Abstract:
:Hydrocephalus is one of the most common sequelae after aneurysmal subarachnoid hemorrhage (aSAH), and it is a large contributor to the condition's high rates of readmission and mortality. Our objective was to quantify the healthcare resource utilization (HCRU) and health economic burden incurred by the US health system due to post-aSAH hydrocephalus. The Truven Health MarketScan® Research database was used to retrospectively quantify the prevalence and HCRU associated with hydrocephalus in aSAH patients undergoing surgical clipping or endovascular coiling from 2008 to 2015. Multivariable longitudinal analysis was conducted to model the relationship between annual cost and hydrocephalus status. In total, 2374 patients were included; hydrocephalus was diagnosed in 959 (40.4%). Those with hydrocephalus had significantly longer initial lengths of stay (median 19.0 days vs. 12.0 days, p < .001) and higher 30-day readmission rates (20.5% vs. 10.4%, p < .001). With other covariates held fixed, in the first 90 days after aSAH diagnosis, the average cost multiplier relative to annual baseline for hydrocephalus patients was 24.60 (95% CI, 20.13 to 30.06; p < .001) whereas for non-hydrocephalus patients, it was 11.52 (95% CI, 9.89 to 13.41; p < .001). The 5-year cumulative median total cost for the hydrocephalus group was $230,282.38 (IQR, 166,023.65 to 318,962.35) versus $174,897.72 (IQR, 110,474.24 to 271,404.80) for those without hydrocephalus. We characterize one of the largest cohorts of post-aSAH hydrocephalus patients in the USA. Importantly, the substantial health economic impact and long-term morbidity and costs from this condition are quantified and reviewed.
journal_name
Transl Stroke Resjournal_title
Translational stroke researchauthors
Adil SM,Liu B,Charalambous LT,Kiyani M,Gramer R,Swisher CB,Verbick LZ,McCabe A,Parente BA,Pagadala P,Lad SPdoi
10.1007/s12975-019-00697-9subject
Has Abstractpub_date
2019-12-01 00:00:00pages
650-663issue
6eissn
1868-4483issn
1868-601Xpii
10.1007/s12975-019-00697-9journal_volume
10pub_type
杂志文章abstract::Cerebral blood flow (CBF) is the key factor for identifying progressive hypoperfusion that is indicative of numerous pathological conditions. CBF measurement is beneficial for the management of cerebrovascular disease, head injury, and intracranial neoplasms. Of the various imaging modalities developed to assess CBF, ...
journal_title:Translational stroke research
pub_type: 杂志文章
doi:10.1007/s12975-010-0064-y
更新日期:2011-06-01 00:00:00
abstract::Anticoagulation increases the risk of intracerebral hemorrhage (ICH) in patients with cerebral amyloid angiopathy (CAA), so the management of stroke-risk in patients with both atrial fibrillation (AF) and CAA is controversial. Advances in left atrial appendage closure (LAAC) techniques provide a stroke-risk-reduction ...
journal_title:Translational stroke research
pub_type: 杂志文章
doi:10.1007/s12975-020-00838-5
更新日期:2020-08-07 00:00:00
abstract::Traumatic brain injury (TBI) affects all age groups in a population and is an injury generating scientific interest not only as an acute event, but also as a complex brain disease with several underlying neurobehavioral and neuropathological characteristics. We review early and long-term alterations after juvenile and...
journal_title:Translational stroke research
pub_type: 杂志文章
doi:10.1007/s12975-011-0126-9
更新日期:2011-12-01 00:00:00
abstract::Rodent animal models of stroke are widely used with brain ischemia inducible by various occlusion methods. Permanent or transient occlusion of the distal portion of the middle cerebral artery (MCAO) offers a reproducible model with low mortality rates, and it is the most likely model of choice for mid- and long-term s...
journal_title:Translational stroke research
pub_type: 杂志文章,评审
doi:10.1007/s12975-012-0234-1
更新日期:2013-06-01 00:00:00
abstract::Our group recently identified a panel of ten genes whose RNA expression levels in whole blood have utility for detection of stroke. The purpose of this study was to determine the mechanisms by which these genes become differentially expressed during stroke pathology. First, we assessed the transcriptional distribution...
journal_title:Translational stroke research
pub_type: 杂志文章
doi:10.1007/s12975-018-0623-1
更新日期:2019-02-01 00:00:00
abstract::The most deadly form of stroke, intracerebral hemorrhage (ICH) continues to puzzle researchers and produce substantial decrements in the quality of patients' lives. Intensive basic research has devised many agents with putative benefit in mitigating the devastating effects of ICH, but these therapies have been largely...
journal_title:Translational stroke research
pub_type: 杂志文章
doi:10.1007/s12975-012-0207-4
更新日期:2012-12-01 00:00:00
abstract::Low translational yield for stroke may reflect the focus of discovery science on rodents rather than humans. Just how little is known about human neuronal ischaemic responses is confirmed by systematic review and meta-analysis revealing that data for the most commonly used SH-SY5Y human cells comprises only 84 papers....
