Prediction of length of stay for stroke patients

Appelros, Peter

doi:10.1111/j.1600-0404.2006.00756.x

Cited by 101 publications

(91 citation statements)

References 18 publications

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“…4 A total NIHSS >25 is an exclusion criterion for rt-PA. 13 One small study looked at the NIHSS items and found that increases in the loss of consciousness and motor limbs total scores were related to neurological deterioration within the first 120 minutes after administration of intravenous rt-PA. 14 Another study reported that an improvement in the total NHISS of >3 points at 15 minutes or of >5 points at 30 minutes predicts a more favorable outcome and helps identify patients who are not responding to rt-PA. 15 A Swedish study of 347 patients found that for each point on the baseline NIHSS there was an increase in length of stay by 0.8 days and the total length of stay (including rehabilitation) by 3.4 days up to a NIHSS of 19 points. 16 The NIHSS was better at predicting the presence of dysphagia compared with a nursing dysphagia screening tool in a retrospective cohort study of veterans admitted with ischemic stroke. 17 Several studies have looked at outcome after hospitalization.…”

Section: Validitymentioning

confidence: 99%

Reliability and Validity of the National Institutes of Health Stroke Scale for Neuroscience Nurses

Hinkle

2014

Stroke

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Section: Validitymentioning

confidence: 99%

Reliability and Validity of the National Institutes of Health Stroke Scale for Neuroscience Nurses

Hinkle

2014

Stroke

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“…This selection may result in the exclusion of individuals with less severe stroke, fewer complications or comorbidities, expedited discharge, or early mortality. 14 The frequency of feeding tube use was compared among hospitals with a minimum of 30 annual stroke admissions. 15 This minimum admission volume ensures that 95% confidence intervals (CIs) were no wider than 10% for hospitals using feeding tubes at the mean rate (approximately 8%).…”

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confidence: 99%

Current practices in feeding tube placement for US acute ischemic stroke inpatients

et al. 2014

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“…These patients often need a longer stay in hospital. 56 Dementia before a stroke increases the risk for both early death 27 and death within 1 year, 8 and also increases the risk of a recurrent stroke. 8 Most likely, the explanation is multifactorial.…”

Section: Prognosismentioning

confidence: 99%

Cognitive Impairment in Lacunar Strokes

Appelros¹

2013

US Neurology

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Vascular cognitive impairment is closely related to stroke. Each condition is a risk factor for the other. Cognitive impairment is a symptom that makes it difficult for a stroke patient to live at home. In this review paper, different types of vascular cognitive impairment are discussed, with emphasis on cognitive impairment related to lacunar strokes (LACS). Symptoms, diagnostics, epidemiology, treatment, and prognosis are surveyed. LACS are often associated with leukoaraiosis, which is related to subcortical ischemic vascular dementia. Even if LACS often are mild, they may therefore be associated with cognitive impairment on longer term. KeywordsStroke, vascular cognitive impairment, leukoaraiosis, small vessel disease Disclosure: The author has no conflicts of interest to declare. DefinitionsAccording to ICD-10, a diagnosis of dementia requires: (1) impairment in short-and long-term memory; (2) impairment in abstract thinking, judgement, higher cortical function, or personality change; (3) memory impairment and intellectual impairment, which cause significant social and occupational impairments; and (4) the occurrence of these traits when patients are not in a state of delirium.Cognitive impairment is a continuum, affecting different cognitive domains at different rates, from different causes. 4 The definition of dementia requires memory impairment plus involvement of at least one other cognitive domain. This definition is less appropriate for vascular cognitive impairment (VCI), because in VCI memory is often less affected than executive functions. In this paper, the terms cognitive impairment and VCI are used whenever possible.Delirium, or confusional state, is a more or less acute disorder of attention and global cognition (memory and perception), which is reversible. 5 Delirium is almost always caused by a provoking event, such as an infection, a metabolic condition, or a psychotropic drug.People with pre-existing cognitive impairment are at higher risk for developing delirium.LACS result from occlusion of the penetrating arteries that provide blood to the brain's deep structures. A corresponding infarction is often small, within 10 mm and affects the deep nuclei of the brain or different neural pathways to and from the cortex. 6,7 Compared to larger infarctions that involve the cortex, patients with LACS often have a lower grade of stroke severity 1 and a better short-time prognosis. 8 Therefore, LACS have been considered as relatively benign. 7On the other hand, LACS are often seen together with leukoaraiosis or cerebral white matter changes. 9,10 These are radiologic findings with bilateral patchy or diffuse areas of hyperintensities of the cerebral white matter on T2-weighted MRI. Leukoaraiosis is probably caused by chronic ischemia in the white matter, leading to loss of myelin and axons, and ultimately to gliosis and atrophy. 11 Leukoaraiosis is related to cognitive impairment. 12,13 Classification of Cognitive ImpairmentNot so many years ago, a rather strict distinction was made between th...

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Prediction of length of stay for stroke patients

Abstract: Stroke severity is a strong and reliable predictor of LOS. The results of this study can be used as a baseline for evaluating cost-effectiveness of stroke care changes, e.g. organizational changes or evaluation of new drugs.

Cited by 101 publications

References 18 publications

Reliability and Validity of the National Institutes of Health Stroke Scale for Neuroscience Nurses

Reliability and Validity of the National Institutes of Health Stroke Scale for Neuroscience Nurses

Current practices in feeding tube placement for US acute ischemic stroke inpatients

Cognitive Impairment in Lacunar Strokes

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