https://nova.newcastle.edu.au/vital/access/ /manager/Index en-au 5 https://nova.newcastle.edu.au/vital/access/ /manager/Repository/uon:34583 Wed 23 Feb 2022 16:04:47 AEDT ]]> https://nova.newcastle.edu.au/vital/access/ /manager/Repository/uon:14864 Wed 11 Apr 2018 10:29:15 AEST ]]> https://nova.newcastle.edu.au/vital/access/ /manager/Repository/uon:25880 Wed 10 Nov 2021 15:05:31 AEDT ]]> https://nova.newcastle.edu.au/vital/access/ /manager/Repository/uon:24519 Wed 09 Mar 2022 16:03:44 AEDT ]]> https://nova.newcastle.edu.au/vital/access/ /manager/Repository/uon:42433 Tue 23 Aug 2022 09:58:38 AEST ]]> https://nova.newcastle.edu.au/vital/access/ /manager/Repository/uon:49887 Tue 13 Jun 2023 13:43:34 AEST ]]> https://nova.newcastle.edu.au/vital/access/ /manager/Repository/uon:27846 90, 60-90, and <60 mL/min/1.73 m², respectively). Outcomes: The effect of admission eGFR on the primary outcome of death or major disability at 90 days (defined as modified Rankin Scale scores of 3-6) was analyzed using a multivariable logistic regression model. Potential effect modification of intensive BP lowering treatment by admission eGFR was assessed by interaction terms. Results: Of 2,623 included participants, 912 (35%) and 280 (11%) had mildly and moderately/severely decreased eGFRs, respectively. Patients with moderately/severely decreased eGFRs had the greatest risk for death or major disability at 90 days (adjusted OR, 1.82; 95% CI, 1.28-2.61). Effects of early intensive BP lowering were consistent across different eGFRs (P = 0.5 for homogeneity). Limitations: Generalizability issues arising from a clinical trial population. Conclusions: Decreased eGFR predicts poor outcome in acute ICH. Early intensive BP lowering provides similar treatment effects in patients with ICH with decreased eGFRs.]]> Thu 09 Dec 2021 11:03:39 AEDT ]]> https://nova.newcastle.edu.au/vital/access/ /manager/Repository/uon:10744 Sat 24 Mar 2018 08:08:21 AEDT ]]> https://nova.newcastle.edu.au/vital/access/ /manager/Repository/uon:10748 Sat 24 Mar 2018 08:08:19 AEDT ]]> https://nova.newcastle.edu.au/vital/access/ /manager/Repository/uon:10907 Sat 24 Mar 2018 08:07:41 AEDT ]]> https://nova.newcastle.edu.au/vital/access/ /manager/Repository/uon:27092 Sat 24 Mar 2018 07:40:35 AEDT ]]> https://nova.newcastle.edu.au/vital/access/ /manager/Repository/uon:4851 Sat 24 Mar 2018 07:18:46 AEDT ]]> https://nova.newcastle.edu.au/vital/access/ /manager/Repository/uon:22862 Sat 24 Mar 2018 07:16:01 AEDT ]]> https://nova.newcastle.edu.au/vital/access/ /manager/Repository/uon:46667 International Statistical Classification of Diseases and Related Health Problems (Tenth Edition, Australian Modification) codes from the hospital admissions and emergency presentation data. The outcome variable and other system factors were derived from the Australian Stroke Clinical Registry dataset. Multivariable, multilevel logistic regression was used to examine factors associated with the prescription of antihypertensive medications at hospital discharge. Results: Of the 10 315 patients included, 79.0% (intracerebral hemorrhage, 74.1%; acute ischemic stroke, 79.8%) were prescribed antihypertensive medications at discharge. Prescription varied between hospital sites, with 6 sites >2 SDs below the national average for provision of antihypertensives at discharge. Prescription was also independently associated with patient and clinical factors including history of hypertension, diabetes mellitus, management in an acute stroke unit, and discharge to rehabilitation. In patients with acute ischemic stroke, females (odds ratio, 0.85; 95% CI, 0.76-0.94), those who had greater stroke severity (odds ratio, 0.81; 95% CI 0.72-0.92), or dementia (odds ratio, 0.65; 95% CI, 0.52-0.81) were less likely to be prescribed. Conclusions: Prescription of antihypertensive medications poststroke varies between hospitals and according to patient factors including age, sex, stroke severity, and comorbidity profile. Implementation of targeted quality improvement initiatives at local hospitals may help to reduce the variation in prescription observed.]]