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Endovascular clot retrieval (ECR) is the standard of care for acute ischemic stroke due to large vessel occlusion. Performing ECR is a time critical and complex process involving many specialized care providers and resources. Maximizing patient benefit while minimizing service cost requires optimization of human and physical assets. The aim of this study is to develop a general computational model of an ECR service, which can be used to optimize resource allocation. Using a discrete event simulation approach, we examined ECR performance under a range of possible scenarios and resource use configurations. The model demonstrated the impact of competing emergency interventional cases upon ECR treatment times and time impact of allocating more physical (more angiographic suites) or staff resources (extending work hours). Our DES model can be used to optimize resources for interventional treatment of acute ischemic stroke and large vessel occlusion. This proof-of-concept study of computational simulation of resource allocation for ECR can be easily extended. For example, center-specific cost data may be incorporated to optimize resource allocation and overall health care value.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6610480 | PMC |
http://dx.doi.org/10.3389/fneur.2019.00653 | DOI Listing |
Cureus
November 2024
Neurosurgery, Baptist Health Neuroscience Partners Neurosurgery, Baptist Medical Center South, Montgomery, USA.
Introduction: Stroke is one of the common causes of mortality. The length of stay (LOS) for a stroke is a quality indicator and affects mortality. However, there are no large studies evaluating the LOS in an acute inpatient setting for stroke patients, mainly hematological and social parameters.
View Article and Find Full Text PDFPharmgenomics Pers Med
December 2024
Department of Cardiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100050, People's Republic of China.
Objective: The objective of this study was to evaluate the impact of clopidogrel-related gene polymorphisms on the occurrence of recurrent thrombotic events and cardiovascular death in patients with acute coronary syndrome (ACS) following percutaneous coronary intervention (PCI).
Methods: We conducted genotype testing for 26 specific loci mapped to 18 clopidogrel-associated genes in ACS patients who had undergone PCI and were receiving dual antiplatelet therapy only involving clopidogrel. We documented major adverse cardiovascular events (MACE) and clinical endpoints, analyzing the effect of genetic polymorphisms on treatment outcomes.
Neurologist
December 2024
Emergency Medicine Department, Emergency Medicine Research Team, Tabriz University of Medical Sciences, Tabriz, Iran.
Objectives: The National Institutes of Health Stroke Scale (NIHSS) is widely used to assess ischemic stroke severity, but its full 11-item version can be time-consuming. This study evaluates the NIHSS-8, a shortened version, for its efficacy compared with NIHSS-11 in an emergency department setting.
Methods: A cohort study was conducted from May 2018 to May 2019 at Imam Reza Hospital, Tabriz, Iran.
J Stroke Cerebrovasc Dis
December 2024
Department of Healthcare Administration and Medical Informatics, Kaohsiung Medical University, Taiwan; Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan; College of Professional Studies, National Pingtung University of Science and Technology, Pingtung, Taiwan. Electronic address:
Background: Obstructive sleep apnea (OSA) is common after stroke. Still, routine screening of OSA with polysomnography (PSG) is often unfeasible in clinical practice, primarily because of how limited resources are and the physical condition of patients. In this study, we used several artificial intelligence techniques to predict moderate-to-severe OSA and identify its features in patients with acute ischemic stroke.
View Article and Find Full Text PDFWorld Neurosurg
December 2024
Department of Nursing, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, 230001, China; Department of Emergency, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, 230001, China.
Objective: Sarcopenia significantly impacts prognosis in patients with acute ischemic stroke (AIS). This study investigates the relationship between serum creatinine/serum cystatin C (Cr/CysC) levels and short-term prognosis in AIS patients, aiming to inform post-treatment strategies.
Methods: We analyzed AIS patients at the First Affiliated Hospital of the University of Science and Technology of China from January 2022 to January 2024.
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