Deans' stroke musings

Changing stroke rehab and research worldwide now.Time is Brain!Just think of all the trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 493 posts on hyperacute therapy, enough for researchers to spend decades proving them out. These are my personal ideas and blog on stroke rehabilitation and stroke research. Do not attempt any of these without checking with your medical provider. Unless you join me in agitating, when you need these therapies they won't be there.

What this blog is for:

Shortly after getting out of the hospital and getting NO information on the process or protocols of stroke rehabilitation and recovery I started searching on the internet and found that no other survivor received useful information. This is an attempt to cover all stroke rehabilitation information that should be readily available to survivors so they can talk with informed knowledge to their medical staff. It's quite disgusting that this information is not available from every stroke association and doctors group.
My back ground story is here:http://oc1dean.blogspot.com/2010/11/my-background-story_8.html

Wednesday, July 25, 2018

Time delays to thrombectomy for stroke reduce patient lifetime and economic value of care

This is the whole problem. Blaming the patient for their lack of recovery. Or blaming lack of speed in processes.  That complete lack of recovery needs to be shatted upon the shoes of the stroke medical world and stay there stinking up their lives until they come up with solutions for 100% recovery for all survivors. If they don't have the leadership capability for that they can walk around in shame for the rest of their days.
Damn it all: stroke is easy; 5 steps.
1.  Describe the problems exactly.
2.  Write thousands of RFPs to researchers to solve those problems.
3.  Fund them with foundation grants.
4.  Write stroke rehab protocols based on the research.
5.  Get the Nobel prize in medicine  


Oops, I'm not playing by the polite rules of Dale Carnegie, 'How to Win Friends and Influence People'. 
Politeness will never solve anything in stroke.
 

Time delays to thrombectomy for stroke reduce patient lifetime and economic value of care 


Society of NeuroInterventional Surgery
San Francisco--Every minute that endovascular thrombectomy (EVT) for a stroke patient is delayed decreases the patient's quality of life and lifespan, and reduces the significant monetary benefits that EVT provides. A new study shows that using a Markov model of lifetime quality-adjusted life years (QALYs) of EVT-treated patients, every 10 minutes of delayed care reduced a patient's disability free lifetime by about 40 days.
In addition to analyzing a person's QALYs, the study--Lifetime Quality of Life and Cost Consequences of Treatment Delays in Endovascular Thrombectomy for Stroke Based on HERMES Data, released today at the 15th Annual Meeting of the Society of NeuroInterventional Surgery--also evaluated health care costs and societal costs, which include losses of productivity and informal care given by family members.
The study found that time delays to EVT significantly reduce the economic value of stroke care, i.e. the amount of health expenditures needed to achieve QALYs for a patient in a particular health care setting. An economic measure that accounts for value of care is net monetary benefit, which combines weighted QALYs and costs into one composite outcome. A time delay of 10 minutes reduced the net monetary benefit of EVT by about $10,000 taking health care system or societal perspectives, respectively.(You're using time delays as an excuse not to solve 100% recovery? How fucking non-leadership can you get? The status quo is NOT OK. )
"This study shows that time delays can have a significant impact on a patient and society," said Dr. Wolfgang Kunz, lead author of the study and radiology resident at Ludwig-Maximilians-University in Munich, Germany. "Significant time delays of on average 2 hours could be prevented in triage if EMS send patients with severe signs of stroke directly to a comprehensive or Level 1 stroke center that provides EVT instead of the closest primary stroke center."
Other recommendations include improving in-hospital workflow by notifying the hospital in advance to have the full stroke team ready when the patient arrives in the emergency room and by distributing tasks among a coordinated stroke team.
"Given the dramatic financial benefits to health care systems by increasing efficiency, there should now be greater impetus toward investment into processes and technologies that reduce onset to reperfusion times," said Dr. Mayank Goyal, senior author of the study, chair of the HERMES collaboration and neurointerventionalist at University of Calgary in Canada.
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To receive a copy of this abstract, or to speak with Dr. Kunz, please contact Sangeetha Sarma at 202-248-5467 or ssarma@vancomm.com.
About the Society of NeuroInterventional Surgery
The Society of NeuroInterventional Surgery (SNIS) is a scientific and educational association dedicated to advancing the specialty of neurointerventional surgery through research, standard-setting, and education and advocacy to provide the highest quality of patient care in diagnosing and treating diseases of the brain, spine, head, and neck. Visit http://www.snisonline.org and follow us on Twitter (@SNISinfo) and Facebook (@SNISOnline).
Disclaimer: AAAS and EurekAlert! are not responsible for the accuracy of news releases posted to EurekAlert! by contributing institutions or for the use of any information through the EurekAlert system.

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