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1. VISIT STROKE: non-inferiority of telemedicine-based neurological consultation for post-acute stroke patients – protocol of a prospective observational controlled multi-center study

Author

Herm, Juliane, Erdur, Hebun, Aigner, Annette, Hengelbrock, Johannes, Angermaier, Anselm, Flöel, Agnes, Hille, Annegret, Gorski, Claudia, Kinze, Stephan, Schmehl, Ingo, Hubert, Gordian J., Wiestler, Hanni, Siepmann, Timo, Arndt, Martin, Gumbinger, Christoph, Heyse, Miriam, Weber, Joachim E., and Audebert, Heinrich J.

Published
2024
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4. Aspirin versus anticoagulation in cervical artery dissection (TREAT-CAD): an open-label, randomised, non-inferiority trial

Author

Kahles, Timo, Nedeltchev, Krassen, Altersberger, Valerian, Bonati, Leo H, Brehm, Alex, Bruni, Nicole, De Marchis, Gian Marco, Engelter, Stefan T, Fabbro, Thomas, Fisch, Urs, Fladt, Joachim, Gensicke, Henrik, Hert, Lisa, Lyrer, Philippe A, Maurer, Marina, Peters, Nils, Polymeris, Alexandros, Psychogios, Marios-Nikos, Schaedelin, Sabine, Stippich, Christoph, Thilemann, Sebastian, Traenka, Christopher, Wagner, Benjamin, Arnold, Marcel, Fischer, Urs, Goeggel Simonetti, Barbara, Gralla, Jan, Heldner, Mirjam, Jung, Simon, Leib, Stephen L, Seiffge, David J, Mueller, Hubertus, Sveikata, Lukas, Sztajzel, Roman, Correia, Pamela, Eskandari, Ashraf, Meyer, Ivo, Michel, Patrik, Nannoni, Stefania, Remillard, Suzette, Sirimarco, Gaia, Zachariadis, Alexandros, Kaegi, Georg, Mueller, Anna, Vehoff, Jochen, Hamann, Janne, Luft, Andreas R, Steiner, Levke, Wegener, Susanne, Erdur, Hebun J, Nolte, Christian H, von Rennenberg, Regina, Scheitz, Jan F, Feil, Katharina, Kellert, Lars, Christensen, Hanne, Rosenbaum, Sverre, Schaedelin, Sabine A, Simonetti, Barbara Goeggel, Kägi, Georg, Seiffge, David, Polymeris, Alexandros A, and Lyrer, Philippe

Published
2021
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7. Intravenous Thrombolysis With or Without Endovascular Treatment for Suspected Ischemic Stroke in Patients With Intracranial Tumors

Author

Seystahl, Katharina, primary, Martinez-Majander, Nicolas, additional, Salerno, Alexander, additional, Beyeler, Morin, additional, Erdur, Hebun, additional, Marto, João Pedro, additional, Hametner, Christian, additional, Zedde, Marialuisa, additional, Pezzini, Alessandro, additional, Leker, Ronen, additional, Altersberger, Valerian, additional, Costamagna, Gianluca, additional, Serôdio, Miguel, additional, Migliaccio, Ludovica, additional, Pascarella, Rosario, additional, Zini, Andrea, additional, Mannismäki, Laura, additional, Béjot, Yannick, additional, Jung, Simon, additional, Gensicke, Henrik, additional, Padjen, Visnja, additional, Ringleb, Peter A., additional, Nolte, Christian, additional, Heldner, Mirjam R, additional, Michel, Patrik, additional, Engelter, Stefan T., additional, Curtze, Sami, additional, Weller, Michael, additional, and Wegener, Susanne, additional

Published
2023
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9. Association of prestroke metformin use, stroke severity, and thrombolysis outcome

Author

Westphal, Laura P., Widmer, Roni, Held, Ulrike, Steigmiller, Klaus, Hametner, Christian, Ringleb, Peter, Curtze, Sami, Martinez-Majander, Nicolas, Tiainen, Marjaana, Nolte, Christian H., Scheitz, Jan F., Erdur, Hebun, Polymeris, Alexandros A., Traenka, Christopher, Eskandari, Ashraf, Michel, Patrik, Heldner, Mirjam R., Arnold, Marcel, Zini, Andrea, Vandelli, Laura, Coutinho, Jonathan M., Groot, Adrien E., Padjen, Visnja, Jovanovic, Dejana R., Bejot, Yannick, Brenière, Céline, Turc, Guillaume, Seners, Pierre, Pezzini, Alessandro, Magoni, Mauro, Leys, Didier, Gilliot, Sixtine, Scherrer, Michael J., Kägi, Georg, Luft, Andreas R., Gensicke, Henrik, Nederkoorn, Paul, Tatlisumak, Turgut, Engelter, Stefan T., and Wegener, Susanne

Published
2020
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11. Intravenous Thrombolysis 4.5–9 Hours After Stroke Onset: A Cohort Study from the TRISP Collaboration

Author

Altersberger, Valerian L; https://orcid.org/0000-0002-0610-9328, Sibolt, Gerli, Enz, Lukas S, Hametner, Christian, Scheitz, Jan F, Henon, Hilde, Bigliardi, Guido, Strambo, Davide, Martinez‐Majander, Nicolas, Stolze, Lotte J, Heldner, Mirjam R; https://orcid.org/0000-0002-3594-2159, Grisendi, Ilaria, Jovanovic, Dejana R, Bejot, Yannick, Pezzini, Alessandro; https://orcid.org/0000-0001-8629-3315, Leker, Ronen R, Kägi, Georg, Wegener, Susanne; https://orcid.org/0000-0003-4369-7023, Cereda, Carlo W; https://orcid.org/0000-0002-6479-1476, Ntaios, Georges, De Marchis, Gian Marco; https://orcid.org/0000-0002-0342-9780, Bonati, Leo H, Psychogios, Marios, Lyrer, Philippe, Räty, Silja; https://orcid.org/0000-0002-6921-0597, Tiainen, Marjaana, Wouters, Anke, Caparros, François, Heyse, Miriam, Erdur, Hebun; https://orcid.org/0000-0001-5383-9625, et al, Altersberger, Valerian L; https://orcid.org/0000-0002-0610-9328, Sibolt, Gerli, Enz, Lukas S, Hametner, Christian, Scheitz, Jan F, Henon, Hilde, Bigliardi, Guido, Strambo, Davide, Martinez‐Majander, Nicolas, Stolze, Lotte J, Heldner, Mirjam R; https://orcid.org/0000-0002-3594-2159, Grisendi, Ilaria, Jovanovic, Dejana R, Bejot, Yannick, Pezzini, Alessandro; https://orcid.org/0000-0001-8629-3315, Leker, Ronen R, Kägi, Georg, Wegener, Susanne; https://orcid.org/0000-0003-4369-7023, Cereda, Carlo W; https://orcid.org/0000-0002-6479-1476, Ntaios, Georges, De Marchis, Gian Marco; https://orcid.org/0000-0002-0342-9780, Bonati, Leo H, Psychogios, Marios, Lyrer, Philippe, Räty, Silja; https://orcid.org/0000-0002-6921-0597, Tiainen, Marjaana, Wouters, Anke, Caparros, François, Heyse, Miriam, Erdur, Hebun; https://orcid.org/0000-0001-5383-9625, and et al

