In this small study of 95 hospitalized elders at the VA, researchers validated a modified RASS screening tool to detect delirium. Patients underwent daily screening with the modified RASS and with a comprehensive assessment for delirium by a geriatric expert. The sensitivity and specificity for delirium as a single assessment was 64% and 93% respectively; but if performed daily, the sensitivity and specificity to detect incident delirium was 85% and 92% respectively. This may be a promising quick tool to screen serially for incident delirium in hospitalized patients, but performs less well as a single assessment (abstract)
In this large multicenter trial, patients with minor stroke or TIA were randomized to clopidogrel+ASA or ASA alone; 90-day stroke occurred in 8% vs 12% respectively, and rates of hemorrhage or hemorrhagic stroke were the same (abstract).
These guidelines provide an evidence based for the use of periprocedural antithrombotics in patients with cerebrovascular disease. They recommend continuing ASA-warfarin for dental procedures, and most other minor procedures. There is little evidence to support the use of procedural bridging with heparin, and it does increase the risk of bleeding. Cessation of therapy for 7 […]
A large analysis from a stroke registry found better outcomes with earlier thrombolytics for acute ischemic stroke; every 15 minutes earlier was associated with an odds ratio of 0.96 for in-hospital death or intracranial hemorrhage, and an odds ratio of 1.03 for being discharged home and 1.04 for walking independently at discharge (abstract).