Background And Purpose: High-dose heparin has been used extensively to treat patients with progressive ischemic stroke, but the scientific support is poor and the current stroke guidelines advise against its use. We studied how heparin treatment for progressive stroke has been discarded in Sweden.
Methods: All 78 hospitals in Sweden that admit acute stroke patients participate in Riks-Stroke, the Swedish Stroke Register. During 2001 to 2008, information on the use of high-dose heparin was available for 155,344 patients with acute ischemic stroke. The determinants as to region, patient characteristics, and stroke service settings were analyzed.
Results: Use of heparin for progressive stroke declined from 7.5% (2001) to 1.6% (2008) of all patients with ischemic stroke. The marked regional differences present in 2001 were reduced over time. The use of heparin declined at a similar rate in all types of hospital settings, in stroke units vs nonstroke units, and in neurological vs medical wards. Independent predictors of use of heparin included younger age, first-ever stroke, independence in activities of daily living before stroke, atrial fibrillation, no aspirin treatment, and lowered consciousness on admission.
Conclusions: There is no immediate, stepwise effect of new scientific information and national guidelines on clinical practice. Rather, the phasing out of heparin has followed a linear course over several years, with less variation between hospitals. We speculate that open comparisons between hospitals in a national stroke register may have helped to reduce the variations in clinical practice.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1161/STROKEAHA.110.597724 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Transmantle pressure under the influence of free breathing: non-invasive quantification of the aqueduct pressure gradient in healthy adults.
Fluids Barriers CNS
January 2025
Medical Image Processing Department, CHU Amiens-Picardie University Hospital, Amiens, France.
Background: The pressure gradient between the ventricles and the subarachnoid space (transmantle pressure) is crucial for understanding CSF circulation and the pathogenesis of certain neurodegenerative diseases. This pressure can be approximated by the pressure difference across the aqueduct (ΔP). Currently, no dedicated platform exists for quantifying ΔP, and no research has been conducted on the impact of breathing on ΔP.
View Article and Find Full Text PDFJoint analysis of blood pressure changes over time and survival of hypertensive patients under treatment at Sawula hospital in Southern Ethiopia.
BMC Public Health
January 2025
Department of Statistics, Borana University, Borena, Oromia Region, Ethiopia.
Introduction: Hypertension is among the most significant non-communicable public health issues worldwide. High blood pressure, or hypertension, has been associated with severe health consequences, including death, aneurysms, stroke, chronic renal disease, eye damage, heart attack, heart failure, peripheral artery disease, and vascular dementia. Consequently, this study aimed to investigate the predictors linked to survival time and the progression of blood pressure measurements in hypertensive patients.
View Article and Find Full Text PDFChanging patterns of cardiovascular diseases and subtypes induced by kidney dysfunction among 25-64 years in China from 1992 to 2021.
BMC Public Health
January 2025
Department of Urology I, The First Hospital of Jilin University, Changchun, Jilin Province, 130021, China.
Background: Cardiovascular diseases (CVD) remain a significant global health burden, particularly in China, where kidney dysfunction (KD) is a key risk factor. This study analyzed trends in the burden of KD-induced CVD and subtypes among the working-age population (25-64 years) in China over the past 30 years and explored its association with age, period, and birth cohort.
Methods: This study extracted data from the Global Burden of Disease (GBD) 2021, focusing on deaths and disability-adjusted life years (DALYs) caused by KD-induced CVD and subtypes, including ischemic heart disease (IHD), stroke, and lower extremity peripheral artery disease (LEPAD) among 25-64 years globally and in China from 1992 to 2021.
Building a growing genomic repository for maternal and fetal health through the PING Consortium.
Pediatr Res
January 2025
Center for Genetic Medicine, Children's National Research Institute, Washington, DC, USA.
Background: Prenatally transmitted viruses can cause severe damage to the developing brain. There is unexplained variability in prenatal brain injury and postnatal neurodevelopmental outcomes, suggesting disease modifiers. Of note, prenatal Zika infection can cause a spectrum of neurodevelopmental disorders, including congenital Zika syndrome.
View Article and Find Full Text PDFGovernance Considerations for Point-of-Care Ultrasound: a HIMSS-SIIM Enterprise Imaging Community Whitepaper in Collaboration with AIUM.
J Imaging Inform Med
January 2025
Independent Consultant, Kirkland, WA, USA.
Point-of-care ultrasound (POCUS) has emerged as a standard of care across a variety of healthcare settings due to its ability to provide critical clinical information and as well as procedural guidance to clinicians directly at the bedside. Implementation of enterprise imaging (EI) strategies is needed such that POCUS images can be appropriately captured, indexed, managed, stored, distributed, viewed, and analyzed. Because of its unique workflow and educational requirements, reliance on traditional order-based workflow solutions may be insufficient.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!