cardioembolic stroke prevention...
January 27, 2020: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://read.qxmd.com/read/31843830/associations-between-work-satisfaction-engagement-and-7-day-patient-mortality-a-cross-sectional-survey
#27
JOURNAL ARTICLE
Kirsten Brubakk, Martin Veel Svendsen, Dag Hofoss, Tonya Moen Hansen, Paul Barach, Ole Tjomsland
OBJECTIVE: This study examines the association between profession-specific work environments and the 7-day mortality of patients admitted to these units with acute myocardial infarction (AMI), stroke and hip fracture. DESIGN: A cross-sectional study combining patient mortality data extracted from the South-Eastern Norway Health Region, and the work environment scores at the hospital ward levels. A case-mix adjustment model was developed for the comparison between hospital wards...
December 15, 2019: BMJ Open
https://read.qxmd.com/read/31796059/why-acute-ischemic-stroke-patients-in-the-united-states-use-or-do-not-use-emergency-medical-services-transport-findings-of-an-inpatient-survey
#28
JOURNAL ARTICLE
Sudha Xirasagar, Meng-Han Tsai, Khosrow Heidari, James W Hardin, Yuqi Wu, Robert Wronski, Dana Hurley, Edward C Jauch, Souvik Sen
BACKGROUND: Patients with acute ischemic stroke (AIS) who use emergency medical services (EMS) receive quicker reperfusion treatment which, in turn, mitigates post-stroke disability. However, nationally only 59% use EMS. We examined why AIS patients use or do not use EMS. METHODS: During 2016-2018, a convenience sample of AIS patients admitted to a primary stroke center in South Carolina were surveyed during hospitalization if they were medically fit, available for survey when contacted, and consented to participate...
December 3, 2019: BMC Health Services Research
https://read.qxmd.com/read/31390461/cha2ds2-vasc-score-performance-to-predict-stroke-after-acute-decompensated-heart-failure-with-and-without-reduced-ejection-fraction
#29
JOURNAL ARTICLE
Anat Berkovitch, Israel Mazin, Arwa Younis, Nir Shlomo, Eyal Nof, Ilan Goldenberg, Roy Beinart
AIMS: To validate the utility of CHA2DS2-VASc score to predict the annual risk of stroke in patients admitted with acute heart failure, comparing those with preserved ejection fraction (HF-presEF) and reduced ejection fraction (HF-redEF). METHODS AND RESULTS: We investigated 2922 patients with known atrial fibrillation who were admitted to the Sheba Medical Center for acute decompensated heart failure (HF). Anticoagulation therapy was prescribed based on CHA2DS2-VASc score or physician's discretion...
August 7, 2019: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://read.qxmd.com/read/31312449/prevalence-risk-factors-and-outcomes-of-patients-coming-from-the-community-with-sepsis-due-to-multidrug-resistant-bacteria
#30
JOURNAL ARTICLE
Nicolò Capsoni, Pietro Bellone, Stefano Aliberti, Giovanni Sotgiu, Donatella Pavanello, Benedetto Visintin, Elena Callisto, Laura Saderi, Davide Soldini, Luca Lardera, Valter Monzani, Anna Maria Brambilla
Background: Although previous studies showed an increasing prevalence of infections due to multi-drug resistant (MDR) bacteria in the community, specific data on sepsis are lacking. We aimed to assess prevalence, risk factors and outcomes of patients with sepsis due to MDR bacteria. Methods: An observational, retrospective study was conducted on consecutive adult patients coming from the community and admitted to the Policlinico Hospital, Milan, Italy, with a diagnosis of sepsis between January 2011 and December 2015...
2019: Multidisciplinary Respiratory Medicine
https://read.qxmd.com/read/31286825/contact-with-primary-health-care-physicians-before-an-acute-hospitalisation
#31
JOURNAL ARTICLE
Lena J Skarshaug, Ellen R Svedahl, Johan H Bjørngaard, Aslak Steinsbekk, Kristine Pape
Objectives: To assess contacts with general practitioners (GPs), both regular GPs and out-of-hours GP services (OOH) during the year before an emergency hospital admission. Design: Longitudinal design with register-based information on somatic health care contacts and use of municipality health care services. Setting: Four municipalities in central Norway, 2012-2013. Subjects: Inhabitants aged 50 and older admitted to hospital for acute myocardial infarction, hip fracture, stroke, heart failure, or pneumonia...
