Abstract:
BACKGROUND AND PURPOSE:Dysphagia can lead to pneumonia and subsequent death after acute stroke. However, no prospective study has demonstrated reduced pneumonia prevalence after implementation of a dysphagia screen. METHODS:We performed a single-center prospective interrupted time series trial of a quality initiative to improve dysphagia screening. Subjects included all patients with ischemic or hemorrhagic stroke admitted to our institution over 42 months with a 31-month (n=1686) preintervention and an 11-month (n=648) postintervention period. The intervention consisted of a dysphagia protocol with a nurse-administered bedside dysphagia screen and a reflexive rapid clinical swallow evaluation by a speech pathologist. RESULTS:The dysphagia initiative increased the percentage of patients with stroke screened from 39.3% to 74.2% (P<0.001). Furthermore, this initiative coincided with a drop in hospital-acquired pneumonia from 6.5% to 2.8% among patients with stroke (P<0.001). Patients admitted postinitiative had 57% lower odds of pneumonia, after controlling for multiple confounds (odds ratio=0.43; confidence interval, 0.255-0.711; P=0.0011). The best predictors of pneumonia were stroke type (P<0.0001), oral intake status (P<0.0001), dysphagia screening status (P=0.0037), and hospitalization before the beginning of the quality improvement initiative (P=0.0449). CONCLUSIONS:A quality improvement initiative using a nurse-administered bedside screen with rapid bedside swallow evaluation by a speech pathologist improves screening compliance and correlates with decreased prevalence of pneumonia among patients with stroke.
journal_name
Strokejournal_title
Strokeauthors
Titsworth WL,Abram J,Fullerton A,Hester J,Guin P,Waters MF,Mocco Jdoi
10.1161/STROKEAHA.111.000204subject
Has Abstractpub_date
2013-11-01 00:00:00pages
3154-60issue
11eissn
0039-2499issn
1524-4628pii
STROKEAHA.111.000204journal_volume
44pub_type
临床试验,杂志文章相关文献
STROKE文献大全abstract::There have been numerous failures in the field of acute stroke therapy over many years, but the first large clinical trial showing preliminary indications of efficacy and safety of a neuroprotective drug, NXY-059, has now been fully reported. If confirmed, it will mean that a second therapy for acute stroke has been i...
journal_title:Stroke
pub_type: 杂志文章,评审
doi:10.1161/01.STR.0000252090.44428.82
更新日期:2007-02-01 00:00:00
abstract:BACKGROUND AND PURPOSE:The purpose of the present study is to determine the effect of mild hypothermia on the synthesis of ubiquitin, an important protein for maintenance of cell viability, in the hippocampal neurons following transient cerebral ischemia. METHODS:Transient ischemia was induced by occluding both common...
journal_title:Stroke
pub_type: 杂志文章
doi:10.1161/01.str.22.12.1574
更新日期:1991-12-01 00:00:00
abstract:BACKGROUND AND PURPOSE:Leptin is the major adipose hormone that regulates body weight and energy expenditure by activating leptin receptors in the hypothalamus. Leptin receptors are also present in other cell types, and a potent antiapoptotic effect for leptin has recently been reported. We investigated whether leptin ...
journal_title:Stroke
pub_type: 杂志文章
doi:10.1161/STROKEAHA.107.482786
更新日期:2007-08-01 00:00:00
abstract:BACKGROUND AND PURPOSE:We sought to characterize the spatial and temporal evolution of human cerebral infarction. Using a novel method of quantitatively mapping the distribution of hypoxic viable tissue identified by 18F-fluoromisonidazole (18F-FMISO) PET relative to the final infarct, we determined its evolution and s...
journal_title:Stroke
pub_type: 临床试验,杂志文章
doi:10.1161/01.STR.0000094422.74023.FF
更新日期:2003-11-01 00:00:00
abstract:BACKGROUND AND PURPOSE:The impact of anesthesia technique on the outcomes of mechanical thrombectomy for acute ischemic stroke remains an issue of debate. We investigated the association of general anesthesia with outcomes in patients undergoing mechanical thrombectomy for ischemic stroke. METHODS:We performed a cohor...