Abstract

ObjectiveTo investigate the safety and effectiveness of intravenous thrombolysis (IVT) >4.5–9 hours after stroke onset, and the relevance of advanced neuroimaging for patient selection.MethodsProspective multicenter cohort study from the ThRombolysis in Ischemic Stroke Patients (TRISP) collaboration. Outcomes were symptomatic intracranial hemorrhage, poor 3‐month functional outcome (modified Rankin scale 3–6) and mortality. We compared: (i) IVT >4.5–9 hours versus 0–4.5 hours after stroke onset and (ii) within the >4.5–9 hours group baseline advanced neuroimaging (computed tomography perfusion, magnetic resonance perfusion or magnetic resonance diffusion‐weighted imaging fluid‐attenuated inversion recovery) versus non‐advanced neuroimaging.ResultsOf 15,827 patients, 663 (4.2%) received IVT >4.5–9 hours and 15,164 (95.8%) within 4.5 hours after stroke onset. The main baseline characteristics were evenly distributed between both groups. Time of stroke onset was known in 74.9% of patients treated between >4.5 and 9 hours. Using propensity score weighted binary logistic regression analysis (onset‐to‐treatment time >4.5–9 hours vs onset‐to‐treatment time 0–4.5 hours), the probability of symptomatic intracranial hemorrhage (OR$_{adjusted}$ 0.80, 95% CI 0.53–1.17), poor functional outcome (OR$_{adjusted}$ 1.01, 95% CI 0.83–1.22), and mortality (OR$_{adjusted}$ 0.80, 95% CI 0.61–1.04) did not differ significantly between both groups. In patients treated between >4.5 and 9 hours, the use of advanced neuroimaging was associated with a 50% lower mortality compared with non‐advanced imaging only (9.9% vs 19.7%; OR$_{adjusted}$ 0.51, 95% CI 0.33–0.79).InterpretationThis study showed no evidence in difference of symptomatic intracranial hemorrhage, poor outcome, and mortality in selected stroke patients treated with IVT between >4.5 and 9 hours after stroke onset compared with those treated within 4.5 hours. Advanced neuroimaging for patient selection was associated with lower mo

Published
2023

12. New Cerebral Microbleeds After Catheter‐Based Structural Heart Interventions: An Exploratory Analysis

Author

Braemswig, Tim Bastian, primary, Kusserow, Madeleine, additional, Bellmann, Barbara, additional, Beckhoff, Frederik, additional, Reinthaler, Markus, additional, von Rennenberg, Regina, additional, Erdur, Hebun, additional, Scheitz, Jan F., additional, Galinovic, Ivana, additional, Villringer, Kersten, additional, Leistner, David M., additional, Audebert, Heinrich J., additional, Endres, Matthias, additional, Landmesser, Ulf, additional, Haeusler, Karl Georg, additional, Fiebach, Jochen B., additional, Lauten, Alexander, additional, Rillig, Andreas, additional, and Nolte, Christian H., additional

Published
2023
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13. Time-to-care metrics in patients with interhospital transfer for mechanical thrombectomy in north-east Germany: Primary telestroke centers in rural areas vs. primary stroke centers in a metropolitan area

Author

Riegler, Christoph, primary, Behrens, Janina R., additional, Gorski, Claudia, additional, Angermaier, Anselm, additional, Kinze, Stephan, additional, Ganeshan, Ramanan, additional, Rocco, Andrea, additional, Kunz, Alexander, additional, Müller, Tobias J., additional, Bitsch, Andreas, additional, Grüger, Albert, additional, Weber, Joachim E., additional, Siebert, Eberhard, additional, Bollweg, Kerstin, additional, von Rennenberg, Regina, additional, Audebert, Heinrich J., additional, Nolte, Christian H., additional, and Erdur, Hebun, additional

Published
2023
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14. Ontology-Based Semantic Annotation of Documents in the Context of Patient Identification for Clinical Trials

Author

Geibel, Peter, Trautwein, Martin, Erdur, Hebun, Zimmermann, Lothar, Krüger, Stefan, Schepers, Josef, Jegzentis, Kati, Müller, Frank, Nolte, Christian Hans, Becker, Anne, Frick, Markus, Setz, Jochen, Scheitz, Jan Friedrich, Tütüncü, Serdar, Usnich, Tatiana, Holzgreve, Alfred, Schaaf, Thorsten, Tolxdorff, Thomas, Hutchison, David, editor, Kanade, Takeo, editor, Kittler, Josef, editor, Kleinberg, Jon M., editor, Mattern, Friedemann, editor, Mitchell, John C., editor, Naor, Moni, editor, Nierstrasz, Oscar, editor, Pandu Rangan, C., editor, Steffen, Bernhard, editor, Sudan, Madhu, editor, Terzopoulos, Demetri, editor, Tygar, Doug, editor, Vardi, Moshe Y., editor, Weikum, Gerhard, editor, Meersman, Robert, editor, Panetto, Hervé, editor, Dillon, Tharam, editor, Eder, Johann, editor, Bellahsene, Zohra, editor, Ritter, Norbert, editor, De Leenheer, Pieter, editor, and Dou, Deijing, editor

Published
2013
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16. A Managed Care System with Telemedicine Support for Neurological Emergencies

Author

Erdur, Hebun, primary, Weber, Joachim E., additional, Angermaier, Anselm, additional, Kinze, Stephan, additional, Sotoodeh, Ali, additional, Gorski, Claudia, additional, Bollweg, Kerstin, additional, Ernst, Stefanie, additional, Kandil, Farid I., additional, Behrens, Janina, additional, Ganeshan, Ramanan, additional, Keysers, Anne, additional, Kotlarz‐Böttcher, Malgorzata, additional, Peters, Daniel, additional, Schlemm, Ludwig, additional, Stangenberg‐Gliss, Kirsten, additional, Witt, Carl, additional, Hennig, Beata, additional, Reber, Katrin C., additional, Schneider, Udo, additional, Franke, Christiana, additional, Schmehl, Ingo, additional, Straub, Hans‐Beatus, additional, Flöel, Agnes, additional, Theen, Sarah, additional, Endres, Matthias, additional, Kurth, Tobias, additional, and Audebert, Heinrich J., additional