journal_title:Translational stroke research
pub_type: 杂志文章,meta分析,评审
doi:10.1007/s12975-018-0620-4
更新日期:2018-12-01 00:00:00
abstract::This review focuses on assessment of behavioral outcomes following traumatic brain injury in juvenile animal models. In the 15 years since the first publication in this field, the majority of studies have used rats roughly equivalent to human toddlers in terms of brain development. Few studies have tested ages closer ...
journal_title:Translational stroke research
pub_type: 杂志文章
doi:10.1007/s12975-011-0132-y
更新日期:2011-12-01 00:00:00
abstract::Preconditioning is a paradigm in which sublethal stress-prior to a more injurious insult-induces protection against injury. In the central nervous system (CNS), preconditioning against ischemic stroke is induced by short durations of ischemia, brief seizures, exposure to anesthetics, and other stresses. Increasing evi...
journal_title:Translational stroke research
pub_type: 杂志文章,评审
doi:10.1007/s12975-017-0547-1
更新日期:2017-12-01 00:00:00
abstract::Although used extensively in stroke research, there is limited knowledge of how 2, 3, 5-triphenyltetrazolium chloride (TTC)-treated rat brain sections are altered and if they can be used for immunohistochemical quantification after staining with TTC. In the present study, we hypothesized that TTC treatment (TTC+) woul...
journal_title:Translational stroke research
pub_type: 杂志文章
doi:10.1007/s12975-017-0604-9
更新日期:2018-10-01 00:00:00
abstract::Quantitative susceptibility mapping (QSM) has been recently introduced as a novel MRI post-processing technique of gradient recalled echo (GRE) data. QSM is useful in depicting both brain anatomy and for detecting abnormalities. Its utility in the context of ischemic stroke has, however, not been extensively character...
journal_title:Translational stroke research
pub_type: 杂志文章
doi:10.1007/s12975-017-0591-x
更新日期:2018-08-01 00:00:00
abstract::In clinical trials, assessing efficacy is based on validated scales, and the primary endpoint is usually based on a single scale. The aim of the review is to revisit the concepts and methods to design and analyze studies focused on restoration, recovery and or compensation. These studies are becoming more frequent wit...
journal_title:Translational stroke research
pub_type: 杂志文章,评审
doi:10.1007/s12975-016-0488-0
更新日期:2016-10-01 00:00:00
abstract::The long-term effects of multiple sport-related concussions are currently at the center of debate in the popular press and scientific community. The question, "How many concussions are too many," is frequently asked in the competitive sport environment by parents, athletes, and coaches. While research suggests that a ...
journal_title:Translational stroke research
pub_type: 杂志文章,评审
doi:10.1007/s12975-012-0237-y
更新日期:2013-08-01 00:00:00
abstract::An argument for preclinical stroke research to make more use of the permanent middle cerebral artery occlusion (MCAO) model, rather than transient MCAO, is presented. Despite STAIR recommending permanent MCAO as the primary model, preclinical stroke research has not been listened. In 2012, Hossmann reported that 64% o...
journal_title:Translational stroke research
pub_type: 杂志文章
doi:10.1007/s12975-017-0554-2
更新日期:2017-07-17 00:00:00
abstract::Noninvasive magnetic resonance (MR) methods have been explored to provide quantitative measurements of cerebral blood flow (CBF), oxygen extraction fraction (OEF), and oxygen metabolic index (OMI = CBF × OEF). In this study, we sought to evaluate whether MR measured OEF, CBF, and OMI can consistently detect the expect...
journal_title:Translational stroke research
pub_type: 杂志文章
doi:10.1007/s12975-011-0142-9
更新日期:2012-06-01 00:00:00
abstract::Cavernous angioma (CA) is a vascular pathology caused by loss of function in one of the 3 CA genes (CCM1, CCM2, and CCM3) that result in rho kinase (ROCK) activation. We investigated a novel ROCK2 selective inhibitor for the ability to reduce brain lesion formation, growth, and maturation. We used genetic methods to e...
journal_title:Translational stroke research
pub_type: 杂志文章
doi:10.1007/s12975-019-00725-8
更新日期:2020-06-01 00:00:00
abstract::Polymorphonuclear neutrophils (PMNs) infiltration into brain parenchyma after cerebrovascular accidents is viewed as a key component of secondary brain injury. Interestingly, a recent study of ischemic stroke suggests that after ischemic stroke, PMNs do not enter brain parenchyma and as such may cause no harm to the b...
journal_title:Translational stroke research
pub_type: 杂志文章
doi:10.1007/s12975-014-0341-2
更新日期:2014-10-01 00:00:00
abstract::Early infection after stroke is associated with a poor outcome. We aimed to determine whether delayed infections (up to 76 days post-stroke) are associated with poor outcome at 90 days. Data came from the international Efficacy of Nitric Oxide Stroke (ENOS, ISRCTN99414122) trial. Post hoc data on infections were obtai...
journal_title:Translational stroke research
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1007/s12975-017-0553-3
更新日期:2017-12-01 00:00:00
abstract::Magnetic resonance imaging (MRI) has dramatically changed our ability to diagnose and treat stroke as well as follow its evolution and response to treatment. Early stroke and ischemia can be visualized using diffusion-weighted imaging that utilizes water diffusion within tissues as a reporter for evolving neuropatholo...
