Increasing Use of Computed Tomographic Perfusion and Computed Tomographic Angiograms in Acute Ischemic Stroke From 2006 to 2010

Vagal, Achala; Meganathan, Karthikeyan; Kleindorfer, Dawn; Adeoye, Opeolu; Hornung, Richard; Khatri, Pooja

doi:10.1161/strokeaha.113.004332

Cited by 40 publications

(22 citation statements)

References 26 publications

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“…Reperfusion treatment was more common among those who were imaged with CTA (13.0%) and CTP (17.6%) compared with those with CT of the head alone (4.0%; P<0.0001). 50 However, when considering implementation of multimodal CT imaging at small or remote access hospitals, resource availability and realistic expectations for gains in efficiency should be taken into account. 5.…”

mentioning

confidence: 99%

2018 Guidelines for the Early Management of Patients With Acute Ischemic Stroke: A Guideline for Healthcare Professionals From the American Heart Association/American Stroke Association

Powers¹,

Rabinstein²,

Ackerson³

et al. 2018

Stroke

4,287

2,535

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Background and Purpose-The purpose of these guidelines is to provide an up-to-date comprehensive set of recommendations for clinicians caring for adult patients with acute arterial ischemic stroke in a single document. The intended audiences are prehospital care providers, physicians, allied health professionals, and hospital administrators. These guidelines supersede the 2013 guidelines and subsequent updates. Methods-Members of the writing group were appointed by the American Heart Association Stroke Council's Scientific Statements Oversight Committee, representing various areas of medical expertise. Strict adherence to the American Heart Association conflict of interest policy was maintained. Members were not allowed to participate in discussions or to vote on topics relevant to their relations with industry. The members of the writing group unanimously approved all recommendations except when relations with industry precluded members voting. Prerelease review of the draft guideline was performed by 4 expert peer reviewers and by the members of the Stroke Council's Scientific Statements Oversight The American Heart Association makes every effort to avoid any actual or potential conflicts of interest that may arise as a result of an outside relationship or a personal, professional, or business interest of a member of the writing panel. Specifically, all members of the writing group are required to complete and submit a Disclosure Questionnaire showing all such relationships that might be perceived as real or potential conflicts of interest. Guidelines for the Early Management of PatientsThis guideline was approved by the American Heart Association Science Advisory and Coordinating Committee on November 29, 2017, and the American Heart Association Executive Committee on December 11, 2017. A copy of the document is available at http://professional.heart.org/statements by using either "Search for Guidelines & Statements" or the "Browse by Topic" area. To purchase additional reprints, call 843-216-2533 or e-mail kelle.ramsay@ wolterskluwer.com. Tables) is available The American Heart Association requests that this document be cited as follows: Powers WJ, Rabinstein AA, Ackerson T, Adeoye OM, Bambakidis NC, Becker K, Biller J, Brown M, Demaerschalk BM, Hoh B, Jauch EC, Kidwell CS, Leslie-Mazwi TM, Ovbiagele B, Scott PA, Sheth KN, Southerland AM, Summers DV, Tirschwell DL; on behalf of the American Heart Association Stroke Council. 2018 Guidelines for the early management of patients with acute ischemic stroke: a guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke. 2018;49:eXXXeXXX. doi: 10.1161/STR.0000000000000158. Data Supplement 1 (EvidenceThe expert peer review of AHA-commissioned documents (eg, scientific statements, clinical practice guidelines, systematic reviews) is conducted by the AHA Office of Science Operations. For more on AHA statements and guidelines development, visit http://professional.heart.org/statements. Select the "Guidelines & Statem...

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confidence: 99%

2018 Guidelines for the Early Management of Patients With Acute Ischemic Stroke: A Guideline for Healthcare Professionals From the American Heart Association/American Stroke Association

Powers¹,

Rabinstein²,

Ackerson³

et al. 2018

Stroke

4,287

2,535

View full text Add to dashboard Cite

show abstract

Section: Discussionmentioning

confidence: 99%

“…In previous studies, the Premier Healthcare Database has been used to identify utilization rates of individual health services, such as patterns of intensive care unit utilization among heart failure patients 12 and computed tomography (CT) angiogram and perfusion utilization among acute ischemic stroke patients. 13 Additionally, Concannon et al 1 used claims data from the HCUP's Inpatient Database to identify PCI services at hospitals and compare claims-based utilization rates with those of the AHA survey. In contrast to these previous studies, we extended the current literature by developing a systematic method to comprehensively identify a wide range of cardiac health services using administrative data.…”

Section: Discussionmentioning

confidence: 99%

Identification of Hospital Cardiac Services for Acute Myocardial Infarction Using Individual Patient Discharge Data

Chang

Krumholz

et al. 2016

JAHA

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BackgroundThe availability of hospital cardiac services may vary between hospitals and influence care processes and outcomes. However, data on available cardiac services are restricted to a limited number of services collected by the American Hospital Association (AHA) annual survey. We developed an alternative method to identify hospital services using individual patient discharge data for acute myocardial infarction (AMI) in the Premier Healthcare Database.Methods and ResultsThirty‐five inpatient cardiac services relevant for AMI care were identified using American Heart Association/American College of Cardiology guidelines. Thirty‐one of these services could be defined using patient‐level administrative data codes, such as International Classification of Diseases, Ninth Revision, Clinical Modification and Current Procedural Terminology codes. A hospital was classified as providing a service if it had ≥5 instances for the service in the Premier database from 2009 to 2011. Using this system, the availability of these services among 432 Premier hospitals ranged from 100% (services such as chest X‐ray) to 1.2% (heart transplant service). To measure the accuracy of this method using administrative data, we calculated agreement between the AHA survey and Premier for a subset of 16 services defined by both sources. There was a high percentage of agreement (≥80%) for 11 of 16 (68.8%) services, moderate agreement for 3 of 16 (18.8%) services, and low agreement (≤50%) for 2 of 16 services (12.5%).ConclusionsThe availability of cardiac services for AMI care varies widely among hospitals. Using individual patient discharge data is a feasible method to identify these cardiac services, particularly for those services pertaining to inpatient care.

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“…10 CTA has seen a large increase in use during the past decade as a result of multidetector CT technology. 11 Older CT systems currently in use in some developing countries may be limited to singleslice or 4-slice acquisition that can affect CTA image quality.…”

Section: Accessibilitymentioning

confidence: 99%

Comparing Vessel Imaging

Demchuk

Menon

Goyal

2016

Stroke

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Increasing Use of Computed Tomographic Perfusion and Computed Tomographic Angiograms in Acute Ischemic Stroke From 2006 to 2010

Cited by 40 publications

References 26 publications

2018 Guidelines for the Early Management of Patients With Acute Ischemic Stroke: A Guideline for Healthcare Professionals From the American Heart Association/American Stroke Association

2018 Guidelines for the Early Management of Patients With Acute Ischemic Stroke: A Guideline for Healthcare Professionals From the American Heart Association/American Stroke Association

Identification of Hospital Cardiac Services for Acute Myocardial Infarction Using Individual Patient Discharge Data

Comparing Vessel Imaging

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