Published
2022
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19. Intracerebral Hemorrhage and Outcome After Thrombolysis in Stroke Patients Using Selective Serotonin-Reuptake Inhibitors

Author

Scheitz, Jan F., Turc, Guillaume, Kujala, Linda, Polymeris, Alexandros A., Heldner, Mirjam R., Zonneveld, Thomas P., Erdur, Hebun, Curtze, Sami, Traenka, Christopher, Brenière, Céline, Wiest, Roland, Rocco, Andrea, Sibolt, Gerli, Gensicke, Henrik, Endres, Matthias, Martinez-Majander, Nicolas, Béjot, Yannick, Nederkoorn, Paul J., Oppenheim, Catherine, Arnold, Marcel, Engelter, Stefan T., Strbian, Daniel, and Nolte, Christian H.

Published
2017
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22. Cerebral embolisation during transcatheter edge-to-edge repair of the mitral valve with the MitraClip system: a prospective, observational study

Author

Braemswig, Tim Braemswig, primary, Kusserow, Madeleine Kusserow, additional, Kruppa, Jochen, additional, Reinthaler, Markus, additional, Erdur, Hebun, additional, Fritsch, Merve, additional, Curio, Jonathan, additional, Alushi, Brunilda, additional, Villringer, Kersten, additional, Galinovic, Ivana, additional, Berger, Christian, additional, Leistner, David Leistner, additional, Audebert, Heinrich Audebert, additional, Endres, Matthias, additional, Landmesser, Ulf, additional, Fiebach, Jochen Fiebach, additional, Nolte, Christian Nolte, additional, Beckhoff, Frederik, additional, and Lauten, Alexander, additional

Published
2022
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23. Intravenous Thrombolysis in Patients Dependent on the Daily Help of Others Before Stroke

Author

Gensicke, Henrik, Strbian, Daniel, Zinkstok, Sanne M., Scheitz, Jan F., Bill, Olivier, Hametner, Christian, Moulin, Solène, Zini, Andrea, Kägi, Georg, Pezzini, Alessandro, Padjen, Visnja, Béjot, Yannick, Corbiere, Sydney, Zonneveld, Thomas P., Seiffge, David J., Roos, Yvo B., Traenka, Christopher, Putaala, Jukka, Peters, Nils, Bonati, Leo H., Curtze, Sami, Erdur, Hebun, Sibolt, Gerli, Koch, Peter, Vandelli, Laura, Ringleb, Peter, Leys, Didier, Cordonnier, Charlotte, Michel, Patrik, Nolte, Christian H., Lyrer, Philippe A., Tatlisumak, Turgut, Nederkoorn, Paul J., and Engelter, Stefan T.

Published
2016
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24. A Managed Care System with Telemedicine Support for Neurological Emergencies.

Author

Erdur, Hebun, Weber, Joachim E., Angermaier, Anselm, Kinze, Stephan, Sotoodeh, Ali, Gorski, Claudia, Bollweg, Kerstin, Ernst, Stefanie, Kandil, Farid I., Behrens, Janina, Ganeshan, Ramanan, Keysers, Anne, Kotlarz‐Böttcher, Malgorzata, Peters, Daniel, Schlemm, Ludwig, Stangenberg‐Gliss, Kirsten, Witt, Carl, Hennig, Beata, Reber, Katrin C., and Schneider, Udo

Subjects
*NEUROLOGICAL emergencies, *MANAGED care programs, *NURSING home care, *TELEMEDICINE, *STROKE units
Abstract

Objectives: Telemedicine is frequently used to provide remote neurological expertise for acute stroke workup and was associated with better functional outcomes when combined with a stroke unit system‐of‐care. We investigated whether such system‐of‐care yields additional benefits when implemented on top of neurological competence already available onsite. Methods: Quality improvement measures were implemented within a "hub‐and‐spoke" teleneurology network in 11 hospitals already provided with onsite or telestroke expertise. Measures included dedicated units for neurological emergencies, standardization of procedures, multiprofessional training, and quality‐of‐care monitoring. Intervention effects were investigated in a controlled study enrolling patients insured at 3 participating statutory health insurances diagnosed with acute stroke or other neurological emergencies. Outcomes during the intervention period between November 2017 and February 2020 were compared with those pre‐intervention between October 2014 and March 2017. To control for temporal trends, we compared outcomes of patients with respective diagnoses in 11 hospitals of the same region. Primary outcome was the composite of up‐to‐90‐day death, new disability with the need of ambulatory or nursing home care, expressed by adjusted hazard ratio (aHR). Results: We included 1,418 patients post‐implementation (55% female, mean age 76.7 ± 12.8 year) and 2,306 patients pre‐implementation (56%, 75.8 ± 13.0 year, respectively). The primary outcome occurred in 479/1,418 (33.8%) patients post‐implementation and in 829/2,306 (35.9%) pre‐implementation. The aHR for the primary outcome was 0.89 (95% confidence interval [CI]: 0.79–0.99, p = 0.04) with no improvement seen in non‐participating hospitals between post‐ versus pre‐implementation periods (aHR 1.04; 95% CI: 0.95–1.15). Interpretation: Implementation of a multicomponent system‐of‐care was associated with a lower risk of poor outcomes. ANN NEUROL 2023;93:511–521 [ABSTRACT FROM AUTHOR]

Published
2023
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28. EndoVAscular treatment and ThRombolysis for Ischemic Stroke Patients (EVA-TRISP) registry: basis and methodology of a pan-European prospective ischaemic stroke revascularisation treatment registry