September 2019: Scandinavian Journal of Primary Health Care
https://read.qxmd.com/read/31005365/successful-management-of-severe-exertional-heat-stroke-with-endovascular-cooling-after-failure-of-standard-cooling-measures
#32
JOURNAL ARTICLE
Michael M Bursey, Meghan Galer, Robert C Oh, B Kent Weathers
BACKGROUND: Exertional heat stroke (EHS) is a potentially life-threatening emergency requiring rapid reduction in core body temperature. Methods of cooling include cold water immersion, ice packs, cold water lavage, and chilled saline, among others. We report a case of EHS successfully cooled using an endovascular cooling device after traditional cooling methods failed to reduce core body temperature. CASE REPORT: A 24-year old soldier collapsed during a 12-mile foot march while training in southern Georgia...
August 2019: Journal of Emergency Medicine
https://read.qxmd.com/read/30785379/icaruss-an-effective-model-for-risk-factor-management-in-stroke-survivors
#33
RANDOMIZED CONTROLLED TRIAL
Jacques Joubert, Stephen M Davis, Geoffrey A Donnan, Christopher Levi, Graeme Gonzales, Lynette Joubert, Graeme J Hankey
BACKGROUND AND PURPOSE: After an initial stroke, the risk of recurrent stroke is high. Models that implement best-practice recommendations for risk factor management in stroke survivors to prevent stroke recurrence remain elusive. We examined a model which focuses on vascular risk factor management to prevent stroke recurrence in survivors returning to their primary care physicians. This model is coordinated from the stroke unit, integrates specialist stroke services with primary care physicians, and directly involves patients and carers in risk factor management...
June 2020: International Journal of Stroke: Official Journal of the International Stroke Society
https://read.qxmd.com/read/30061440/study-protocol-for-a-single-centre-prospective-non-blinded-randomised-12-month-parallel-group-superiority-study-to-compare-the-efficacy-of-pharmacist-intervention-versus-usual-care-for-elderly-patients-hospitalised-in-orthopaedic-wards
#34
JOURNAL ARTICLE
Junpei Komagamine, Kenichi Sugawara, Miho Kaminaga, Shinpei Tatsumi
INTRODUCTION: Given that polypharmacy and potentially inappropriate prescribing are common in elderly orthopaedic patients, pharmacist interventions to improve medication practices among this population are important. However, past studies have reported mixed results regarding the effectiveness of pharmacist-led interventions in inpatient elderly care. Furthermore, few randomised controlled trials have evaluated patient-relevant outcomes as a primary endpoint. Therefore, we will evaluate whether a pharmacist-led intervention could reduce readmission of hospitalised elderly orthopaedic patients with polypharmacy or potentially inappropriate prescribing...
July 30, 2018: BMJ Open
https://read.qxmd.com/read/29524340/creation-and-implementation-of-an-outpatient-pathway-for-atrial-fibrillation-in-the-emergency-department-setting-results-of-an-expert-panel
#35
JOURNAL ARTICLE
Christopher W Baugh, Carol L Clark, Jason W Wilson, Ian G Stiell, Abraham G Kocheril, Krista K Luck, Troy D Myers, Charles V Pollack, Steven K Roumpf, Gery F Tomassoni, James M Williams, Brian B Patel, Fred Wu, Jesse M Pines
Atrial fibrillation and flutter (AF) is a common condition among emergency department (ED) patients in the United States. Traditionally, ED care for primary complaints related to AF focus on rate control, and patients are often admitted to an inpatient setting for further care. Inpatient care may include further telemetry monitoring and diagnostic testing, rhythm control, a search for identification of AF etiology, and stroke prophylaxis. However, many patients are eligible for safe and effective outpatient management pathways...
September 2018: Academic Emergency Medicine
https://read.qxmd.com/read/29402689/patient-provider-and-environmental-factors-associated-with-adherence-to-cardiovascular-and-cerebrovascular-clinical-practice-guidelines-in-the-ed
#36
JOURNAL ARTICLE
Stacy A Trent, Michael A Johnson, Erica A Morse, Edward P Havranek, Jason S Haukoos
OBJECTIVES: Myocardial infarction and stroke are two of the leading causes of death in the U.S. Both diseases have clinical practice guidelines (CPGs) specific to the emergency department (ED) that improve patient outcomes. Our primary objectives were to estimate differences in ED adherence across CPGs for these diseases and identify patient, provider, and environmental factors associated with adherence. METHODS: Design: Retrospective study at 3 hospitals in Colorado using standard medical record review...
