Mechanism of in-hospital cerebral ischemia.

Kelley, Roger E.; Kovacs, Andrew G.

doi:10.1161/01.str.17.3.430

Cited by 56 publications

(52 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Although embolism and cardiac diseases have been known to be more common with IHS [11], few studies have compared risk factors for stroke between IHS and OHS [4]. This study shows that cardiac disease is more frequent in IHS patients, whilst hypertension, smoking, and dyslipidemia, which are well-known risk factors for atherosclerosis, were less commonly noted.…”

Section: Discussionmentioning

confidence: 64%

Comparison of the characteristics for in‐hospital and out‐of‐hospital ischaemic strokes

Park

Cho

Kim

et al. 2009

Euro J of Neurology

View full text Add to dashboard Cite

Background and purpose: Patients who are being admitted to a hospital due to diseases other than stroke may develop a stroke (in-hospital stroke; IHS). Methods: We enrolled 111 consecutive patients who developed IHS outside a neurology ward during a 5-year period at a single hospital. The frequency, characteristics, and outcomes for IHS patients were compared with patients who develop ischaemic stroke outside of the hospital (out-of-hospital stroke; OHS). Results: Forty-six percent of IHS occurred in the department of cardiology or cardiovascular surgery and 60% were associated with surgery or procedures. In comparison with the OHS patient group, the IHS patient group showed an increased frequency of cardiac disease, leukocytosis, and anemia. Cardioembolism, stroke of other determined etiologies, and an incomplete evaluation were more common in the IHS group, whereas large artery atherosclerosis was more frequent in the OHS group. The IHS group had up to a 10-fold higher mortality than the OHS group, with sepsis being the most common cause of death in the IHS group. Conclusions: IHS has distinct etiologies and stroke mechanisms from OHS. The prevention and management of infection could decrease mortality in IHS patients.

show abstract

Section: Discussionmentioning

confidence: 64%

Comparison of the characteristics for in‐hospital and out‐of‐hospital ischaemic strokes

Park

Cho

Kim

et al. 2009

Euro J of Neurology

View full text Add to dashboard Cite

show abstract

“…The fraction of strokes with onset in the hospital in the GWTG-Stroke registry was lower than that seen in other studies. 1,3 Sites not reporting in-hospital strokes were significantly more likely to be nonacademic, rural, have smaller number of hospital beds, and have lower annual stroke volumes (data not shown). More severe strokes, or those receiving tPA, may be more likely to be reported among the population of inhospital strokes, which may introduce reporting bias.…”

mentioning

confidence: 97%

“…[1][2][3][4][5][6] There are an estimated 35 000 to 75 000 of these in-hospital strokes in the United States each year. 7 Relatively little is known about the characteristics, treatments, quality of care, and outcomes of these patients.…”

mentioning

confidence: 99%

Quality of Care and Outcomes for In-Hospital Ischemic Stroke

Cumbler

Wald

Bhatt

et al. 2014

Stroke

View full text Add to dashboard Cite

Background and Purpose-Analysis of quality of care for in-hospital stroke has not been previously performed at the national level. This study compares patient characteristics, process measures of quality, and outcomes for in-hospital strokes with those for community-onset strokes in a national cohort. Methods-We performed a retrospective cohort study of the Get With The Guidelines-Stroke (GWTG-Stroke) database ofThe American Heart Association from January 2006 to April 2012, using data from 1280 sites that reported ≥1 in-hospital stroke. Patient characteristics, comorbid illnesses, medications, quality of care measures, and outcomes were analyzed for 21 349 in-hospital ischemic strokes compared with 928 885 community-onset ischemic strokes. Results-Patients with in-hospital stroke had more thromboembolic risk factors, including atrial fibrillation, prosthetic heart valves, carotid stenosis, and heart failure (P<0.0001), and experienced more severe strokes (median National Institutes of Health Stroke Score 9.0 versus 4.0; P<0.0001). Using GWTG-Stroke achievement measures, the proportion of patients with defect-free care was lower for in-hospital strokes (60.8% versus 82.0%; P<0.0001). After accounting for patient and hospital characteristics, patients with in-hospital strokes were less likely to be discharged home (adjusted odds ratio 0.37; 95% confidence intervals [0.35-0.39]) or be able to ambulate independently at discharge (adjusted odds ratio 0.42; 95% confidence intervals [0.39-0.45]). In-hospital mortality was higher for in-hospital stroke (adjusted odds ratio 2.72; 95% confidence intervals [2.57-2.88]). Conclusions-Compared with community-onset ischemic stroke, patients with in-hospital stroke experienced more severe strokes, received lower adherence to process-based quality measures, and had worse outcomes. These findings suggest there is an important opportunity for targeted quality improvement efforts for patients with in-hospital stroke.

show abstract

“…It is less known that between 2.2% and 17% of all strokes occur in hospitalized patients, with a lower percentage reported in smaller hospitals and multicenter studies 3,4 and higher rate in tertiary clinics 5,6 . This difference is presumably due to a higher percentage of critically ill patients in larger hospitals, more frequent high-risk procedures and, possibly, a lower rate of reported cases in some participating centers in multicenter studies.…”

Section: Epidemiology and Definitionmentioning

confidence: 99%

In-hospital stroke

Reich¹

2017

J Neurol Neuromedicine

View full text Add to dashboard Cite

Mechanism of in-hospital cerebral ischemia.

Cited by 56 publications

References 20 publications

Comparison of the characteristics for in‐hospital and out‐of‐hospital ischaemic strokes

Comparison of the characteristics for in‐hospital and out‐of‐hospital ischaemic strokes

Quality of Care and Outcomes for In-Hospital Ischemic Stroke

In-hospital stroke

Contact Info

Product

Resources

About