Author

Nordanstig, Annika, primary, Curtze, Sami, additional, Gensicke, Henrik, additional, Zinkstok, Sanne M, additional, Erdur, Hebun, additional, Karlsson, Camilla, additional, Karlsson, Jan-Erik, additional, Martinez-Majander, Nicolas, additional, Sibolt, Gerli, additional, Lyrer, Philippe, additional, Traenka, Christopher, additional, Baharoglu, Merih I, additional, Scheitz, Jan F, additional, Bricout, Nicolas, additional, Hénon, Hilde, additional, Leys, Didier, additional, Eskandari, Ashraf, additional, Michel, Patrik, additional, Hametner, Christian, additional, Ringleb, Peter Arthur, additional, Arnold, Marcel, additional, Fischer, Urs, additional, Sarikaya, Hakan, additional, Seiffge, David J, additional, Pezzini, Alessandro, additional, Zini, Andrea, additional, Padjen, Visnja, additional, Jovanovic, Dejana R, additional, Luft, Andreas, additional, Wegener, Susanne, additional, Kellert, Lars, additional, Feil, Katharina, additional, Kägi, Georg, additional, Rentzos, Alexandros, additional, Lappalainen, Kimmo, additional, Leker, Ronen R, additional, Cohen, Jose E, additional, Gomori, John, additional, Brehm, Alex, additional, Liman, Jan, additional, Psychogios, Marios, additional, Kastrup, Andreas, additional, Papanagiotou, Panagiotis, additional, Gralla, Jan, additional, Magoni, Mauro, additional, Majoie, Charles B L M, additional, Bohner, Georg, additional, Vukasinovic, Ivan, additional, Cvetic, Vladimir, additional, Weber, Johannes, additional, Kulcsar, Zsolt, additional, Bendszus, Martin, additional, Möhlenbruch, Markus, additional, Ntaios, George, additional, Kapsalaki, Eftychia, additional, Jood, Katarina, additional, Nolte, Christian H, additional, Nederkoorn, Paul J J, additional, Engelter, Stefan, additional, Strbian, Daniel, additional, and Tatlisumak, Turgut, additional

Published
2021
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32. Aspirin versus anticoagulation in cervical artery dissection (TREAT-CAD): an open-label, randomised, non-inferiority trial

Author

Engelter, Stefan T, primary, Traenka, Christopher, additional, Gensicke, Henrik, additional, Schaedelin, Sabine A, additional, Luft, Andreas R, additional, Simonetti, Barbara Goeggel, additional, Fischer, Urs, additional, Michel, Patrik, additional, Sirimarco, Gaia, additional, Kägi, Georg, additional, Vehoff, Jochen, additional, Nedeltchev, Krassen, additional, Kahles, Timo, additional, Kellert, Lars, additional, Rosenbaum, Sverre, additional, von Rennenberg, Regina, additional, Sztajzel, Roman, additional, Leib, Stephen L, additional, Jung, Simon, additional, Gralla, Jan, additional, Bruni, Nicole, additional, Seiffge, David, additional, Feil, Katharina, additional, Polymeris, Alexandros A, additional, Steiner, Levke, additional, Hamann, Janne, additional, Bonati, Leo H, additional, Brehm, Alex, additional, De Marchis, Gian Marco, additional, Peters, Nils, additional, Stippich, Christoph, additional, Nolte, Christian H, additional, Christensen, Hanne, additional, Wegener, Susanne, additional, Psychogios, Marios-Nikos, additional, Arnold, Marcel, additional, Lyrer, Philippe, additional, Altersberger, Valerian, additional, Engelter, Stefan T, additional, Fabbro, Thomas, additional, Fisch, Urs, additional, Fladt, Joachim, additional, Hert, Lisa, additional, Lyrer, Philippe A, additional, Maurer, Marina, additional, Polymeris, Alexandros, additional, Schaedelin, Sabine, additional, Thilemann, Sebastian, additional, Wagner, Benjamin, additional, Goeggel Simonetti, Barbara, additional, Heldner, Mirjam, additional, Seiffge, David J, additional, Mueller, Hubertus, additional, Sveikata, Lukas, additional, Correia, Pamela, additional, Eskandari, Ashraf, additional, Meyer, Ivo, additional, Nannoni, Stefania, additional, Remillard, Suzette, additional, Zachariadis, Alexandros, additional, Kaegi, Georg, additional, Mueller, Anna, additional, Erdur, Hebun J, additional, and Scheitz, Jan F, additional

Published
2021
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33. Association of prestroke metformin use, stroke severity, and thrombolysis outcome

Author

Westphal, Laura P, Widmer, Roni, Held, Ulrike, Steigmiller, Klaus, Hametner, Christian; https://orcid.org/0000-0002-9955-5430, Ringleb, Peter, Curtze, Sami, Martinez-Majander, Nicolas, Tiainen, Marjaana, Nolte, Christian H, Scheitz, Jan F, Erdur, Hebun, Polymeris, Alexandros A, Traenka, Christopher, Eskandari, Ashraf, Michel, Patrik, Heldner, Mirjam R; https://orcid.org/0000-0002-3594-2159, Arnold, Marcel, Zini, Andrea; https://orcid.org/0000-0003-1486-4507, Vandelli, Laura, Coutinho, Jonathan M, Groot, Adrien E, Padjen, Visnja, Jovanovic, Dejana R, Bejot, Yannick, Brenière, Céline, Turc, Guillaume, Seners, Pierre, Pezzini, Alessandro, Magoni, Mauro, Gensicke, Henrik, Nederkoorn, Paul, Luft, Andreas Rüdiger; https://orcid.org/0000-0001-9865-7382, Leys, Didier, Tatlisumak, Turgut, Kägi, Georg, Scherrer, Michael J, Gilliot, Sixtine, Engelter, Stefan T, Wegener, Susanne, Westphal, Laura P, Widmer, Roni, Held, Ulrike, Steigmiller, Klaus, Hametner, Christian; https://orcid.org/0000-0002-9955-5430, Ringleb, Peter, Curtze, Sami, Martinez-Majander, Nicolas, Tiainen, Marjaana, Nolte, Christian H, Scheitz, Jan F, Erdur, Hebun, Polymeris, Alexandros A, Traenka, Christopher, Eskandari, Ashraf, Michel, Patrik, Heldner, Mirjam R; https://orcid.org/0000-0002-3594-2159, Arnold, Marcel, Zini, Andrea; https://orcid.org/0000-0003-1486-4507, Vandelli, Laura, Coutinho, Jonathan M, Groot, Adrien E, Padjen, Visnja, Jovanovic, Dejana R, Bejot, Yannick, Brenière, Céline, Turc, Guillaume, Seners, Pierre, Pezzini, Alessandro, Magoni, Mauro, Gensicke, Henrik, Nederkoorn, Paul, Luft, Andreas Rüdiger; https://orcid.org/0000-0001-9865-7382, Leys, Didier, Tatlisumak, Turgut, Kägi, Georg, Scherrer, Michael J, Gilliot, Sixtine, Engelter, Stefan T, and Wegener, Susanne

