Healthcare resource utilization and clinical outcomes associated with acute care and inpatient rehabilitation of stroke patients in Japan

So don't have a severe stroke in Japan. You will cost too much and don't recover very well. The takeaway should be finding stroke protocols that reduce that severity to a manageable level. Like maybe solving these 5 causes of the neuronal cascade of death. 

Healthcare resource utilization and clinical outcomes associated with acute care and inpatient rehabilitation of stroke patients in Japan

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Kyoko Murata, Shiro Hinotsu, Nobutake Sadamasa, Kazumichi Yoshida, Yamagata Sen, Shoji Asari, Susumu Miyamoto, Koji Kawakami

DOI: http://dx.doi.org/10.1093/intqhc/mzw127 First published online: 15 December 2016

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Abstract

Objective To investigate healthcare resource utilization and changes in functional status in stroke patients during hospitalization in an acute hospital and a rehabilitation hospital.

Design Retrospective cohort study.

Setting One acute and one rehabilitation hospital in Japan.

Participants Patients who were admitted to the acute hospital due to stroke onset and then transferred to the rehabilitation hospital (n = 263, 56% male, age 70 ± 12 years).

Main outcome measures Hospitalization costs and functional independence measure (FIM) were evaluated according to stroke subtype and severity of disability at discharge from the acute hospital.

Results Median (IQR) costs at the acute hospital were dependent on the length of stay (LOS) and implementation of neurosurgery, which resulted in higher costs in subarachnoid hemorrhage [$52 413 ($49 166–$72 606) vs $14 129 ($11 169–$19 459) in cerebral infarction; and vs $15 035 ($10 920–$21 864) in intracerebral hemorrhage]. The costs at the rehabilitation hospital were dependent on LOS, and higher in patients with moderate disability than in those with mild disability [$30 026 ($18 419–$39 911) vs $18 052 ($10 631–$24 384)], while those with severe disability spent $25 476 ($13 340–$43 032). Patients with moderate disability gained the most benefits during hospitalization in the rehabilitation hospital, with a median (IQR) total FIM gain of 16 (5–24) points, compared with a modest improvement in patients with mild (6, 2–14) or severe disability (0, 0–5).

Conclusions The costs for in-hospital stroke care were substantial and the improvement in functional status varied by severity of disability. Our findings would be valuable to organize efficient post-acute stroke care.

It looks like a hearing aid, but new device records EEGs, helps detect seizures

And your doctor with some tuning should be able to determine where the damage is in your brain after a stroke. Or will they continue to use; mild, medium, severe which tells you absolutely nothing?
http://medcitynews.com/2013/08/it-looks-like-a-hearing-aid-but-new-device-records-eegs-helps-detect-seizures/?
A tiny, unobtrusive brain monitor could help track daily seizures.
Neuroscientists often use electroencephalography (EEG) as an inexpensive way to record electrical signals in the brain. Though it would be useful to run these recordings for long periods of time, that usually isn’t practical: EEG recording traditionally involves attaching many electrodes and cables to a patient’s scalp.
Now engineers at Imperial College in London have developed an EEG device that can be worn inside the ear, like a hearing aid. They say the device will allow scientists to record EEGs for several days at a time; this would allow doctors to monitor patients who have regularly recurring problems like seizures or microsleep.
“The ideal is to have a very stable recording system, and recordings which are repeatable,” explains co-creator Danilo Mandic. “It’s not interfering with your normal life, because there are acoustic vents so people can hear. After a while, they forget they’re having an EEG.”

By nestling the EEG inside the ear, the engineers avoid a lot of signal noise usually introduced by body movement. They can also ensure that the electrodes are always placed in exactly the same spot, which, they say, will make repeated readings more reliable.
Since the device attaches to just one area, it can record only from the temporal region. This limits its potential applications to events that involve local activity. Tzzy-Ping Jung, co-director of the University of California, San Diego’s Center for Advanced Neurological Engineering, says that this does not mean the device will not be valuable.
“Different modalities will have different applications. I would not rule out the usefulness of any modalities,” says Jung. “I think it’s a very good idea with very promising results.”

Read more: http://medcitynews.com/2013/08/it-looks-like-a-hearing-aid-but-new-device-records-eegs-helps-detect-seizures/#ixzz2cAXT0Yre

Acidity in the brain could hold the key to stroke treatment

A non-invasive way to measure stroke damage. With that I bet someone innovative could come up with a 3d map of the damage, and then we could compare strokes against each other and how effective rehabilitation protocols are. May 2006 so according to their timeline they should have something useful by now.
http://www.alphagalileo.org/ViewItem.aspx?ItemId=23318&CultureCode=en
Development of a new technique for detecting brain damage caused by stroke has been boosted up by a £1m grant to scientists at The University of Manchester. Professor Gareth Morris of the School of Chemistry and Professor Risto Kauppinen of the University of Birmingham are to lead the development of a new non-invasive technique which measures acidity (pH) in the brain.

A stroke is caused when part of the blood supply to the brain is cut off. This causes acidity in the brain to build up, leading to damage.

CT scans are currently used to detect bleeding, swelling and tumours in the brain, but the visibility of soft tissue is very limited, making damage difficult to detect.

Professors Morris and Kauppinen will use advanced Nuclear Magnetic Resonance (NMR) technologies to allow MRI scanners to create detailed images of pH in the brain.

The images will be used to compare healthy (neutral, pH 7) and damaged (acidic, lower pH) areas of the brain, and to measure how the pH of the brain changes over time, with the aim of providing more targeted and effective treatments.

Professor Morris said: “Within two to three years we hope to have developed an NMR technique which can be translated into a machine that can image acidity in the brain.

“If we can map stroke damage accurately, doctors will have a better chance to provide more targeted and effective treatment. Current techniques often only enable one to see damage once it is too late to intervene.”

NMR will be used to measure the rate at which hydrogen ions are exchanged between water and proteins in the brain. Acidity causes this rate to increase, changing the NMR signal of water.

The grant, from the Engineering and Physical Sciences Research Council, will fund three new NMR instruments in the university's School of Chemistry, which is the second largest university Chemistry department in the UK and one of the largest in Europe. The new instruments will also support a wide range of other developments in organic, inorganic and materials chemistry.