Intracerebral Hemorrhage Specific Intensity of Care Quality Metrics

Qureshi, Adnan I.

doi:10.1007/s12028-010-9453-z

Cited by 33 publications

(22 citation statements)

References 206 publications

(233 reference statements)

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“…Only 5 patients in our study initiated acute reversal therapy within 2 hours of presentation despite risks of both early and prolonged hematoma expansion without rapid, complete reversal. 5,6,8 Before transfer, only one in 5 patients received sufficient acute reversal. 9 Patients who received more aggressive reversal therapy had better outcomes despite longer transfer delays.…”

Section: Discussionmentioning

confidence: 99%

Warfarin-Associated Intracerebral Hemorrhage Is Inadequately Treated at Community Emergency Departments

Liotta

Garg

Temes

et al. 2012

Stroke

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Background and Purpose-The purpose of this study was to investigate time delays, adherence to guidelines, and their impact on outcomes in patients with warfarin-associated intracerebral hemorrhage transferred from community emergency departments to a comprehensive stroke center. Methods-We collected demographic, clinical, transfer time, treatment, and outcome data for patients transferred to our institution with warfarin-associated intracerebral hemorrhage from community emergency departments. Results-Among 928 patients with intracerebral hemorrhage, 56 (6%) with warfarin-associated intracerebral hemorrhage (median international normalized ratio, 2.55) were transferred to the comprehensive stroke center. Twenty patients received no acute reversal therapy before transfer, only 4 of whom had international normalized ratios Յ1.4 in the community emergency department. Median time of emergency department stay was 3.66 hours and median time to initiation of acute reversal therapy was 4.48 hours. Those who received Ն3 U of fresh-frozen plasma or recombinant activated Factor VIIa (11 patients) before transfer had lower repeat international normalized ratios and better discharge dispositions than those treated less aggressively. Conclusions-Treatment of warfarin-associated intracerebral hemorrhage in community emergency departments is often suboptimal and does not adhere to published guidelines. Treating coagulopathy aggressively before interhospital transfer may improve outcomes and warrants further investigation. (Stroke. 2012;43:2503-2505.)

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Section: Discussionmentioning

confidence: 99%

Warfarin-Associated Intracerebral Hemorrhage Is Inadequately Treated at Community Emergency Departments

Liotta

Garg

Temes

et al. 2012

Stroke

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“…In countries where labetalol was not available, intravenous diltiazem or urapidil was used. Additional care was based on the best available evidence 15 and the guidelines from the American Stroke Association Stroke Council 12 and the European Stroke Initiative Writing Committee. 16 We assessed the success, or lack thereof, of the reduction in the systolic blood-pressure level.…”

Section: Trial Interventionmentioning

confidence: 99%

Intensive blood-pressure lowering in patients with acute cerebral hemorrhage

Alrahbi

Alaraimi

Alzaabi

et al. 2017

CJEM

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“…Airway protection, anticoagulation reversal, blood pressure management, and intracranial pressure (ICP) management are vitally important strategies that need to be initiated as early as possible. In a recent article, 26 quality indicators were proposed for the systematic evaluation of ICH patient care, although many have not yet been validated as predictors of better outcome [54].…”

Section: General Principlesmentioning

confidence: 99%