Abstract

OBJECTIVE To evaluate whether pretreatment with metformin (MET) is associated with less stroke severity and better outcome after IV thrombolysis (IVT), we analyzed a cohort of 1,919 patients with stroke with type 2 diabetes mellitus in a multicenter exploratory analysis. METHODS Data from patients with diabetes and ischemic stroke treated with IVT were collected within the European Thrombolysis in Ischemic Stroke Patients (TRISP) collaboration. We applied propensity score matching (PSM) to obtain balanced baseline characteristics of patients treated with and without MET. RESULTS Of 1,919 patients with stroke with type 2 diabetes who underwent IVT, 757 (39%) had received MET before stroke (MET+), whereas 1,162 (61%) had not (MET-). MET+ patients were younger with a male preponderance. Hypercholesterolemia and pretreatment with statins, antiplatelets, or antihypertensives were more common in the MET+ group. After PSM, the 2 groups were well balanced with respect to demographic and clinical aspects. Stroke severity on admission (NIH Stroke Scale 10.0 ± 6.7 vs 11.3 ± 6.5), 3-month degree of independence on modified Rankin Scale (2 [interquartile range (IQR) 1.0-4.0] vs 3 [IQR 1.0-4.0]), as well as mortality (12.5% vs 18%) were significantly lower in the MET+ group. The frequency of symptomatic intracerebral hemorrhages did not differ between groups. HbA1c levels were well-balanced between the groups. CONCLUSIONS Patients with stroke and diabetes on treatment with MET receiving IVT had less severe strokes on admission and a better functional outcome at 3 months. This suggests a protective effect of MET resulting in less severe strokes as well as beneficial thrombolysis outcome.

Published
2020

34. Ontology-Based Semantic Annotation of Documents in the Context of Patient Identification for Clinical Trials

Author

Geibel, Peter, primary, Trautwein, Martin, additional, Erdur, Hebun, additional, Zimmermann, Lothar, additional, Krüger, Stefan, additional, Schepers, Josef, additional, Jegzentis, Kati, additional, Müller, Frank, additional, Nolte, Christian Hans, additional, Becker, Anne, additional, Frick, Markus, additional, Setz, Jochen, additional, Scheitz, Jan Friedrich, additional, Tütüncü, Serdar, additional, Usnich, Tatiana, additional, Holzgreve, Alfred, additional, Schaaf, Thorsten, additional, and Tolxdorff, Thomas, additional

Published
2013
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35. Stroke Admissions, Stroke Severity, and Treatment Rates in Urban and Rural Areas During the COVID-19 Pandemic

Author

Erdur, Hebun, primary, Siegerink, Bob, additional, Leithner, Christoph, additional, Franke, Christiana, additional, Lorenz-Meyer, Irina, additional, Theen, Sarah, additional, Angermaier, Anselm, additional, Kinze, Stephan, additional, Weber, Joachim E., additional, Rohmann, Jessica L., additional, Scheitz, Jan F., additional, Nolte, Christian H., additional, Endres, Matthias, additional, and Audebert, Heinrich J., additional

Published
2021
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36. Intravenous Thrombolysis in Patients With Ischemic Stroke Aged ≥90 Years: A Cohort Study From the TRISP Collaboration

Author

Altersberger, Valerian L., Rusche, Norman, Martinez-Majander, Nicolas, Hametner, Christian, Scheitz, Jan F., Henon, Hilde, Dell’Acqua, Maria Luisa, Strambo, Davide, Stolp, Jeffrey, Heldner, Mirjam R., Grisendi, Ilaria, Jovanovic, Dejana R., Bejot, Yannick, Pezzini, Alessandro, Leker, Ronen R., Kägi, Georg, Wegener, Susanne, Cereda, Carlo W., Lindgren, Erik, Ntaios, George, Piot, Ines, Polymeris, Alexandros A., Lyrer, Philippe A., Räty, Silja, Sibolt, Gerli, Tiainen, Marjaana, Heyse, Miriam, Erdur, Hebun, Kaaouana, Olfa, Padjen, Visnja, Zedde, Marialuisa, Arnold, Marcel, Nederkoorn, Paul J., Michel, Patrik, Bigliardi, Guido, Zini, Andrea, Cordonnier, Charlotte, Nolte, Christian H., Ringleb, Peter A., Curtze, Sami, Engelter, Stefan T., and Gensicke, Henrik

Published
2022
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37. Intravenous thrombolysis for suspected ischemic stroke with seizure at onset

Author

Polymeris, Alexandros A, Curtze, Sami, Erdur, Hebun, Hametner, Christian, Heldner, Mirjam R, Groot, Adrien E, Zini, Andrea, Béjot, Yannick, Dietrich, Annina, Martinez-Majander, Nicolas, von Rennenberg, Regina, Gumbinger, Christoph, Schaedelin, Sabine, De Marchis, Gian Marco, Thilemann, Sebastian, Traenka, Christopher, Lyrer, Philippe A, Bonati, Leo H, Wegener, Susanne, Ringleb, Peter A, Tatlisumak, Turgut, Nolte, Christian H, Scheitz, Jan F, Arnold, Marcel, Strbian, Daniel, Nederkoorn, Paul J, Gensicke, Henrik, Engelter, Stefan T, TRISP Collaborators, University of Zurich, and Polymeris, Alexandros A

Subjects
2728 Neurology (clinical), 2808 Neurology, 610 Medicine & health, 10040 Clinic for Neurology
Published
2019
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38. Association Between Dispatch of Mobile Stroke Units and Functional Outcomes Among Patients With Acute Ischemic Stroke in Berlin.

Author

Ebinger, Martin, Siegerink, Bob, Kunz, Alexander, Wendt, Matthias, Weber, Joachim E., Schwabauer, Eugen, Geisler, Frederik, Freitag, Erik, Lange, Julia, Behrens, Janina, Erdur, Hebun, Ganeshan, Ramanan, Liman, Thomas, Scheitz, Jan F., Schlemm, Ludwig, Harmel, Peter, Zieschang, Katja, Lorenz-Meyer, Irina, Napierkowski, Ira, and Waldschmidt, Carolin

