Predictors of Functional Outcome Following Stroke

Harvey, Richard L.

doi:10.1016/j.pmr.2015.07.002

Cited by 93 publications

(75 citation statements)

References 92 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Predictor of functional outcome Consistent with previous reports, we have found that the strongest predictor of functional outcomes following stroke is the age of the patient and stroke severity (17). We also found that thrombectomies and tme-to-treatment of the thrombectomy were significantly related to functional outcome; however, the application of thrombolytic's was not related to functional outcome.…”

Section: Prevalence Of Thrombectomiessupporting

confidence: 89%

Changing Trends in Hyperacute Stroke Treatment and Early Clinical Outcomes Reflecting Recent Improvement in Endovascular Thrombectomy Techniques

Davidson

Chakraborty

2017

UOJM

View full text Add to dashboard Cite

Objective: Ischemic stroke is a major disease causing death and permanent neurological disability with the mainstay treatment being to re-established blood flow as quickly as possible. Recent changes in the efficiency of endovascular devices performing thrombectomies have led to it now being considered the gold standard. Nevertheless, successful endovascular thrombectomy (EVT) requires access to many resources and expertise which may impact its effectiveness. The objective of the current study is to describe the application and utility of EVT in the clinical treatment of ischemic stroke at a single tertiary care hospital. Methods: This is a descriptive retrospective cohort study from a stroke database. A total of 548 patients diagnosed with an ischemic stroke affecting large cerebral arteries between January 2010 and June 2016 were included. National Institute of Health Stroke Scale (NIHSS) score was used to evaluate stroke severity upon admission. Modified Ranking Scale was used to determine the functional status of patients upon discharge. Successful reperfusion defined as a TICI score of 2B or 3, age, thrombolytic use and time- to-treatment were all considered for analysis. Results: Thrombectomies became more frequent (p<0.001) with shorter time-to-treatment in recent years (p=0.001). A successful thrombectomy has significantly improved functional status at discharge (p<0.001), even when thrombolytics were not given (p=0.003) or when patients were over 80 years old (p=0.021). Conclusion: The current work provides evidence that this single hospital has increased its frequency of application of EVT for ischemic stroke, leading to a better functional outcome at discharge independent of prior thrombolysis or age.

show abstract

Section: Prevalence Of Thrombectomiessupporting

confidence: 89%

Changing Trends in Hyperacute Stroke Treatment and Early Clinical Outcomes Reflecting Recent Improvement in Endovascular Thrombectomy Techniques

Davidson

Chakraborty

2017

UOJM

View full text Add to dashboard Cite

show abstract

“…This study found that initial stroke and aphasia severity were consistently the best factors to predict aphasia recovery. Furthermore, aphasia has been found to be associated with greater functional dependence as measured by the modified Rankin Scale [6]. This finding is consistent with the idea that residual comprehension deficits are associated with lower probability of a patient returning home after an IRU stay and with lower motor and cognitive scores on the Functional Independence Measure (FIM) [7].…”

Section: Case Scenariosupporting

confidence: 73%

Should This Patient With Global Aphasia After a Left Cerebral Stroke Be Admitted to Your Hospital‐Based Inpatient Rehabilitation Unit?

Lindsay

Lercher

O’Dell

2017

PM&R

View full text Add to dashboard Cite

“…Therefore, we included these factors in the subsequent stepwise hierarchical regression analyses. NIHSS and CST lesion load were also included, since both are well-known outcome predictors (Harvey, 2015;Kwakkel et al, 2010;Kwakkel and Kollen, 2013;Radlinska et al, 2010). Several significant models predicting ΔFIM, ΔLIMOS, and ΔLIMOS upper limb were identified (see Table 3).…”

Section: Clinical and Demographic Factors Predicting General Functionmentioning

confidence: 99%

Theta burst stimulation in neglect after stroke: functional outcome and response variability origins

Nyffeler

Vanbellingen

Kaufmann

et al. 2019

Brain

View full text Add to dashboard Cite

Spatial neglect is a strong and negative predictor of general functional outcome after stroke, and its therapy remains a challenge. Whereas inhibitory non-invasive brain stimulation (NIBS) over the contralesional, intact hemisphere has generally been shown to ameliorate neglect on a group level, a conspicuous variability of the effects at the individual level is typically observed. We aimed to comprehensively assess the characteristics and determinants of the effects of inhibitory NIBS in neglect, identifying which patients would respond to this therapeutic approach and which not. To this end, we prospectively included sixty patients with a subacute right-hemispheric stroke. In thirty patients with spatial neglect, continuous Theta Burst Stimulation (cTBS) was applied over the left posterior parietal cortex (PPC) in a randomized clinical trial, either in 8 or 16 trains, or as sham stimulation. Thirty patients without neglect served as control group. Neglect severity was measured with a neuropsychological test battery and the Catherine Bergego Scale (CBS), at admission to and at discharge from inpatient neurorehabilitation, as well as at 3 months follow-up. General functional outcome was assessed by means of the Functional Independent Measurement (FIM) and the Lucerne ICF-based Multidisciplinary Observation Scale (LIMOS). The impact of clinical and demographic factors was evaluated, and the influence of lesion location and extension was assessed by means of voxel-based lesionsymptom mapping (VLSM). On a group level, both cTBS protocols (i.e., 8 and 16 trains) significantly reduced neglect severity in both the CBS and the neuropsychological tests, at discharge and 3 months later. Furthermore, cTBS significantly improved general functional outcome. On an individual level, hierarchical cluster and VLSM analyses revealed that the variability in the responses to cTBS is determined by the integrity of inter-hemispheric connections within the corpus callosum, in particular parieto-parietal connections. In cTBS responders, in whom neglect and general functional outcome were significantly improved, the corpus callosum was intact, whereas this was not the case in cTBS non-responders. Moreover, analyses based on the Proportional recovery rule and the Maugeri predictive stroke recovery model showed that the recovery ! ! 3! ! of neglect and of the activities of daily living (ADL) was accelerated only in cTBS responders. Furthermore, the level of ADL recovery of these neglect patients was brought close to the one of right-hemispheric control patients without neglect. Hence, in neglect patients with intact interhemispheric connectivity, cTBS over the contralesional PPC significantly improves and accelerates neglect recovery and, associated with it, general functional outcome.

show abstract

Predictors of Functional Outcome Following Stroke

Cited by 93 publications

References 92 publications

Changing Trends in Hyperacute Stroke Treatment and Early Clinical Outcomes Reflecting Recent Improvement in Endovascular Thrombectomy Techniques

Changing Trends in Hyperacute Stroke Treatment and Early Clinical Outcomes Reflecting Recent Improvement in Endovascular Thrombectomy Techniques

Should This Patient With Global Aphasia After a Left Cerebral Stroke Be Admitted to Your Hospital‐Based Inpatient Rehabilitation Unit?

Theta burst stimulation in neglect after stroke: functional outcome and response variability origins

Contact Info

Product

Resources

About