Benefits of Urgent Evaluation and Treatment for TIA and Minor Stroke Summary and Comment by Kristi L. Koenig, MD, FACEP Published in Journal Watch Emergency.

Slides:

Advertisements

Similar presentations

Implementing NICE guidance

Advertisements

Preventing Strokes One at a Time Acute Interventions and Management 2009.

Latha G. Stead, MD, FACEP Transient Ischemic Attack Patient Update: The Optimal Management of Emergency Department Patients With Suspected Cerebral Ischemia.

Stroke Mark Sudlow Consultant and Senior Lecturer

Canadian Cardiovascular Society Antiplatelet Guidelines

Chiropractic Care: Organizational Perspectives Ontario Chiropractic Association 

Andrew W. Asimos, MD, FACEP Transient Ischemic Attack Patient Update: The Optimal Management of Emergency Department Patients With Suspected Cerebral Ischemia.

National rapid access to best-quality stroke services Prevent 1 stroke every day Avoid death or dependence in 1 patient every day National Stroke Clinical.

J. Stephen Huff, MD, FACEP Transient Ischemic Attack Patient Update: The Optimal Management of Emergency Department Patients With Suspected Cerebral Ischemia.

Stroke Issues & prevention. Agenda  Impact of Stroke –Definitions –Epidemiology –Risk factors  Management of Stroke –Acute management –Primary & Secondary.

Copyright restrictions may apply JAMA Pediatrics Journal Club Slides: Decreasing Hospital LOS for Bronchiolitis Sandweiss DR, Mundorff MB, Hill T, et al.

Copyright restrictions may apply JAMA Pediatrics Journal Club Slides: Nebulized Hypertonic Saline for Bronchiolitis Florin TA, Shaw KN, Kittick M, Yakscoe.

FERNE/EMRA The Management of ED TIA Patients: What is the optimal outpatient work-up, treatment and disposition?

Canadian Diabetes Association Clinical Practice Guidelines Management of Stroke in Diabetes Chapter 27 Michael Sharma, Gord Gubitz.

Acute Ischemic Stroke Management: 2004 Emergency Medicine Perspectives.

Jonathan A. Edlow, MD, FACEP Transient Ischemic Attack Patient Update: The Optimal Management of Emergency Department Patients With Suspected Cerebral.

Healthcare for London is part of Commissioning Support for London – an organisation providing clinical and business support to London’s NHS. Healthcare.

Stroke Units Southern Neurology. Definition of a stroke unit A stroke unit can be defined as a unit with dedicated stroke beds and a multidisciplinary.

BEAUTI f UL: morBidity-mortality EvAlUaTion of the I f inhibitor ivabradine in patients with coronary disease and left ventricULar dysfunction Purpose.

Andrew W. Asimos, MD, FACEP Transient Ischemic Attack Patient Update: The Optimal Management of Emergency Department Patients With Suspected Cerebral Ischemia.

Telephone Triage for Stroke by Ambulance Services in the U.K. Summary and Comment by J. Stephen Bohan, MD, MS, FACP, FACEP Published in Journal Watch Emergency.

ACOVE 4: Continuity and Coordination of Care in Vulnerable Elders Continuity is ‘‘care over time by a single individual or team of healthcare professionals’’

Memory in Elders: Food for Thought Summary and Comment by Jonathan Silver, MD Published in Journal Watch Psychiatry March 9, 2009Journal Watch Psychiatry.

1 Statin treatment is associated with improved prognosis in patients with AF-related stroke G. Ntaios, V. Papavasileiou, K.Makaritsis, A.Karagiannaki,

Emergency Intubations for Trauma: One Center's Experience Summary and Comment by Ron M. Walls, MD, FRCPC, FAAEM Published in Journal Watch Emergency Medicine.

AEDs Do Not Improve Survival from In-Hospital Arrest Summary and Comment by Daniel J. Pallin, MD, MPH Dr. Pallin is an attending physician in the Department.

Combination Therapy for Hypertension Summary and Comment by Harlan M. Krumholz, MD, SM Published in Journal Watch Cardiology December 3, 2008Journal Watch.

Better Outcomes at Level I vs. Level II Trauma Centers Summary and Comment by John A. Marx, MD, FAAEM, FACEP Published in Journal Watch Emergency Medicine.