> Mon 28 Nov 2022 18:46:24 AEDT ]]> https://nova.newcastle.edu.au/vital/access/ /manager/Repository/uon:46642 p < 0.0001). There was no heterogeneity of the effects of BP lowering (intensive vs. guideline) on functional recovery between standard-dose (OR 0.81, 95% CI 0.59-1.12) and low-dose alteplase (1.06, 0.77-1.47; p = 0.25 for interaction). Similar results were observed for ICH (p = 0.50 for interaction). Conclusions: In thrombolysis-treated patients with predominantly mild-to-moderate severity AIS, intensive BP lowering neither improve functional recovery, either with low-or standard-dose intravenous alteplase, nor beneficially interact with low-dose alteplase in reducing ICH. Trial Registration: The trial is registered with ClinicalTrials.gov (NCT01422616).]]> Mon 28 Nov 2022 16:54:24 AEDT ]]> https://nova.newcastle.edu.au/vital/access/ /manager/Repository/uon:46624 unadjusted 1 year, -0.147; 95% CI, -0.258 to -0.036; 5 years, -0.090; 95% CI, -0.119 to -0.062). After adjustment for age, stroke severity, prestroke dependency, and depression, these pooled median differences were attenuated, more greatly at 1 year (-0.067; 95% CI, -0.111 to -0.022) than at 5 years (-0.085; 95% CI, -0.135 to -0.034). Conclusions: Women consistently exhibited poorer HRQoL after stroke than men. This was partly attributable to women's advanced age, more severe strokes, prestroke dependency, and poststroke depression, suggesting targets to reduce the differences. There was some evidence of residual differences in HRQoL between sexes but they were small and unlikely to be clinically significant.]]> Mon 28 Nov 2022 11:32:40 AEDT ]]> https://nova.newcastle.edu.au/vital/access/ /manager/Repository/uon:42211 P =.78). Patients managed in SUs more often received recommended management (e.g. swallowing screening). Conclusion: The benefits of SU care may extend to patients experiencing in-hospital stroke. Validation, including accounting for potential residual confounding factors, is required.]]> Fri 26 Aug 2022 09:25:59 AEST ]]> https://nova.newcastle.edu.au/vital/access/ /manager/Repository/uon:40030 Fri 22 Jul 2022 13:07:48 AEST ]]> https://nova.newcastle.edu.au/vital/access/ /manager/Repository/uon:47863 n = 45 hospitals) were analyzed. Differences in processes of care by the timing of discharge are described. Multilevel regression and survival analyses (up to 180 days postevent) were undertaken. Results: Among 30,649 registrants, 2621 (8.6%) were discharged on weekends (55% male; median age 74 years). Compared to those discharged on weekdays, patients discharged on weekends were more often patients with a transient ischemic attack (weekend 35% vs. 19%; p < 0.001) but were less often treated in a stroke unit (69% vs. 81%; p < 0.001), prescribed antihypertensive medication at discharge (65% vs. 71%; p < 0.001) or received a care plan if discharged to the community (47% vs. 53%; p < 0.001). After accounting for patient characteristics and clustering by hospital, patients discharged on weekends had a 1 day shorter length of stay (coefficient = -1.31, 95% confidence interval [CI] = -1.52, -1.10), were less often discharged to inpatient rehabilitation (aOR = 0.39, 95% CI = 0.34, 0.44) and had a greater hazard of death within 180 days (hazard ratio = 1.22, 95% CI = 1.04, 1.42) than those discharged on weekdays. Conclusions: Patients with stroke/transient ischemic attack discharged on weekends were more likely to receive suboptimal care and have higher long-term mortality. High quality of stroke care should be consistent irrespective of the timing of hospital discharge.]]> Fri 03 Feb 2023 14:00:52 AEDT ]]> https://nova.newcastle.edu.au/vital/access/ /manager/Repository/uon:33634 Fri 01 Apr 2022 09:21:50 AEDT ]]>