Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association
-
J Stroke Cerebrovasc Dis · Nov 2018
Observational StudyAn Audit of Thrombophilia Testing in Patients with Ischemic Stroke or Transient Ischemic Attack: The Futility of Testing.
Many patients admitted with an ischemic stroke or transient ischemic attack (TIA) undergo thrombophilia testing. There is limited evidence to support this practice. We examined the effect of thrombophilia testing on management of patients admitted with an ischemic stroke or TIA. ⋯ Thrombophilia testing in the acute inpatient setting rarely impacted the clinical management of patients admitted with a stroke or TIA. By avoiding thrombophilia testing, both the potential for misdiagnosis and health care costs can be reduced. Therefore, we have discontinued thrombophilia testing in in-patients with a diagnosis of stroke.
-
J Stroke Cerebrovasc Dis · Nov 2018
Statin Use and the Risk of Dementia in Patients with Stroke: A Nationwide Population-Based Cohort Study.
Patients with stroke have an increased risk of dementia. Some studies have found that statin use might lower the risk of incident dementia; however, there is still a lack of data from patients with stroke. Therefore, the aim of our study was to investigate the impact of statin use on the risk of dementia in patients with stroke. ⋯ In this nationwide cohort study, statin use was associated with decreased risk of dementia among patients with stroke. The use of high-potency statins, lipophilic statins, and prolonged exposure to statins may be associated with greater benefits.
-
J Stroke Cerebrovasc Dis · Nov 2018
Review Meta AnalysisEfficacy and Safety of Citalopram for the Treatment of Poststroke Depression: A Meta-Analysis.
To objectively evaluate the efficacy and safety of citalopram versus other antidepressant drugs in poststroke depression (PSD) treatment. ⋯ This meta-analysis indicates that the efficacy of citalopram is similar to that of other SSRIs and SNRIs, but citalopram takes action faster than other SSRIs. The adverse effects of citalopram have no significant difference compared to other antidepressants and those adverse effects are less and mild.
-
J Stroke Cerebrovasc Dis · Nov 2018
Coagulation Profile after Spontaneous Intracerebral Hemorrhage: A Cohort Study.
Intracerebral hemorrhage (ICH) causes death or disability and the incidence increases with age. Knowledge of acute hemostatic function in patients with ICH without anticoagulant and antiplatelet therapy is sparse. Increased knowledge of the coagulation profile in the acute phase of ICH could improve acute treatment and recovery. We investigated coagulation at admission and changes in coagulation during the first 24hours after symptom onset. ⋯ ICH patients without anticoagulant or antiplatelet therapy demonstrated activated coagulation at admission and within 24hours after symptom onset.
-
J Stroke Cerebrovasc Dis · Nov 2018
Comparative StudyRace is a Predictor of Withdrawal of Life Support in Patients with Intracerebral Hemorrhage.
Medical and socioeconomic factors may impact decisions to change the goals of care for patients with intracerebral hemorrhage (ICH) to comfort measures only. ⋯ Lower GCS score, higher IVH volume, and race were independent predictors of comfort measures only. Black patients were 76% less likely to withdraw life support than white patients. There were no significant differences in mortality between black and white patients. Providers should be aware of potential racial disparities.