Publications by authors named "Scott Moody"
Background: Delirium is an acute cognitive disturbance frequently characterized by abnormal psychomotor activity and sleep-wake cycle disruption. However, the degree to which delirium affects activity patterns in the acute period after stroke is unclear. We aimed to examine these patterns in a cohort of patients with intracerebral hemorrhage (ICH).
View Article and Find Full Text PDFObjective: Delirium is associated with worse outcomes in patients with stroke and neurocritical illness, but delirium detection in these patients can be challenging with existing screening tools. To address this gap, we aimed to develop and evaluate machine learning models that detect episodes of post-stroke delirium based on data from wearable activity monitors in conjunction with stroke-related clinical features.
Design: Prospective observational cohort study.
Objective: Spontaneous angiogram-negative nonperimesencephalic subarachnoid hemorrhage (an-NPSAH) can represent a diagnostic and management dilemma. The authors sought to determine radiographic predictors of aneurysmal etiology based on admission noncontrast head CT scans.
Methods: The authors performed a retrospective cohort study of prospectively collected data from consecutive patients who were admitted for spontaneous subarachnoid hemorrhage (SAH) with suspected aneurysmal etiology to an academic center from 2016 to 2021.
Article Synopsis
- - The study aimed to find early radiographic signs that could predict persistent hydrocephalus needing a ventriculoperitoneal shunt (VPS) in patients with aneurysmal subarachnoid hemorrhage (aSAH).
- - Researchers analyzed CT scans from 229 patients and developed a scoring system (CISCO) based on the amount of blood clot in certain brain regions, finding that higher scores were linked to a greater need for VPS.
- - Using CISCO was effective in forecasting VPS requirements, showing better predictive accuracy than other admission indicators, and the authors suggest further research to solidify this tool's utility.
Article Synopsis
- A novel delirium screening tool, the Fluctuating Mental Status Evaluation (FMSE), was developed for neurocritical care patients, targeting those with intracerebral hemorrhage (ICH).
- The study involved a pilot cohort of 40 ICH patients, with daily assessments revealing that 85% experienced delirium, and the FMSE demonstrated high sensitivity and specificity in detecting delirium.
- The FMSE proved effective even in patients with communication challenges and varying levels of alertness, suggesting it could be a reliable tool for delirium detection in neurocritical care settings.
Article Synopsis
- Researchers studied a kind of brain bleeding called pmSAH, which is usually not as dangerous as other types, but some cases could be caused by a hidden brain aneurysm.
- They looked at brain scans from patients to see different features of blood clots and created a scoring system to help tell if the bleeding is from an aneurysm or not.
- Their scoring system showed very high accuracy in predicting the cause of bleeding in both their study group and another group they tested it on later.
Short- and long-term opioid use in survivors of subarachnoid hemorrhage.
Clin Neurol Neurosurg
August 2021
Objectives: Opioids are frequently used for analgesia in patients with acute subarachnoid hemorrhage (SAH) due to a high prevalence of headache and neck pain. However, it is unclear if this practice may pose a risk for opioid dependence, as long-term opioid use in this population remains unknown. We sought to determine the prevalence of opioid use in SAH survivors, and to identify potential risk factors for opioid utilization.
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- An increase in white blood cell (WBC) count soon after aneurysmal subarachnoid hemorrhage (SAH) may indicate systemic inflammation and can potentially be used to predict patient outcomes.
- A study analyzed 167 SAH patients, examining WBC counts during their first five days of hospitalization and correlating them with their functional status three months later.
- Results showed that higher peak WBC counts were linked to poorer outcomes, suggesting that monitoring WBC levels could help identify patients at higher risk for complications and guide treatment strategies.
Purpose: To examine associations between physiologic stress and delirium in the setting of a direct neurologic injury.
Materials And Methods: We obtained initial neutrophil-to-lymphocyte ratio (NLR), glucose, and troponin in consecutive non-comatose patients with non-traumatic intracerebral hemorrhage (ICH) over 1 year, then used multivariable regression models to determine associations between each biomarker and incident delirium. Delirium diagnoses were established using DSM-5-based methods, with exploratory analyses further categorizing delirium as first occurring <24 h ("early-onset") or > 24 h after presentation ("later-onset").
Objective: To determine the impact of delirium on withdrawal of life-sustaining treatment (WLST) after intracerebral hemorrhage (ICH) in the context of established predictors of poor outcome, using data from an institutional ICH registry.
Methods: We performed a single-center cohort study on consecutive patients with ICH admitted over 12 months. ICH features were prospectively adjudicated, and WLST and corresponding hospital day were recorded retrospectively.
Background And Purpose: Hypertension is a known risk factor for intracerebral hemorrhage (ICH), but it is unclear whether blood pressure (BP) at hospital arrival can be used to distinguish hypertensive ICH from non-hypertensive etiologies.
Patients And Methods: We performed a single-center cohort study using data from consecutive ICH patients over 12 months. ICH characteristics including etiology were prospectively adjudicated by two attending neurologists.
Background: Alpha-1 antitrypsin (AAT) is a potent anti-protease enzyme which may play a role in arterial wall stability. A variant of its encoding gene has been recently linked to ischemic stroke due to large artery atherosclerosis (LAA). We sought to explore potential relationships between ischemic stroke mechanisms, atherosclerosis burden and serum AAT levels.
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- The study looked at how often delirium, a serious confusion state, happens in patients who had bleeding in their brains (intracerebral hemorrhage) and if it’s being missed by doctors.
- Researchers observed 60 patients and found that more than half (57%) showed signs of delirium during daily check-ups, with specific symptoms like confusion and sleep issues being common.
- Some symptoms were hard to evaluate because patients had trouble speaking, but using non-verbal ways to check attention helped doctors understand more about their condition.
Background: In humans, serotonin has typically been investigated as a neurotransmitter. However, serotonin also functions as a hormone across animal phyla, including those lacking an organized central nervous system. This hormonal action allows serotonin to have physiological consequences in systems outside the central nervous system.
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