journal_title:Stroke
pub_type: 杂志文章
doi:10.1161/STROKEAHA.116.015343
更新日期:2017-02-01 00:00:00
abstract:BACKGROUND AND PURPOSE:Wall shear stress (WSS) is one of the main pathogenic factors in the development of saccular cerebral aneurysms. The magnitude and distribution of the WSS in and around human middle cerebral artery (MCA) aneurysms were analyzed using the method of computed fluid dynamics (CFD). METHODS:Twenty ma...
journal_title:Stroke
pub_type: 杂志文章
doi:10.1161/01.STR.0000144648.89172.0f
更新日期:2004-11-01 00:00:00
abstract:BACKGROUND AND PURPOSE:We evaluated the impact of lifestyle factors on the risk of ischemic stroke. METHODS:We used a nested case-control design. The cases comprised 163 persons (median age 69 years) admitted to a stroke unit and diagnosed with acute cerebral infarction. All cases had earlier participated in the North...
journal_title:Stroke
pub_type: 杂志文章
doi:10.1161/01.str.23.6.829
更新日期:1992-06-01 00:00:00
abstract:BACKGROUND AND PURPOSE:Treatment with the ketone body precursor 1,3-butanediol has been suggested to ameliorate hypoxic/ischemic brain damage. Butanediol could provide an alternative energy substrate for the brain, thereby decreasing the amount of glycolytically produced lactate. Hyperglycemia aggravates brain damage a...
journal_title:Stroke
pub_type: 杂志文章
doi:10.1161/01.str.23.5.719
更新日期:1992-05-01 00:00:00
abstract:BACKGROUND AND PURPOSE:Interhemispheric inhibition via the corpus callosum has been proposed as an exacerbating factor in outcome from stroke. METHODS:We measured infarct volume and behavioral outcome after middle cerebral artery occlusion in callosotomized rats and acallosal mice. RESULTS:Neither callosotomy in rats...
journal_title:Stroke
pub_type: 杂志文章
doi:10.1161/STROKEAHA.111.613349
更新日期:2011-09-01 00:00:00
abstract:BACKGROUND AND PURPOSE:Ischemic injury triggers multiple pathological responses in the brain tissue, including spreading depolarizations across the cerebral cortex (cortical spreading depolarizations [CSD]). Microglia have been recently shown to play a significant role in the propagation of CSD. However, the intracellu...
journal_title:Stroke
pub_type: 杂志文章
doi:10.1161/STROKEAHA.120.032766
更新日期:2021-01-01 00:00:00
abstract:BACKGROUND AND PURPOSE:Stroke leads to a reduction in bone mineral density, altered calcium homeostasis, and an increase in hip fractures. Vitamin D deficiency is well documented in long-term stroke survivors and is associated with post-stroke hip fractures. Less is known regarding levels in acute stroke. METHODS:We c...
journal_title:Stroke
pub_type: 杂志文章
doi:10.1161/01.STR.0000195184.24297.c1
更新日期:2006-01-01 00:00:00
abstract:BACKGROUND AND PURPOSE:Screening for dysphagia is essential to the implementation of preventive therapies for patients with stroke. A systematic review was undertaken to determine the evidence-based validity of dysphagia screening items using instrumental evaluation as the reference standard. METHODS:Four databases fr...
journal_title:Stroke
pub_type: 杂志文章,meta分析,评审
doi:10.1161/STROKEAHA.111.640946
更新日期:2012-03-01 00:00:00
abstract:BACKGROUND AND PURPOSE:Short-term elevations in fine particulate matter air pollution (PM2.5) are associated with increased risk of acute cerebrovascular events. Evidence from the peripheral circulation suggests that vascular dysfunction may be a central mechanism. However, the effects of PM2.5 on cerebrovascular funct...