Normal ECG During Chest Pain Does Not Rule Out ACS Summary and Comment by Diane M. Birnbaumer, MD, FACEP Published in Journal Watch Emergency Medicine.

Acute Stroke: Principles of Modern Management A program of the American Academy of Neurology The AAN Acute Stroke Management courses are supported in part.

Prasugrel vs. Clopidogrel for Acute Coronary Syndromes Patients Managed without Revascularization — the TRILOGY ACS trial On behalf of the TRILOGY ACS.

Depression and Parkinson Disease: An Old Drug Still Works (Better) Summary and Comment by Jonathan Silver, MD Published in Journal Watch Psychiatry February.

Monthly Journal article review: Vimmi Kang PGY 2

Aim To determine the effects of a Coversyl- based blood pressure lowering regimen on the risk of recurrent stroke among patients with a history of stroke.

Terutroban versus aspirin in Patients with Cerebral Ischaemic Events (PREFORM): a Randomized, Double- blind Parallel-group Trial Daniel Wells Mercer University.

Does the Choice of Antihypertensive Agent Affect Risk for AFib? Summary and Comment by Joel M. Gore, MD Published in Journal Watch Cardiology February.

Decreasing Incidence of Cardiogenic Shock Summary and Comment by J. Stephen Bohan, MD, MS, FACP, FACEP Published in Journal Watch Emergency Medicine December.

The idea: provide intensive support to services to accelerate implementation of the strategy during 2010/11 The aim: achieve key ‘milestones’ in care across.

Prehospital ECGs for Acute Coronary Syndromes Summary and Comment by Aaron E. Bair, MD, MSc, FAAEM, FACEP Published in Journal Watch Emergency Medicine.

DR AMER JAFAR ‘STROKE’ October Ethnicity and recurrence of stroke Population-based study Compared poststroke recurrence and survival in Mexican.

Adenosine for Regular Wide-Complex Tachycardia Summary and Comment by Daniel J. Pallin, MD, MPH Published in Journal Watch Emergency Medicine October 9,

Emergency Cricothyrotomy: Comparing Four Methods Summary and Comment by Aaron E. Bair, MD, MSc, FAAEM, FACEP Published in Journal Watch Emergency Medicine.

Which Beta-Blocker is Best for Patients with Heart Failure? Summary and Comment by Joel M. Gore, MD Published in Journal Watch Cardiology December 17,

Bigger Waist Means Higher Asthma Risk Summary and Comment by Wendy S. Biggs, MD Published in Journal Watch Women's Health September 24, 2009Journal Watch.

Discharge Instructions: Understanding the Misunderstandings Summary and Comment by Richard D. Zane, MD, FAAEM Published in Journal Watch Emergency Medicine.

Short Sleep Duration as a Predictor of Cardiovascular Events Summary and Comment by Jamaluddin Moloo, MD, MPH Published in Journal Watch General Medicine.

The Burden of Angina Summary and Comment by Harlan M. Krumholz, MD, SM Published in Journal Watch Cardiology March 25, 2009Journal Watch Cardiology In.

Induced Hypothermia After VF Cardiac Arrest Improves Outcomes Summary and Comment by Kristi L. Koenig, MD, FACEP Published in Journal Watch Emergency Medicine.

Do IV Meds Matter in Out-of-Hospital Cardiac Arrest? Summary and Comment by John A. Marx, MD, FAAEM Published in Journal Watch Emergency Medicine December.

A Resuscitation Protocol That Minimizes Hands- Off Time Improves Survival Summary and Comment by Aaron E. Bair, MD, MSc, FAAEM, FACEP Published in Journal.

 Friends and Family Test (FFT) -single question ‘would you recommend…’  The Adult National Inpatient Survey (AIPS) - AIPS uses validated questions based.

Cost analysis of Tele-ICU: The Memorial Hermann study

Stroke helplineWebsite www.stroke.org.uk Developments in Stroke Services.

Why Treat Patent Forman Ovale Clifford J Kavinsky, MD, PHD Professor of Medicine and pediatrics Associate Director, Center for Congenital and Structural.

Management of Stroke and TIA Dr Anthony G Hemsley BMedSci MD FRCP Stroke Physician Lead Clinician Elderly Care.

Angela Aziz Donnelly April 5, 2016

R1. 이정미 / prof. 김우식. INTRODUCTION Reduction in low-density lipoprotein (LDL) cholesterol levels has proved to be highly effective in reducing rates of.

