Changing stroke rehab and research worldwide now.Time is Brain! trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 523 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:

My blog is not to help survivors recover, it is to have the 10 million yearly stroke survivors light fires underneath their doctors, stroke hospitals and stroke researchers to get stroke solved. 100% recovery. The stroke medical world is completely failing at that goal, they don't even have it as a goal. 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 lays out what needs to be done to get stroke survivors closer to 100% recovery. It's quite disgusting that this information is not available from every stroke association and doctors group.

Thursday, January 2, 2020

Prestroke Disability Predicts Adverse Poststroke Outcome

 Well what are you doing to change that status quo of failure to get those persons recovered?  Throwing up your hands in defeat is not allowed. 100% RECOVERY IS THE GOAL FOR ALL SURVIVORS.

Prestroke Disability Predicts Adverse Poststroke Outcome

Originally published17 Dec 2019https://doi.org/10.1161/STROKEAHA.119.027740Stroke. ;0:STROKEAHA.119.027740

Abstract

Background and Purpose—

Information on what effect disability before stroke can have on stroke outcome is lacking. We assessed prestroke disability in relation to poststroke hospital outcome.

Methods—

Analysis of prospectively collected data from the Sentinel Stroke National Audit Programme. A total of 1656 men (mean age ±SD =73.1±13.2 years) and 1653 women (79.3±13.0 years) were admitted to hyperacute stroke units with acute stroke in 4 major UK between 2014 and 2016. Prestroke disability, assessed by modified Rankin Scale (mRS), was tested against poststroke adverse outcomes, adjusted for age, sex, and coexisting morbidities.

Results—

Compared with patients with prestroke mRS score =0, individuals with prestroke mRS scores =3, 4, or 5 had greater adjusted risks of moderately severe or severe stroke on arrival (4.4% versus 16.7%; odds ratio [OR], 3.2 [95% CI, 2.3–4.6] P<0.001); urinary tract infection or pneumonia within 7 days of admission (9.6% versus 35.9%; OR, 3.7 [95% CI, 2.8–4.8] P<0.001); mortality (7.2% versus 37.1%; OR, 4.9 [95% CI, 3.7–6.5] P<0.001); requiring help with activities of daily living on discharge (12.3% versus 26.7%; OR, 3.1 [95% CI, 2.3–4.1] P<0.001); and transferred to new care home (2.4% versus 9.4%; OR, 2.1 [95% CI, 1.3–3.3] P=0.002). Patients with mRS scores =1 or 2 had intermediate risk of adverse outcomes. Overall, those with a mRS score =1 or 2 had length of stay on hyperacute stroke units extended by 5.3 days (95% CI, 2.8–7.7; P<0.001) and mRS score =3, 4 or 5 by 7.2 days (95% CI, 4.0–10.5; P<0.001).

Conclusions—

Individuals with evidence of prestroke disability, assessed by mRS, had significantly increased risk of post stroke adverse outcomes and longer length of stay on hyperacute stroke units and higher level of care on discharge.

Footnotes

Correspondence to Thang S. Han, MD, PhD, Royal Holloway, University of London, Biological Sciences, Bourne Laboratory, Egham TW20 0EX, United Kingdom. Email

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