journal_title:Stroke
pub_type: 杂志文章
doi:10.1161/STROKEAHA.111.000395
更新日期:2013-06-01 00:00:00
abstract:BACKGROUND AND PURPOSE:Nimodipine, a calcium antagonist, has been reported to have beneficial effects in acute ischemic infarction. Some calcium channel antagonists have antiplatelet effects. We investigated the effect of oral nimodipine on platelet function in healthy volunteers. METHODS:Twelve healthy volunteers (6 ...
journal_title:Stroke
pub_type: 临床试验,杂志文章
doi:10.1161/01.str.24.1.10
更新日期:1993-01-01 00:00:00
abstract:BACKGROUND AND PURPOSE:Treatment of stroke patients in specialized stroke units has become more frequent, yet the effect of this treatment has not been determined. METHODS:In a community-based, prospective, and consecutive study of 1241 unselected acute stroke patients, we compared outcome of stroke treatment between ...
journal_title:Stroke
pub_type: 杂志文章
doi:10.1161/01.str.26.7.1178
更新日期:1995-07-01 00:00:00
abstract:BACKGROUND AND PURPOSE:Apraxia of speech (AOS) is a motor speech disorder, which is clinically characterized by the combination of phonemic segmental changes and articulatory distortions. AOS has been believed to arise from impairment in motor speech planning/programming and differentiated from both aphasia and dysarth...
journal_title:Stroke
pub_type: 杂志文章
doi:10.1161/STROKEAHA.115.010402
更新日期:2016-01-01 00:00:00
abstract:BACKGROUND AND PURPOSE:The aim of our study was to compare outcome and its determinants in familial subarachnoid hemorrhage and in sporadic subarachnoid hemorrhage in a large and well-documented patient population. METHODS:Patients with aneurysmal subarachnoid hemorrhage (SAH) treated at the Department of Neurosurgery...
journal_title:Stroke
pub_type: 杂志文章
doi:10.1161/01.str.30.5.1099
更新日期:1999-05-01 00:00:00
abstract:BACKGROUND AND PURPOSE:It is unclear whether anxiety is a risk factor for stroke. We assessed the association between anxiety and the risk of incident stroke. METHODS:This population-based cohort study was based on 2 rounds of the Rotterdam Study. Each round was taken separately as baseline. In 1993 to 1995, anxiety s...
journal_title:Stroke
pub_type: 杂志文章
doi:10.1161/STROKEAHA.115.012361
更新日期:2016-04-01 00:00:00
abstract::Moyamoya is an intriguing and controversial syndrome. This patient study serves to align the pathophysiology of intracranial hemorrhage in moyamoya with the cerebral vascular disease seen with hypertension, or aging. The historical evidence linking lipohyalinosis and microaneurysms to cerebral hemorrhage is reviewed, ...
journal_title:Stroke
pub_type: 杂志文章
doi:10.1161/01.str.11.4.405
更新日期:1980-07-01 00:00:00
abstract::Cerebral cortical blood flow was measured in rabbits with the hydrogen clearance technique. The reactivity to CO2, tested by changing the end tidal CO2 (ETCO2) in steps from 2 to 6 volumes %, was highly dependent on the kind of anesthesia, being greatest under halothane and least under nitrous oxide. Reactivity to CO2...
journal_title:Stroke
pub_type: 杂志文章
doi:10.1161/01.str.9.2.160
更新日期:1978-03-01 00:00:00
abstract:BACKGROUND AND PURPOSE:Although modern multisequence stroke MRI protocols are an emerging imaging routine for the diagnostic assessment of acute ischemic stroke, their sensitivity for intracerebral hemorrhage (ICH), the most important differential diagnosis, is still a matter of debate. We hypothesized that stroke MRI ...
journal_title:Stroke
pub_type: 临床试验,杂志文章,多中心研究
doi:10.1161/01.STR.0000114203.75678.88
更新日期:2004-02-01 00:00:00
abstract:BACKGROUND AND PURPOSE:Cerebral sinovenous thrombosis is a rare disease with severe neurological sequelae. The aim of this retrospective multicenter study was to investigate the clinical course, possible risk factors, and outcome of a cohort of neonatal patients with sinovenous thrombosis and, second, to estimate the i...