Risk of stroke at 3 months6 Expected Strokes at 3 months

Prediction and Prevention of Stroke in Patients with Symptomatic Carotid Stenosis: The High-risk Period and the High-risk Patient P.M. Rothwell European.

Adnan K. Chhatriwalla, MD Saint-Luke’s Mid America Heart Institute

Low-Dose Aspirin for Primary Prevention of Cardiovascular Events in Patients With Diabetes: A Meta-Analysis Stavros Stavrakis, MD The American Journal.

Cocaine-Related Chest Pain: The Year After

The European Society of Cardiology Presented by Dr. Bo Lagerqvist

Information Transfer – ROP Compliance

Panelists. Secondary Prevention of Acute Ischemic Stroke: Can We Improve Outcomes?

Managing Patients With Transient Ischemic Attack

George E. Kikano, MD, Marie T. Brown, MD Mayo Clinic Proceedings

Monthly Journal article review: Vimmi Kang PGY 2

Urgent carotid endarterectomy to prevent recurrence and improve neurologic outcome in mild-to-moderate acute neurologic events Laura Capoccia, MD, Enrico.

The CHA(2)DS2-(VASc) stroke risk and HAS-BLED bleeding risk index are calculated by totalling the scores for each risk factor present.68–71 The lower graph.

Presentation transcript:

Benefits of Urgent Evaluation and Treatment for TIA and Minor Stroke Summary and Comment by Kristi L. Koenig, MD, FACEP Published in Journal Watch Emergency Medicine March 6, 2009Journal Watch Emergency Medicine Early neurological assessment and treatment is cost-effective and prevents long- term disability. CopyrightCopyright © Massachusetts Medical Society. All rights reserved.Massachusetts Medical Society

Covering Luengo-Fernandez R et al. Effect of urgent treatment for transient ischaemic attack and minor stroke on disability and hospital costs (EXPRESS study): A prospective population-based sequential comparison. Lancet Neurol 2009 Mar; 8:235. CopyrightCopyright © Massachusetts Medical Society. All rights reserved.Massachusetts Medical Society

Background Do patients with transient ischemic attack (TIA) or minor stroke need urgent specialty evaluation and treatment? As part of the two-phase, prospective, population-based EXPRESS (Early use of eXisting PREventive Strategies for Stroke) study, British researchers evaluated the effect of early assessment and treatment on hospital admission, costs, and disability. In the first phase, 310 patients were referred to a specialty clinic by their primary care physicians within several days of the acute event, and treatment recommendations were faxed to the primary care physicians (median time to treatment, 19 days); in the second phase, 281 patients were sent directly to the specialty clinic and received treatment the same day. CopyrightCopyright © Massachusetts Medical Society. All rights reserved.Massachusetts Medical Society

The Research The rate of hospital admission for recurrent stroke within 90 days was significantly lower in the second phase than in the first phase (2% vs. 8%). The number of hospital bed-days for stroke and other cardiovascular conditions declined from 1365 in the first phase to 427 in the second phase, yielding an average hospital cost savings per patient of £624 (about US$900). The incidence of fatal or disabling stroke at 6-month follow-up was significantly lower in the second phase than in the first phase (0.3% vs. 5.1%). The authors conclude that urgent assessment and treatment of patients with minor stroke or TIA reduces disability and healthcare costs. CopyrightCopyright © Massachusetts Medical Society. All rights reserved.Massachusetts Medical Society

Comment Patients with TIA should be considered to have unstable angina of the brain and to require urgent attention. Prompt neurological evaluation and treatment not only benefits individual patients but also results in decreased overall healthcare costs, both in the short term and in the long term (by reducing severe stroke disability). CopyrightCopyright © Massachusetts Medical Society. All rights reserved.Massachusetts Medical Society

About Journal Watch Journal Watch helps physicians and allied heath professionals save time and stay informed by providing brief, clearly written, clinically focused perspectives on the medical developments that affect practice. Journal Watch is an independent, trustworthy source, from the publishers of the New England Journal of Medicine. These slides were derived from Journal Watch Emergency Medicine.Journal Watch Emergency Medicine The best way to stay informed with Journal Watch, is through our alerts. To sign up, visit the My Alerts page.My Alerts page CopyrightCopyright © Massachusetts Medical Society. All rights reserved.Massachusetts Medical Society