Abstract

Importance: Effects of thrombolysis in acute ischemic stroke are time-dependent. Ambulances that can administer thrombolysis (mobile stroke units [MSUs]) before arriving at the hospital have been shown to reduce time to treatment.Objective: To determine whether dispatch of MSUs is associated with better clinical outcomes for patients with acute ischemic stroke.Design, Setting, and Participants: This prospective, nonrandomized, controlled intervention study was conducted in Berlin, Germany, from February 1, 2017, to October 30, 2019. If an emergency call prompted suspicion of stroke, both a conventional ambulance and an MSU, when available, were dispatched. Functional outcomes of patients with final diagnosis of acute cerebral ischemia who were eligible for thrombolysis or thrombectomy were compared based on the initial dispatch (both MSU and conventional ambulance or conventional ambulance only).Exposure: Simultaneous dispatch of an MSU (computed tomographic scanning with or without angiography, point-of-care laboratory testing, and thrombolysis capabilities on board) and a conventional ambulance (n = 749) vs conventional ambulance alone (n = 794).Main Outcomes and Measures: The primary outcome was the distribution of modified Rankin Scale (mRS) scores (a disability score ranging from 0, no neurological deficits, to 6, death) at 3 months. The coprimary outcome was a 3-tier disability scale at 3 months (none to moderate disability; severe disability; death) with tier assignment based on mRS scores if available or place of residence if mRS scores were not available. Common odds ratios (ORs) were used to quantify the association between exposure and outcome; values less than 1.00 indicated a favorable shift in the mRS distribution and lower odds of higher levels of disability.Results: Of the 1543 patients (mean age, 74 years; 723 women [47%]) included in the adjusted primary analysis, 1337 (87%) had available mRS scores (primary outcome) and 1506 patients (98%) had available the 3-tier disability scale assessment (coprimary outcome). Patients with an MSU dispatched had lower median mRS scores at month 3 (1; interquartile range [IQR], 0-3) than did patients without an MSU dispatched (2; IQR, 0-3; common OR for worse mRS, 0.71; 95% CI, 0.58-0.86; P < .001). Similarly, patients with an MSU dispatched had lower 3-month coprimary disability scores: 586 patients (80.3%) had none to moderate disability; 92 (12.6%) had severe disability; and 52 (7.1%) had died vs patients without an MSU dispatched: 605 (78.0%) had none to moderate disability; 103 (13.3%) had severe disability; and 68 (8.8%) had died (common OR for worse functional outcome, 0.73, 95% CI, 0.54-0.99; P = .04).Conclusions and Relevance: In this prospective, nonrandomized, controlled intervention study of patients with acute ischemic stroke in Berlin, Germany, the dispatch of mobile stroke units, compared with conventional ambulances alone, was significantly associated with lower global disability at 3 months. Clinical trials in other regions are warranted. [ABSTRACT FROM AUTHOR]

Published
2021
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39. A Score for Risk of Thrombolysis-Associated Hemorrhage Including Pretreatment with Statins

Author

Erdur, Hebun, Polymeris, Alexandros, Grittner, Ulrike, Scheitz, Jan F., Tütüncü, Serdar, Seiffge, David J., Audebert, Heinrich J., Nolte, Christian H., Engelter, Stefan T., and Rocco, Andrea

Subjects
thrombolysis, Neurology, ischemic stroke, stroke outcome, Neurology (clinical), hemorrhage, predictive models, 600 Technik, Medizin, angewandte Wissenschaften::610 Medizin und Gesundheit::610 Medizin und Gesundheit, Neuroscience, Original Research
Abstract

Background: Symptomatic intracranial hemorrhage (sICH) after intravenous thrombolysis with recombinant tissue-plasminogen activator (rt-PA) for acute ischemic stroke is associated with a poor functional outcome. We aimed to develop a score assessing risk of sICH including novel putative predictors—namely, pretreatment with statins and severe renal impairment. Methods: We analyzed our local cohort (Berlin) of patients receiving rt-PA for acute ischemic stroke between 2006 and 2016. Outcome was sICH according to ECASS-III criteria. A multiple regression model identified variables associated with sICH and receiver operating characteristics were calculated for the best discriminatory model for sICH. The model was validated in an independent thrombolysis cohort (Basel). Results: sICH occurred in 53 (4.0%) of 1,336 patients in the derivation cohort. Age, baseline National Institutes of Health Stroke Scale, systolic blood pressure on admission, blood glucose on admission, and prior medication with medium- or high-dose statins were associated with sICH and included into the risk of intracranial hemorrhage score. The validation cohort included 983 patients of whom 33 (3.4%) had a sICH. c-Statistics for sICH was 0.72 (95% CI 0.66–0.79) in the derivation cohort and 0.69 (95% CI 0.60–0.77) in the independent validation cohort. Inclusion of severe renal impairment did not improve the score. Conclusion: We developed a simple score with fair discriminating capability to predict rt-PA- related sICH by adding prior statin use to known prognostic factors of sICH. This score may help clinicians to identify patients with higher risk of sICH requiring intensive monitoring.

Published
2017

40. Intracerebral Hemorrhage and Outcome After Thrombolysis in Stroke Patients Using Selective Serotonin-Reuptake Inhibitors

Author

Scheitz, Jan F, Turc, Guillaume, Wiest, Roland, Rocco, Andrea, Sibolt, Gerli, Gensicke, Henrik, Endres, Matthias, Martinez-Majander, Nicolas, Béjot, Yannick, Nederkoorn, Paul J, Oppenheim, Catherine, Arnold, Marcel, Kujala, Linda, Engelter, Stefan T, Strbian, Daniel, Nolte, Christian H, TRISP Collaboration, Polymeris, Alexandros A, Heldner, Mirjam R, Zonneveld, Thomas P, Erdur, Hebun, Curtze, Sami, Traenka, Christopher, and Brenière, Céline

Subjects
Male, medicine.medical_specialty, therapeutic use [Anticoagulants], medicine.medical_treatment, Subgroup analysis, epidemiology [Cerebral Hemorrhage], Risk Assessment, Cohort Studies, 03 medical and health sciences, adverse effects [Serotonin Uptake Inhibitors], 0302 clinical medicine, Modified Rankin Scale, Internal medicine, medicine, Humans, Thrombolytic Therapy, 030212 general & internal medicine, ddc:610, 610 Medicine & health, Stroke, Cerebral Hemorrhage, Aged, Retrospective Studies, Advanced and Specialized Nursing, Intracerebral hemorrhage, Aged, 80 and over, therapy [Cerebral Hemorrhage], business.industry, Anticoagulants, Thrombolysis, Odds ratio, Middle Aged, medicine.disease, adverse effects [Selective Serotonin Reuptake Inhibitors], Prognosis, drug therapy [Stroke], Treatment Outcome, Anesthesia, Concomitant, Serotonin Uptake Inhibitors, Female, Neurology (clinical), Cardiology and Cardiovascular Medicine, business, 030217 neurology & neurosurgery, Selective Serotonin Reuptake Inhibitors, epidemiology [Stroke], Cohort study
Abstract

