Interhospital transfer on intravenous thrombolysis in patients with acute ischemic stroke in three chinese municipal stroke centers.

We included acute ischemic stroke (AIS) patients who received recombinant tissue plasminogen activator (rt-PA) at three stroke centers via either interhospital transfer or direct presentation and compared the clinical outcomes and time metrics to analyze the impact of interhospital transfer on intravenous thrombolysis (IVT). We retrospectively enrolled patients with AIS admitted to three stroke centers from October 1, 2016, to June 1, 2018. Patients treated with rt-PA were classified into the transfer and direct groups. We collected the patients' general information and time points. Statistical analyses were conducted to examine differences in the clinical outcomes and time metrics between the two groups. A total of 326 patients were enrolled, including 84 patients in the transfer group and 242 in the direct group. The transfer group had a longer onset-to-door time (OTD) (124.5 ± 50.6 min versus 83.2 ± 47.2 min, P < 0.01) but a shorter door-to-needle time (DNT) (53.0 ± 26.3 min versus 81.5 ± 31.1 min, P < 0.01), and the stroke onset-to-needle time was 177.4 ± 51.0 min versus 164.7 ± 53.3 min (P = 0.057). Compared with the direct group, the transfer group achieved similar modified Rankin scale (mRS) 0-2 outcomes (59.5% versus 58.7%, P = 0.768). Interhospital transfer was not an independent risk factor associated with a poor outcome at 90 days. In three Chinese municipal stroke centers, patients with an AIS referral have a longer OTD but a shorter DNT. DNTs of municipal hospitals were far longer than the current international standard, and their improvement is an important task.

Braden scale for predicting pneumonia after spontaneous intracerebral hemorrhage.

OBJECTIVE: Stroke-associated pneumonia is an infection that commonly occurs in patients with spontaneous intracerebral hemorrhage and causes serious burdens. In this study, we evaluated the validity of the Braden scale for predicting stroke-associated pneumonia after spontaneous intracerebral hemorrhage. METHODS: Patients with spontaneous intracerebral hemorrhage were retrospectively included and divided into pneumonia and no pneumonia groups. The admission clinical characteristics and Braden scale scores at 24 h after admission were collected and compared between the two groups. Receiver operating characteristic curve analysis was performed to assess the predictive validity of the Braden scale. Multivariable analysis was conducted to identify the independent risk factors associated with pneumonia after intracerebral hemorrhage. RESULTS: A total of 629 intracerebral hemorrhage patients were included, 150 (23.8%) of whom developed stroke-associated pneumonia. Significant differences were found in age and fasting blood glucose levels between the two groups. The mean score on the Braden scale in the pneumonia group was 14.1±2.4, which was significantly lower than that in the no pneumonia group (16.5±2.6), p<0.001. The area under the curve for the Braden scale for the prediction of pneumonia after intracerebral hemorrhage was 0.760 (95%CI 0.717-0.804). When the cutoff point was 15 points, the sensitivity was 74.3%, the specificity was 64.7%, the accuracy was 72.0%, and the Youden's index was 39.0%. Multivariable analysis showed that a lower Braden scale score (OR 0.696; 95%CI 0.631-0.768; p<0.001) was an independent risk factor associated with stroke-associated pneumonia after intracerebral hemorrhage. CONCLUSION: The Braden scale, with a cutoff point of 15 points, is moderately valid for predicting stroke-associated pneumonia after spontaneous intracerebral hemorrhage.

Braden scale for predicting pneumonia after spontaneous intracerebral hemorrhage

SUMMARY OBJECTIVE: Stroke-associated pneumonia is an infection that commonly occurs in patients with spontaneous intracerebral hemorrhage and causes serious burdens. In this study, we evaluated the validity of the Braden scale for predicting stroke-associated pneumonia after spontaneous intracerebral hemorrhage. METHODS: Patients with spontaneous intracerebral hemorrhage were retrospectively included and divided into pneumonia and no pneumonia groups. The admission clinical characteristics and Braden scale scores at 24 h after admission were collected and compared between the two groups. Receiver operating characteristic curve analysis was performed to assess the predictive validity of the Braden scale. Multivariable analysis was conducted to identify the independent risk factors associated with pneumonia after intracerebral hemorrhage. RESULTS: A total of 629 intracerebral hemorrhage patients were included, 150 (23.8%) of whom developed stroke-associated pneumonia. Significant differences were found in age and fasting blood glucose levels between the two groups. The mean score on the Braden scale in the pneumonia group was 14.1±2.4, which was significantly lower than that in the no pneumonia group (16.5±2.6), p<0.001. The area under the curve for the Braden scale for the prediction of pneumonia after intracerebral hemorrhage was 0.760 (95%CI 0.717-0.804). When the cutoff point was 15 points, the sensitivity was 74.3%, the specificity was 64.7%, the accuracy was 72.0%, and the Youden's index was 39.0%. Multivariable analysis showed that a lower Braden scale score (OR 0.696; 95%CI 0.631-0.768; p<0.001) was an independent risk factor associated with stroke-associated pneumonia after intracerebral hemorrhage. CONCLUSION: The Braden scale, with a cutoff point of 15 points, is moderately valid for predicting stroke-associated pneumonia after spontaneous intracerebral hemorrhage.