journal_title:Stroke
pub_type: 杂志文章,多中心研究
doi:10.1161/STROKEAHA.110.583542
更新日期:2010-07-01 00:00:00
abstract:BACKGROUND AND PURPOSE:We have shown that acute treatment with candesartan in an experimental model of stroke resulted in vascular protection and improved outcomes at 24 hours poststroke, but the mechanisms are unknown. We now examine effects of candesartan on proangiogenic factors and 7-day outcomes using the same tre...
journal_title:Stroke
pub_type: 杂志文章
doi:10.1161/STROKEAHA.108.537225
更新日期:2009-05-01 00:00:00
abstract:BACKGROUND AND PURPOSE:Inflammatory and immune mechanisms can precipitate cerebrovascular thrombosis and hemorrhage. Immunologic tolerance can be induced to a specific antigen by intranasal instillation of that antigen. Lymphocytes tolerized in this way provide local immunosuppression on restimulation with the same ant...
journal_title:Stroke
pub_type: 杂志文章
doi:10.1161/01.str.0000029821.82531.8b
更新日期:2002-09-01 00:00:00
abstract:BACKGROUND AND PURPOSE:The impact of asymptomatic coronary artery disease on the risk of major vascular events in patients with cerebral infarction is unknown. METHODS:Four hundred five patients with acute cerebral infarction underwent carotid, femoral artery, thoracic, and abdominal aorta ultrasound examination. Of 3...
journal_title:Stroke
pub_type: 杂志文章
doi:10.1161/STROKEAHA.111.000142
更新日期:2013-06-01 00:00:00
abstract::The external diameters of rat and rabbit basilar arteries were determined before and after formaldehyde fixation in relaxed and drug constricted vessels. Fixation usually resulted in an immediate vessel constriction followed by partial relaxation after several hours. However, the results were inconstant from vessel to...
journal_title:Stroke
pub_type: 杂志文章
doi:10.1161/01.str.11.1.99
更新日期:1980-01-01 00:00:00
abstract:BACKGROUND AND PURPOSE:A simple method of testing cerebral autoregulation by observing transcranial Doppler changes in middle cerebral artery flow velocity (FV) during a brief ipsilateral carotid artery compression (the transient hyperemic response test) was studied in 11 normal healthy volunteers. The aim of this stud...
journal_title:Stroke
pub_type: 杂志文章
doi:10.1161/01.str.27.12.2197
更新日期:1996-12-01 00:00:00
abstract:BACKGROUND AND PURPOSE:The ABC/2 method for calculating intracerebral hemorrhage (ICH) volume has been well validated. However, the formula, derived from the volume of an ellipse, assumes the shape of ICH is elliptical. We sought to compare the agreement of the ABC/2 formula with other methods through retrospective ana...
journal_title:Stroke
pub_type: 杂志文章
doi:10.1161/STROKEAHA.117.016677
更新日期:2018-02-01 00:00:00
abstract:BACKGROUND:Mechanisms involved in stroke progression are incompletely understood. Ischemic brain injury is characterized by acute local inflammatory response mediated by cytokines. Anti-inflammatory cytokines act in a feedback loop to inhibit continued proinflammatory cytokine production. We assessed the implication of...
journal_title:Stroke
pub_type: 临床试验,杂志文章
doi:10.1161/01.STR.0000057976.53301.69
更新日期:2003-03-01 00:00:00
abstract:BACKGROUND AND PURPOSE:This study was conducted to analyze the association between reported risk factors for Alzheimer's disease, apolipoprotein E epsilon4 allele, and cardiovascular disease and neuropathological changes essential for the diagnosis of Alzheimer's disease. METHODS:Our data are based on clinical and pos...
journal_title:Stroke
pub_type: 杂志文章
doi:10.1161/01.str.30.3.613
更新日期:1999-03-01 00:00:00