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Item type:Publication, Validation of the transcranial Doppler rescue criteria for mechanical thrombectomy(2024)1 - Some of the metrics are blocked by yourconsent settings
Item type:Publication, A Chilean Experience of Telestroke in a COVID-19 Pandemic Year(2022); ; <jats:p><b><i>Background and Purpose:</i></b> Telemedicine for stroke patients’ care (telestroke [TS]) has grown notably in recent decades and may offer advantages during health crisis. Hospital admissions related to stroke have decreased globally during the COVID-19 pandemic, but scarce information is available regarding the effect of COVID-19 in TS. Using a population-based TS registry, we investigated the impact of the first year of the COVID-19 pandemic throughout our TS network in Santiago, Chile. <b><i>Methods:</i></b> Stroke codes evaluated after the onset of COVID-19 restrictions in Chile (defined as March 15, 2020) were compared with those evaluated in 2019. We analyzed differences between number of stroke codes, thrombolysis rate, stroke severity, and time from the stroke onset to hospital admission. <b><i>Results:</i></b> We observed that the number of stroke codes and the number of patients undergoing reperfusion therapy did not change significantly (<i>p</i> = 0.669 and 0.415, respectively). No differences were found with respect to the median time from the stroke onset to admission (<i>p</i> = 0.581) or in National Institutes of Health Stroke Scale (NIHSS) scores (<i>p</i> = 0.055). The decision-making-to-needle time was significantly shorter in the COVID-19 period (median 5 min [IQR 3–8], <i>p</i> &#x3c; 0.016), but no significant changes were found at the other times. <b><i>Conclusions:</i></b> This study demonstrates the potential of adapting TS to extreme situations such as the COVID-19 pandemic, as well as the importance of establishing networks that facilitate patient access to quality treatments. </jats:p>Scopus© Citations 7 1 - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Quantifying regional variations in components of acute stroke unit (ASU) care in the international HeadPoST study(2020)Scopus© Citations 4 1 - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Timing of Recanalization and Functional Recovery in Acute Ischemic Stroke(2020); Jürgen Eggers<jats:p>Background and Purpose Although onset-to-treatment time is associated with early clinical recovery in acute ischemic stroke (AIS) patients treated with intravenous tissue plasminogen activator (tPA), the effect of the timing of tPA-induced recanalization on functional outcomes remains debatable.Methods We conducted a multicenter, prospective observational cohort study to determine whether early (within 1-hour from tPA-bolus) complete or partial recanalization assessed during 2-hour real-time transcranial Doppler monitoring is associated with improved outcomes in patients with proximal occlusions. Outcome events included dramatic clinical recovery (DCR) within 2 and 24-hours from tPA-bolus, 3-month mortality, favorable functional outcome (FFO) and functional independence (FI) defined as modified Rankin Scale (mRS) scores of 0–1 and 0–2 respectively.Results We enrolled 480 AIS patients (mean age 66±15 years, 60% men, baseline National Institutes of Health Stroke Scale score 15). Patients with early recanalization (53%) had significantly (<i>P</i><0.001) higher rates of DCR at 2-hour (54% vs. 10%) and 24-hour (63% vs. 22%), 3-month FFO (67% vs. 28%) and FI (81% vs. 39%). Three-month mortality rates (6% vs. 17%) and distribution of 3-month mRS scores were significantly lower in the early recanalization group. After adjusting for potential confounders, early recanalization was independently associated with higher odds of 3-month FFO (odds ratio [OR], 6.19; 95% confidence interval [CI], 3.88 to 9.88) and lower likelihood of 3-month mortality (OR, 0.34; 95% CI, 0.17 to 0.67). Onset to treatment time correlated to the elapsed time between tPA-bolus and recanalization (unstandardized linear regression coefficient, 0.13; 95% CI, 0.06 to 0.19).Conclusions Earlier tPA treatment after stroke onset is associated with faster tPA-induced recanalization. Earlier onset-to-recanalization time results in improved functional recovery and survival in AIS patients with proximal intracranial occlusions.</jats:p>Scopus© Citations 37 1