Background and Purpose— Selective serotonin-reuptake inhibitors (SSRIs) impair platelet function and have been linked to a higher risk of spontaneous intracerebral hemorrhage—an association that may be augmented by oral anticoagulants (OAC). We aimed to assess whether preadmission treatment with SSRIs in patients with acute ischemic stroke is associated with post-thrombolysis symptomatic intracerebral hemorrhage (sICH) and functional outcome. Methods— A multicenter retrospective analysis was conducted in prospective registries of patients treated by thrombolysis within 4.5 hours of stroke onset. The association between preadmission treatment with SSRIs and sICH (ECASS II definition [European Cooperative Acute Stroke Study]) or unfavorable 3-month outcome (modified Rankin Scale >2) was assessed by logistic regression, taking into account potential interaction with concomitant use of antithrombotics. Results— Six thousand two hundred forty-two patients were included (mean age, 70.1±14.0 years; median National Institutes of Health Stroke Scale, 9 [5–16]). Preadmission treatment with SSRIs was present in 4.3% (n=266) of patients. Overall, SICH rate was 3.9% (95% confidence interval [CI], 3.5%–4.4%; n=244), and SSRI use was not significantly associated with sICH in unadjusted (odds ratio [OR], 1.28; 95% CI, 0.72–2.27) or adjusted (OR, 1.30; 95% CI, 0.71–2.40) analysis. However, there was a significant interaction of concomitant use of OACs (international normalized ratio P =0.01). SICH was significantly more frequent in patients taking both OAC and SSRI (23.1%; 95% CI, 8.2%–50.3%) than in patients taking OAC but not SSRI (adjusted OR, 9.04; 95% CI, 1.95–41.89). Preadmission use of SSRI was associated with unfavorable 3-month outcome (unadjusted OR, 1.90; 95% CI, 1.48–2.46; adjusted OR, 1.59; 95% CI, 1.15–2.19). Conclusions— Preadmission treatment with SSRIs was not significantly associated with an increased risk of post-thrombolysis sICH in this cohort study. However, subgroup analysis suggested an increased risk of sICH in patients taking both SSRI and OAC. Preadmission treatment with SSRIs was associated with unfavorable outcome, which may reflect the prognostic significance of prestroke depression.

Published
2017
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46. Non-office-hours admission affects intravenous thrombolysis treatment times and clinical outcome

Author

Zonneveld, Thomas P, primary, Curtze, Sami, additional, Zinkstok, Sanne M, additional, Gensicke, Henrik, additional, Moulin, Solène, additional, Scheitz, Jan F, additional, Seiffge, David J, additional, Hametner, Christian, additional, Heldner, Mirjam R, additional, Traenka, Christopher, additional, Erdur, Hebun, additional, Baharoglu, Irem, additional, Martinez-Majander, Nicolas, additional, Pezzini, Alessandro, additional, Zini, Andrea, additional, Padjen, Visnja, additional, Correia, Pamela N, additional, Strbian, Daniel, additional, Michel, Patrik, additional, Béjot, Yannick, additional, Arnold, Marcel, additional, Leys, Didier, additional, Ringleb, Peter Arthur, additional, Tatlisumak, Turgut, additional, Nolte, Christian H, additional, Engelter, Stefan T, additional, and Nederkoorn, Paul J, additional

Published
2017
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47. Microbleeds, Cerebral Hemorrhage, and Functional Outcome After Stroke Thrombolysis

Author

Charidimou, Andreas, primary, Turc, Guillaume, additional, Oppenheim, Catherine, additional, Yan, Shenqiang, additional, Scheitz, Jan F., additional, Erdur, Hebun, additional, Klinger-Gratz, Pascal P., additional, El-Koussy, Marwan, additional, Takahashi, Wakoh, additional, Moriya, Yusuke, additional, Wilson, Duncan, additional, Kidwell, Chelsea S., additional, Saver, Jeffrey L., additional, Sallem, Asma, additional, Moulin, Solene, additional, Edjlali-Goujon, Myriam, additional, Thijs, Vincent, additional, Fox, Zoe, additional, Shoamanesh, Ashkan, additional, Albers, Gregory W., additional, Mattle, Heinrich P., additional, Benavente, Oscar R., additional, Jäger, H. Rolf, additional, Ambler, Gareth, additional, Aoki, Junya, additional, Baron, Jean-Claude, additional, Kimura, Kazumi, additional, Kakuda, Wataru, additional, Takizawa, Shunya, additional, Jung, Simon, additional, Nolte, Christian H., additional, Lou, Min, additional, Cordonnier, Charlotte, additional, and Werring, David J., additional

Published
2017
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48. Effects of Ultraearly Intravenous Thrombolysis on Outcomes in Ischemic Stroke

Author

Kunz, Alexander, primary, Nolte, Christian H., additional, Erdur, Hebun, additional, Fiebach, Jochen B., additional, Geisler, Frederik, additional, Rozanski, Michal, additional, Scheitz, Jan F., additional, Villringer, Kersten, additional, Waldschmidt, Carolin, additional, Weber, Joachim E., additional, Wendt, Matthias, additional, Winter, Benjamin, additional, Zieschang, Katja, additional, Grittner, Ulrike, additional, Kaczmarek, Sabina, additional, Endres, Matthias, additional, Ebinger, Martin, additional, and Audebert, Heinrich J., additional

Published
2017
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49. Die Herzfrequenz als prognostischer Faktor für Mortalität im Krankenhaus bei Patienten mit akutem ischämischem Schlaganfall

Author

Erdur, Hebun

Subjects
sympathetic nervous system, heart rate, outcome, 600 Technik, Medizin, angewandte Wissenschaften::610 Medizin und Gesundheit, mortality, stroke
Abstract