August 2018: American Journal of Emergency Medicine
https://read.qxmd.com/read/28780236/tenecteplase-versus-alteplase-for-management-of-acute-ischaemic-stroke-nor-test-a-phase-3-randomised-open-label-blinded-endpoint-trial
#37
RANDOMIZED CONTROLLED TRIAL
Nicola Logallo, Vojtech Novotny, Jörg Assmus, Christopher E Kvistad, Lars Alteheld, Ole Morten Rønning, Bente Thommessen, Karl-Friedrich Amthor, Hege Ihle-Hansen, Martin Kurz, Håkon Tobro, Kamaljit Kaur, Magdalena Stankiewicz, Maria Carlsson, Åse Morsund, Titto Idicula, Anne Hege Aamodt, Christian Lund, Halvor Næss, Ulrike Waje-Andreassen, Lars Thomassen
BACKGROUND: Tenecteplase is a newer thrombolytic agent with some pharmacological advantages over alteplase. Previous phase 2 trials of tenecteplase in acute ischaemic stroke have shown promising results. We aimed to investigate the safety and efficacy of tenecteplase versus alteplase in patients with acute stroke who were eligible for intravenous thrombolysis. METHODS: This phase 3, randomised, open-label, blinded endpoint, superiority trial was done in 13 stroke units in Norway...
October 2017: Lancet Neurology
https://read.qxmd.com/read/28615894/unknown-patients-and-neurology-casualty-services-in-an-indian-metropolitan-city-a-decades-experience
#38
JOURNAL ARTICLE
Achary Umesh, Guru S Gowda, Channaveerachari Naveen Kumar, Dwarakanath Srinivas, Bharath Rose Dawn, Ragasudha Botta, Ravi Yadav, Suresh Bada Math
OBJECTIVES: A large number of unknown patients without any personal, family, or other identification details represent a unique problem in the neurological emergency services of developing countries like India in a context of legal, humanitarian, and treatment issues. These patients pose a diagnostic and management challenge to treating physicians and staff. There are sparse data on these patients. The objective of this study was to know the clinical, socio-demographic, and investigational profile of "unknown" patients...
April 2017: Annals of Indian Academy of Neurology
https://read.qxmd.com/read/28231814/the-impact-of-a-physician-staffed-helicopter-on-outcome-in-patients-admitted-to-a-stroke-unit-a-prospective-observational-study
#39
JOURNAL ARTICLE
Kamilia S Funder, Lars S Rasmussen, Nicolai Lohse, Rasmus Hesselfeldt, Volkert Siersma, Jesper Gyllenborg, Sandra Wulffeld, Ole M Hendriksen, Freddy K Lippert, Jacob Steinmetz
BACKGROUND: Transportation by helicopter may reduce time to hospital admission and improve outcome. We aimed to investigate the effect of transport mode on mortality, disability, and labour market affiliation in patients admitted to the stroke unit. METHODS: Prospective, observational study with 5.5 years of follow-up. We included patients admitted to the stroke unit the first three years after implementation of a helicopter emergency medical services (HEMS) from a geographical area covered by both the HEMS and the ground emergency medical services (GEMS)...
February 23, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://read.qxmd.com/read/27884458/risk-of-carotid-stroke-after-chiropractic-care-a-population-based-case-crossover-study
#40
JOURNAL ARTICLE
J David Cassidy, Eleanor Boyle, Pierre Côté, Sheilah Hogg-Johnson, Susan J Bondy, Scott Haldeman
BACKGROUND: Chiropractic manipulation is a popular treatment for neck pain and headache, but may increase the risk of cervical artery dissection and stroke. Patients with carotid artery dissection can present with neck pain and/or headache before experiencing a stroke. These are common symptoms seen by both chiropractors and primary care physicians (PCPs). We aimed to assess the risk of carotid artery stroke after chiropractic care by comparing association between chiropractic and PCP visits and subsequent stroke...
April 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
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