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, March 4, 2021

Delirium REduction after Administration of Melatonin in acute ischemic Stroke (DREAMS): A Propensity Score Matched Analysis

I had not heard of this problem. You'll have to hope like hell that your doctor has and knows the protocol to prevent it.  

1 in 4 have delirium post stroke from this research:

Delirium – an overlooked complication of stroke

The latest here:

Delirium REduction after Administration of Melatonin in acute ischemic Stroke (DREAMS): A Propensity Score Matched Analysis

First published: 03 March 2021
https://doi.org/10.1111/ene.14792

This article has been accepted for publication and undergone full peer review but has not been through the copyediting, typesetting, pagination and proofreading process, which may lead to differences between this version and the Version of Record. Please cite this article as doi:10.1111/ene.14792

Abstract

Background

Post‐stroke delirium (PSD) comprises a common and severe complication after stroke. Yet, treatment options for PSD remain insufficient. We investigated whether prophylactic melatonin supplementation may be associated with reduced risk for PSD.

Methods

Consecutive patients admitted to Tübingen University Stroke Unit, Germany, with acute ischemic stroke (AIS), who underwent standard care (between August and December 2017) and patients who additionally received prophylactic melatonin (2 mg per day at night) within 24 hours of symptom onset (between August and December 2018) were included. Primary outcomes were: (i) PSD prevalence in AIS patients, (ii) PSD risk and PSD‐free survival in patients with cerebral infarction who underwent melatonin supplementation compared to propensity‐score‐matched (PSM) controls. Secondary outcomes included time of PSD‐onset and PSD‐duration.

Results

Out of 465 (81.2%) with cerebral infarction and 108 (18.8%) TIA patients, 152 (26.5%) developed PSD (median time‐to‐onset [IQR]: 16 [8,32] hours; duration 24 [8,40] hours). Higher age, cerebral infarction (rather than TIA), higher NIHSS and aphasia on admission were significant predictors of PSD. After PSM (164 melatonin‐treated patients with cerebral infarction versus 164 matched‐controls), 42 (25.6%) melatonin‐treated patients developed PSD vs. 60 (36.6%) controls (OR [95% CI]: 0.597 [0.372‐0.958], p=.032). PSD‐free survival differed significantly between groups (p=.027), favoring melatonin‐treated patients. In patients with PSD, no between‐group differences in the time of PSD‐onset and PSD‐duration were noted.

Conclusions

Patients prophylactically treated with melatonin within 24 hours of AIS onset had lower risk for PSD than patients undergoing standard care. Prospective randomized trials are warranted to corroborate these findings.

 
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