Hintergrund: Eine höhere Herzfrequenz ist bei Patienten mit vaskulären Erkrankungen im längerfristigen Verlauf ein prognostisch ungünstiger Faktor und insbesondere mit Mortalität assoziiert. Wir untersuchten, ob die Herzfrequenz bei Aufnahme bei Patienten mit akutem ischämischem Schlaganfall auch mit frühem Tod im Krankenhaus assoziiert ist. Methoden: Über einen Zeitraum von 30 Monaten wurden alle Patienten mit akutem ischämischem Schlaganfall, die auf unserer Stroke Unit behandelt wurden, prospektiv eingeschlossen. Patienten mit Vorhofflimmern bei Aufnahme wurden nicht in die Studie aufgenommen. Wir führten univariate und multiple logistische Regressionsanalysen durch, um einen möglichen Zusammenhang von Herzfrequenz bei Aufnahme mit Mortalität im Krankenhaus zu untersuchen. Die Herzfrequenz wurde dabei sowohl als kontinuierliche als auch als kategorielle Variable (Tertile) modelliert. Ergebnisse: Insgesamt wurden 1335 Patienten in die Studie eingeschlossen (medianes Alter 73 (Interquartilsbereich, IQB 65–81), medianer National Institutes of Health Stroke Scale Punktwert 4 (IQB 2–8), mediane Dauer des Krankenhausaufenthalts 5 Tage (IQB 4–7), weibliches Geschlecht 46%). Die Mortalität während des Krankenhausaufenthalts betrug 2,6%. Im Modell mit der Herzfrequenz als kategorieller Variable war eine Herzfrequenz ≥ 83/min im Vergleich zum Referenztertil (Herzfrequenz ≤ 69/min) unabhängig mit Mortalität im Krankenhaus assoziiert, wobei das Modell für prognostisch ungünstige Faktoren adjustiert war (adjustierte Odds Ratio 4,42, 95%-Konfidenzintervall 1,36–14,42, p=0,01). Im adjustierten Modell mit der Herzfrequenz als kontinuierlicher Variable war das relative Risiko, im Krankenhaus zu versterben, um 40% für jede Steigerung der Herzfrequenz um 10/min erhöht (p = 0,003). Dieser Zusammenhang blieb auch nach Berücksichtigung der Einnahme von Beta-Blockern im multiplen Modell unverändert bestehen. Schlussfolgerung: Bei Patienten mit akutem ischämischem Schlaganfall ist eine höhere Herzfrequenz bei Aufnahme auch nach Berücksichtigung anderer prognostisch ungünstiger Faktoren unabhängig mit einem höheren Risiko, im Krankenhaus zu versterben, assoziiert. Eine höhere Herzfrequenz könnte frühe ungünstige Folgen eines autonomen Ungleichgewichts anzeigen. Die Senkung einer höheren Herzfrequenz könnte ein therapeutisches Ziel bei akutem ischämischem Schlaganfall sein., Background: A higher heart rate is associated with worse outcomes – in particular death – in long term follow-up of patients with vascular diseases. We investigated whether heart rate measured on admission is associated with early in-hospital mortality in acute ischemic stroke patients. Methods: We prospectively enrolled all patients admitted to our hospital with acute ischemic stroke but without atrial fibrillation over a period of 30 months. We conducted univariate and multiple logistic regression analyses to estimate the impact of heart rate on in-hospital mortality. We analysed heart rate as continuous and categorical variable. Results: A total of 1335 patients (median age 73 (IQR 65–81), median National Institutes of Health Stroke Scale score 4 (IQR 2–8), median length of stay 5 days (IQR 4–7), female sex 46%) were studied. In-hospital mortality was 2.6%. When analyzed as categorical variable, heart rate ≥83 bpm was independently associated with in-hospital mortality after adjustment for predictors of poor outcome compared to the reference tertile (heart rate ≤69 bpm) (adjusted odds ratio 4.42, 95% CI 1.36–14.42, p= 0.01). When heart rate was modelled as continuous variable, relative risk for in-hospital death was elevated by 40% for every additional 10-bpm (p = 0.003). Including beta-blockers as covariate into the multiple regression model did not change the main results. Conclusions: Heart rate on admission is independently associated with in-hospital mortality in acute ischemic stroke patients suggesting early negative effects of autonomic imbalance. Heart rate may represent a therapeutic target to improve outcome after ischemic stroke.

Published
2015
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50. Intravenous thrombolysis for suspected ischemic stroke with seizure at onset.

Author

Polymeris, Alexandros A., Curtze, Sami, Erdur, Hebun, Hametner, Christian, Heldner, Mirjam R., Groot, Adrien E., Zini, Andrea, Béjot, Yannick, Dietrich, Annina, Martinez‐Majander, Nicolas, von Rennenberg, Regina, Gumbinger, Christoph, Schaedelin, Sabine, De Marchis, Gian Marco, Thilemann, Sebastian, Traenka, Christopher, Lyrer, Philippe A., Bonati, Leo H., Wegener, Susanne, and Ringleb, Peter A.

Subjects
SEIZURES (Medicine), STROKE, THROMBOLYTIC therapy, LOGISTIC regression analysis, ODDS ratio, STROKE-related mortality, RESEARCH, RESEARCH methodology, PROGNOSIS, EVALUATION research, MEDICAL cooperation, TREATMENT effectiveness, COMPARATIVE studies, CEREBRAL ischemia, DISEASE complications
Abstract

Objective: Seizure at onset (SaO) has been considered a relative contraindication for intravenous thrombolysis (IVT) in patients with acute ischemic stroke, although this appraisal is not evidence based. Here, we investigated the prognostic significance of SaO in patients treated with IVT for suspected ischemic stroke.Methods: In this multicenter, IVT-registry-based study we assessed the association between SaO and symptomatic intracranial hemorrhage (sICH, European Cooperative Acute Stroke Study II definition), 3-month mortality, and 3-month functional outcome on the modified Rankin Scale (mRS) using unadjusted and adjusted logistic regression, coarsened exact matching, and inverse probability weighted analyses.Results: Among 10,074 IVT-treated patients, 146 (1.5%) had SaO. SaO patients had significantly higher National Institutes of Health Stroke Scale score and glucose on admission, and more often female sex, prior stroke, and prior functional dependence than non-SaO patients. In unadjusted analysis, they had generally less favorable outcomes. After controlling for confounders in adjusted, matched, and weighted analyses, all associations between SaO and any of the outcomes disappeared, including sICH (odds ratio [OR]unadjusted = 1.53 [95% confidence interval (CI) = 0.74-3.14], ORadjusted = 0.52 [95% CI = 0.13-2.16], ORmatched = 0.68 [95% CI = 0.15-3.03], ORweighted = 0.95 [95% CI = 0.39-2.32]), mortality (ORunadjusted = 1.49 [95% CI = 1.00-2.24], ORadjusted = 0.98 [95% CI = 0.5-1.92], ORmatched = 1.13 [95% CI = 0.55-2.33], ORweighted = 1.17 [95% CI = 0.73-1.88]), and functional outcome (mRS ≥ 3/ordinal mRS: ORunadjusted = 1.33 [95% CI = 0.96-1.84]/1.35 [95% CI = 1.01-1.81], ORadjusted = 0.78 [95% CI = 0.45-1.32]/0.78 [95% CI = 0.52-1.16], ORmatched = 0.75 [95% CI = 0.43-1.32]/0.45 [95% CI = 0.10-2.06], ORweighted = 0.87 [95% CI = 0.57-1.34]/1.00 [95% CI = 0.66-1.52]). These results were consistent regardless of whether patients had an eventual diagnosis of ischemic stroke (89/146) or stroke mimic (57/146 SaO patients).Interpretation: SaO was not an independent predictor of poor prognosis. Withholding IVT from patients with assumed ischemic stroke presenting with SaO seems unjustified. ANN NEUROL 2019;86:770-779. [ABSTRACT FROM AUTHOR]

Published
2019
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