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Venous Thrombosis III: Interprofessional Care01:29

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Venous thrombosis requires effective prevention and treatment strategies to improve patient outcomes and reduce potential complications.Prevention StrategiesHealthcare providers must prioritize preventing venous thromboembolism (VTE) for all adult patients upon admission. Interventions depend on bleeding and thrombosis risk, medical history, current medications, diagnoses, planned procedures, and patient preferences. Patients on bed rest should change positions every two hours and, if not...
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Stroke Outcomes and Hyperacute Treatment Utilization in Multiple Sclerosis.

Vinicius A Schoeps1, Emmanuelle Waubant2, Nishita Singh3

  • 1Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA, United States; Department of Neurology, UCSF Weill Institute for Neurosciences, University of California, San Francisco, CA, United States.

Multiple Sclerosis and Related Disorders
|December 9, 2022
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Summary

People with multiple sclerosis (MS) face worse stroke outcomes and reduced use of endovascular thrombectomy (EVT), despite similar thrombolysis rates. This highlights disparities in stroke care for MS patients.

Keywords:
Endovascular treatmentIschemic strokeMultiple sclerosisNational databasesThrombolysis

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Area of Science:

  • Neurology
  • Cardiovascular Disorders
  • Health Services Research

Background:

  • People with multiple sclerosis (MS) have a higher prevalence of comorbidities and increased risk of cardiovascular disorders, including stroke.
  • Stroke is a significant concern for individuals with MS due to potential pre-existing neurological disability.
  • Limited data exists on stroke outcomes and resource utilization specifically for people with MS.

Purpose of the Study:

  • To assess the risk of adverse stroke outcomes in people with MS.
  • To evaluate hyperacute stroke treatment utilization in people with MS.
  • To analyze stroke care disparities in a U.S. population-based sample.

Main Methods:

  • Utilized the 2018 National Inpatient Sample to identify patients with ischemic stroke.
  • Compared discharge outcomes and hyperacute stroke treatment between MS patients (n=2,795) and non-MS patients (n=682,730).
  • Employed regression models adjusted for cardiovascular risk factors and hospital characteristics to account for complex survey design.

Main Results:

  • People with MS were 32% less likely to have a good discharge outcome (adj.OR 0.68).
  • No increased mortality risk was observed in people with MS compared to controls.
  • People with MS had a 57% lower likelihood of receiving endovascular thrombectomy (EVT) (adj.OR 0.43), with similar thrombolysis rates.

Conclusions:

  • Patients with MS experience poorer discharge outcomes following ischemic stroke.
  • Lower rates of endovascular thrombectomy (EVT) were observed in MS patients.
  • Thrombolysis rates were similar between MS and non-MS patients, suggesting targeted treatment disparities.