Neurology

Readmit rates for stroke

In this large database analysis from Taiwan, readmit rates for stroke were 10% at 30 days, 17% at 90 days, and 36% at 1 year. The most common reasons were infections, recurrent stroke, and cardiovascular event. Hospital utilization post-stroke is high, and patients / families should be counseled about post-stroke complications (abstract)

Stroke centers have lower mortality

In this large retrospective analysis of a statewide database, patients with acute ischemic stroke had lower mortality and higher thrombolytic use in designated stroke centers, compared to nondesignated centers. For patients with acute ischemic stroke, there is a survival advantage for those admitted to designated stroke centers (abstract)

Fluoxetine may help motor symptoms after stroke

In this small trial of patients post ischemic stroke, they were randomized to fluoxetine or placebo for 3 months; those in the fluoxetine group improved significantly more on motor scales than those in the placebo group. In patients with motor deficits and need for anti-depressants post-stroke, fluoxetine may be a good choice (abstract)

Very early mobilization benefits stroke patients

In this meta-analysis of 2 small randomized trials, which randomized stroke patients to very early mobilization (within 36 hours) or usual care, those in the early mobilization group had a significantly higher odds of independence (OR 3.1) than those in the usual care group, although the confidence interval was wide due to small sample sized (95% CI 1-9). However, when feasible, stroke patients should be evaluated for early mobilization (abstract)

3 month outcomes in stroke patients

In this large population based cohort, 40% of first-time stroke patients had a poor outcome at 3 months (death, dependent, or institutionalized). Patient and family counseling for first time strokes should include these statistics (abstract)
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