Accuracy of identifying acute stroke admissions in a Michigan Stroke Registry.

Introduction: The accurate identification of acute stroke cases is an essential requirement of hospital-based stroke registries. We determined the accuracy of acute stroke diagnoses in Michigan hospitals participating in a prototype of the Paul Coverdell National Acute Stroke Registry.

Methods: From May through November 2002, registry teams (ie, nurse and physician) from 15 Michigan hospitals prospectively identified all suspect acute stroke admissions and classified them as stroke or nonstroke.

Presenting symptoms and onset-to-arrival time in patients with acute stroke and transient ischemic attack.

Delayed arrival to the emergency department (ED) precludes most stroke patients from receiving thrombolytic treatment. Our objective in this study was to examine the association between presenting symptoms and onset-to-arrival time (ie, time between onset of symptoms to arrival at the ED) in a statewide stroke registry. Demographics, clinical data, and presenting symptoms were collected for patients with acute stroke or symptomatic transient ischemic attack (TIA) admitted to 15 Michigan hospitals (n = 1922).

Do presenting symptoms explain sex differences in emergency department delays among patients with acute stroke?

Background And Purpose: Previous studies report that women with stroke may experience longer delays in diagnostic workup than men after arriving at the emergency department. We hypothesized that presenting symptom differences could explain these delays.

Methods: Data were collected on 1922 acute stroke cases who presented to 15 hospitals participating in a statewide stroke registry.

Inter-rater reliability of data elements from a prototype of the Paul Coverdell National Acute Stroke Registry.

Background: The Paul Coverdell National Acute Stroke Registry (PCNASR) is a U.S. based national registry designed to monitor and improve the quality of acute stroke care delivered by hospitals.

The lectin-like domain of tumor necrosis factor-alpha improves alveolar fluid balance in injured isolated rabbit lungs.

Objective: Identification of mechanisms that preserve optimal alveolar fluid balance during pulmonary edema is of great clinical importance. This study was performed to determine whether the lectin-like domain of tumor necrosis factor-alpha (designated TIP) can improve fluid balance in experimental lung injury by affecting alveolocapillary permeability and/or fluid clearance.

Design: Prospective, randomized laboratory investigation.

Sex differences in acute stroke care in a statewide stroke registry.

Background And Purpose: Many studies have reported poorer stroke outcomes in women, and some studies have reported sex differences in care. We analyzed data from a hospital-based stroke registry to determine whether acute stroke care and discharge status differed by sex.

Methods: Detailed chart-level information was collected on 2566 subjects admitted for acute stroke or transient ischemic attack to 15 Michigan hospitals in 2002.

In-hospital stroke in a statewide stroke registry.

Background: In-hospital stroke (IHS) represents 5-15% of all hospitalized acute stroke cases, and is associated with poor outcomes. IHS represents an important area for prevention since many cases occur in high-risk patients undergoing cardiovascular procedures. Our objectives were to compare the quality of care, treatments, and outcomes of IHS with out-of-hospital stroke (OHS) cases.

Closing gaps between evidence-based stroke care guidelines and practices with a collaborative quality improvement project.

Background: Michigan's prototype of the Paul Coverdell National Acute Stroke Registry revealed improvement opportunities in acute stroke care.

Methods: A partnership among the registry investigators, American Stroke Association (ASA), Michigan Department of Community Health, and 13 Michigan hospitals was implemented in 2004. The Institute for Healthcare Improvement Breakthrough Series model and the ASA's Get With The Guidelines-Stroke program and Patient Management Tool (PMT) were used to implement tailored stroke practice guidelines at each hospital.

Lipid testing and lipid-lowering therapy in hospitalized ischemic stroke and transient ischemic attack patients: results from a statewide stroke registry.

Background And Purpose: Recent recommendations call for in-hospital initiation of lipid-lowering therapy (LLT) for most ischemic stroke (IS) and transient ischemic attack (TIA) survivors; however, little is known about actual use. This study describes use of and predictors for in-hospital lipid testing and LLT using data from a statewide stroke registry.

Methods: In 2002, the registry ascertained cases from a stratified sample of 16 hospitals.