Stroke treatment outcomes in hospitals with and without stroke units

Masjuán, Jaime; Culleré, J. Gállego; García, Emilio Ignacio; Solves, José Joaquín Mira; Ortiz, Andrés; Francisco, D. Vidal de; López-Mesonero, Luis; Bestué, M; Alberti, Oswaldo; Acebrón, Fernando; Soler, I.M. Navarro

doi:10.1016/j.nrleng.2017.06.005

Cited by 3 publications

(3 citation statements)

References 12 publications

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“…They also did not observe differences between groups in the number of patients presenting a disability at discharge (mRS > 2; p = 0.986). However, they did observe a lower rate of disability at discharge among patients who received IV-tPA versus those who did not, in both hospital groups (group A: 19 vs. 30, p < 0.05; group B: 2 vs. 41, p < 0.001) [25].…”

Section: Discussionmentioning

confidence: 87%

Emergency Department Time Targets for Interhospital Transfer of Patients with Acute Ischemic Stroke

Popa,

Iancu,

Petrica

et al. 2023

JPM

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Background and objectives: Although the intravenous tissue plasminogen activator (rt-PA) has been shown to be effective in the treatment of acute ischemic stroke (AIS), only a small proportion of stroke patients receive this drug. The low administration rate is mainly due to the delayed presentation of patients to the emergency department (ED) or the lack of a stroke team/unit in most of the hospitals. Thus, the aim of this study is to analyze ED time targets and the rate of rt-PA intravenous administration after the initial admission of patients with AIS in an ED from a traditional healthcare center (without a neurologist or stroke team/unit). Methods: To analyze which factors influence the administration of rt-PA, we split the general sample (n = 202) into two groups: group No rt-PA (n = 137) and group rt-PA (n = 65). This is based on the performing or no intravenous thrombolysis. Results: Analyzing ED time targets for all samples, we found that the median onset-to-ED door time was 180 min (IQR, 120–217.5 min), door-to-physician time was 4 min (IQR, 3–7 min), door-to-CT time was 52 min (IQR, 48–55 min), and door-in-door-out time was 61 min (IQR, 59–65 min). ED time targets such as door-to-physician time (p = 0.245), door-to-CT time (p = 0.219), door-in-door-out time (p = 0.24), NIHSS at admission to the Neurology department (p = 0.405), or NIHSS after 24 h (p = 0.9) did not have a statistically significant effect on the administration or no rt-PA treatment in patients included in our study. Only the highest door-to-CT time was statistically significantly correlated with the death outcome. Conclusion: In our study, the iv rt-PA administration rate was 32.18%. A statistically significant correlation between the highest door-to-CT time and death outcome was found.

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Section: Discussionmentioning

confidence: 87%

Emergency Department Time Targets for Interhospital Transfer of Patients with Acute Ischemic Stroke

Popa,

Iancu,

Petrica

et al. 2023

JPM

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“…Stroke is the second leading cause of death worldwide; it is the first leading cause of disability and the second leading cause of dementia. The high morbidity and mortality rates associated with stroke have led to the increasing creation of specialised units for its treatment [ 1 ]. Around 30% of people who survive stroke require assistance in activities of daily life (ADLs), 20% need help with ambulation, and 16% need institutional care [ 2 ].…”

Section: Introductionmentioning

confidence: 99%

Efficacy of the therapeutic use of video games on the depressive state of stroke patients: Protocol for systematic review and meta-analysis

et al. 2022

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Aim To assess the effects of virtual reality (VR) on the depressive state of patients with stroke admitted to neuro-rehabilitation units. Design: Systematic review and meta-analysis protocol. Methods Randomized Controlled Trials (RCTs) focusing on the effects of virtual reality on depressive state as a primary outcome will be included. Grey literature and the following databases will be consulted: PubMed, Cinahl, PsycInfo, Scopus, Embase, Cochrane Library and Web of Science. The recently revised Cochrane risk of bias tool will be used to assess the quality of included studies. Data will be extracted and meta-analyses will be performed within the specific condition of the emotional state of stroke patients admitted to neurorehabilitation units. Meta-regression and subgroup analyses will be used to identify effective modes and patterns of therapy delivery. The approach of assessment, development and evaluation of recommendations will be applied to reach a convincing conclusion. Discussion An accurate, transparent and standardized review process is expected to provide recommendations on the use of VR technology in the healthcare of stroke patients. Impact Emotional difficulties are common after stroke and have an impact on rehabilitation outcome. VR seems to have an important role in the treatment and depression in neurological patients, as it is able to improve levels of well-being, coping strategies and social relationships. The systematic review may contribute to a more convincing and specific conclusion compared to existing studies of this type. Trial registration Systematic review registration: CRD42022303968.

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“…7 The availability of primary stroke centers, stroke units, and comprehensive stroke centers have been demonstrated to provide greater capacity to respond with intravenous thrombolysis as opposed to general hospital treatments. 8 A modeling study of stroke in Saudi Arabia showed that the development of an up-to-date comprehensive stroke pathway was associated with an increase in clinical functionality, a decrease in disabling strokes and a cost savings of $602 million over 15 years in a 10-year cohort study. 9 Approaches to improving stroke management should be conducted through a multidisciplinary system to optimize evidence-based acute stroke management delivery.…”

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confidence: 99%

Assessing the readiness of hospitals in Riyadh Province for efficient and timely stroke management: A pilot study

Aseri

Al-Senani

Ahmed

et al. 2021

NSJ

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The data were analyzed using SPSS version 21.0. Appropriate statistical tests )chi-square and Fisher's exact test( were used for bivariate analyses.Results: A total of 3932 stroke patient visits were recorded in 37 hospitals in the central region of Saudi Arabia. The most common limitations of acute stroke services were that 25 )67.57%( of the hospitals had no stroke unit and 21 )56.76%( had inadequate clinical staff. Magnetic resonance imaging and computed tomography were available in 32 )86.49%( and 36 )97.30%( hospitals, respectively. Only two-thirds of hospitals 25 )67.57%( followed protocols for rapid Emergency Department )ED( triage. Conclusion:We found that most of our hospitals were not fully prepared to address acute stroke management in a manner that was reasonably consistent with international guidelines. We recommend raising the hospital's requirements a higher level to be in line with the stroke guidelines.

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Stroke treatment outcomes in hospitals with and without stroke units

Cited by 3 publications

References 12 publications

Emergency Department Time Targets for Interhospital Transfer of Patients with Acute Ischemic Stroke

Emergency Department Time Targets for Interhospital Transfer of Patients with Acute Ischemic Stroke

Efficacy of the therapeutic use of video games on the depressive state of stroke patients: Protocol for systematic review and meta-analysis

Assessing the readiness of hospitals in Riyadh Province for efficient and timely stroke management: A pilot study

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