journal_title:Translational stroke research
pub_type: 杂志文章
doi:10.1007/s12975-011-0139-4
更新日期:2012-03-01 00:00:00
abstract::Intracerebral hemorrhage is by far the most destructive form of stroke. Apart from the management in a specialized stroke or neurological intensive care unit (NICU), no specific therapies have been shown to consistently improve outcomes after ICH. Current guidelines endorse early aggressive optimization of physiologic...
journal_title:Translational stroke research
pub_type: 杂志文章
doi:10.1007/s12975-012-0175-8
更新日期:2012-07-01 00:00:00
abstract::Approximately, 16 million strokes occur worldwide each year, causing 6 million deaths and considerable disability, implying an enormous social, individual health, and economic burden. Due to this high incidence, strategies to promote stroke recovery are urgently needed. Research into new therapeutic approaches for str...
journal_title:Translational stroke research
pub_type: 杂志文章,评审
doi:10.1007/s12975-018-0654-7
更新日期:2019-06-01 00:00:00
abstract::Silent information regulator 1 (SIRT1) is a NAD+-dependent histone deacetylase that represses gene expression and plays a role in longevity. SIRT1 responds to diverse stress conditions and regulates metabolism in nutrient deficiency conditions; therefore, it is involved in adaptive pathways to better fulfill tissue ne...
journal_title:Translational stroke research
pub_type: 杂志文章,评审
doi:10.1007/s12975-013-0277-y
更新日期:2013-12-01 00:00:00
abstract::Despite being a conveniently portable technology for stroke assessment, Transcranial Doppler ultrasound (TCD) remains widely underutilized due to complex training requirements necessary to reliably obtain and interpret cerebral blood flow velocity (CBFV) waveforms. The validation of objective TCD metrics for large ves...
journal_title:Translational stroke research
pub_type: 杂志文章
doi:10.1007/s12975-018-0667-2
更新日期:2019-10-01 00:00:00
abstract::Management of intracranial aneurysms remains controversial. For unruptured aneurysms, many factors should be taken into account before deciding the type of treatment and whether to treat or not. Ruptured aneurysms on the other hand are almost always treated. Still, the question remains what are the indicators that one...
journal_title:Translational stroke research
pub_type: 杂志文章,评审
doi:10.1007/s12975-013-0311-0
更新日期:2014-04-01 00:00:00
abstract::Global ischemia following cardiac arrest is characterized by high mortality and significant neurological deficits in long-term survivors. Its mechanisms of neuronal cell death have only partially been elucidated. 12/15-lipoxygenase (12/15-LOX) is a major contributor to delayed neuronal cell death and vascular injury i...
journal_title:Translational stroke research
pub_type: 杂志文章
doi:10.1007/s12975-016-0509-z
更新日期:2017-04-01 00:00:00
abstract::Motor impairment is the most common complication after stroke, and recovery of motor function has been shown to be dependent on the extent of lesion in the ipsilesional corticospinal tract (iCST) and activity within ipsilesional primary and secondary motor cortices. However, work from neuroimaging research has suggest...
journal_title:Translational stroke research
pub_type: 杂志文章,评审
doi:10.1007/s12975-017-0551-5
更新日期:2017-12-01 00:00:00
abstract::Neurogenesis is essential for a good post-stroke outcome. Exogenous stem cells are currently being tested to promote neurogenesis after stroke. Elsewhere, we demonstrated that treatment with the PPARγ agonist pioglitazone (PGZ) before cerebral ischemia induction reduced brain damage and activated survival-related gene...
journal_title:Translational stroke research
pub_type: 杂志文章
doi:10.1007/s12975-017-0577-8
更新日期:2018-06-01 00:00:00
abstract::Stroke prevention efforts typically focus on either ischemic or hemorrhagic stroke. This approach is overly simplistic due to the frequent coexistence of ischemic and hemorrhagic cerebrovascular disease. This coexistence, termed "mixed cerebrovascular disease", offers a conceptual framework that appears useful for str...
journal_title:Translational stroke research
pub_type: 杂志文章
doi:10.1007/s12975-012-0185-6
更新日期:2012-07-01 00:00:00
abstract::Impaired cerebral autoregulation and neurovascular coupling (NVC) contribute to delayed cerebral ischemia after subarachnoid hemorrhage (SAH). Retinal vessel analysis (RVA) allows non-invasive assessment of vessel dimension and NVC hereby demonstrating a predictive value in the context of various neurovascular disease...
journal_title:Translational stroke research
pub_type: 杂志文章
doi:10.1007/s12975-017-0585-8
更新日期:2018-06-01 00:00:00
abstract::Cerebrovascular disease is a leading cause of death-from-disease and of disability worldwide, affecting some 15 million people. The incidence of stroke or "brain attack" is unlikely to recede for a decade at minimum by most predictions, despite large public health initiatives in stroke prevention. It has been well est...
journal_title:Translational stroke research
pub_type: 杂志文章,评审
doi:10.1007/s12975-012-0238-x
更新日期:2013-08-01 00:00:00