How incompetent is your hospital in not creating a protocol on this in the past 19 years? Will anyone be fired? I'd suggest firing the board of directors for not setting proper goals for the hospital. Clean everything out from the top and on down.
Lipid-lowering agent use at ischemic stroke onset is associated with decreased mortality
Abstract
Background:
3-Hydroxy-3-methylglutaryl-coenzyme A reductase inhibitors (statins),
the most frequently used lipid-lowering agents (LLAs) have
neuroprotective effects in rodent models of ischemic stroke. The authors
hypothesized that patients with ischemic stroke taking LLAs would have
better outcomes than patients not taking LLAs.
Methods:
The Northern Manhattan Study is a population-based study designed to
determine stroke incidence and prognosis in a multiethnic, urban
population. Northern Manhattan residents age 40 years or older diagnosed
with their first ischemic stroke were eligible. Patients or their
proxies were interviewed regarding medications being taken at home
before stroke onset. The NIH Stroke Scale was used to assess stroke
severity, categorized as mild (≤5), moderate (6 to 13), or severe (≥14),
and the Barthel Index at 6 months to assess functional outcome.
Clinical worsening in hospital was recorded by trial neurologists. Odds
ratios and 95% CIs for association of LLA use and stroke severity,
mortality, and functional outcome were calculated using logistic
regression.
Results: Of 650 patients,
57 (8.8%) were taking LLAs. The majority (90.9%) of LLA users were
taking a statin. Clinical worsening in hospital occurred less frequently
among patients taking LLAs at stroke onset (6.3% vs 18.2%; p = 0.04). Ninety-day mortality was lower in those taking LLAs (1.8% vs 10.6%, p = 0.03). The proportion of patients with severe stroke among those taking LLAs was not lower (10.7% vs 16.8%, p = 0.39).
Conclusion:
Patients taking lipid-lowering agents (LLAs) at the time of an ischemic
stroke may have lower poststroke mortality and a lower risk of
worsening during hospitalization. Prospective studies are warranted to
determine whether LLAs, and statins in particular, have neuroprotective
properties or other beneficial effects in acute ischemic stroke.
(This statin therapy should already be in your hyperacute protocol immediately post stroke. Is it? Or is your hospital completely incompetent in that also? Along with everything else in stroke they are incompetent at!
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