A5081968344- Acute Ischemic Stroke Management
- Stroke Rehabilitation and Recovery
- COVID-19 and healthcare impacts
- Venous Thromboembolism Diagnosis and Management
- Climate Change and Health Impacts
- Cerebrovascular and Carotid Artery Diseases
- Health Systems, Economic Evaluations, Quality of Life
- Peripheral Artery Disease Management
- Healthcare cost, quality, practices
- Clinical practice guidelines implementation
- Trauma and Emergency Care Studies
- Healthcare Systems and Public Health
- Long-Term Effects of COVID-19
- Traumatic Brain Injury and Neurovascular Disturbances
- Chronic Disease Management Strategies
- Intracerebral and Subarachnoid Hemorrhage Research
McMaster University
2024
Alberta Health Services
2019-2024
Population Health Research Institute
2024
Hamilton Health Sciences
2024
Deleted Institution
2023
University of Calgary
2017-2023
Alberta Health
2019-2023
Foothills Medical Centre
2022
University of Alberta
2022
Allen Institute for Brain Science
2022
Improving door-to-needle times (DNTs) for thrombolysis of acute ischemic stroke patients improves outcomes, but participation in DNT improvement initiatives has been mostly limited to larger, academic medical centers with an existing interest quality improvement. It is not known whether can improve at a population level, including smaller community hospitals. This study aims determine the effect provincial collaborative intervention on and patient outcomes.A pre post cohort was conducted...
Pandemics may promote hospital avoidance, and added precautions exacerbate treatment delays for medical emergencies such as stroke. We sought to evaluate ischemic stroke presentations, management outcomes during the first year of COVID-19 pandemic.We conducted a population-based study, using linked administrative registry data from Alberta identify all patients presenting with before pandemic (Jan. 1, 2016 Feb. 27, 2020) in 5 periods over (Feb. 28, 2020 Mar. 31, 2021), reflecting changes...
Home-time is a patient-prioritized stroke outcome that can be derived from administrative data linkages. The effect of faster time-to-treatment with endovascular thrombectomy (EVT) on home-time after acute unknown.
Abstract Background: CT angiography (CTA), MR (MRA), and ultrasound are noninvasive vascular imaging modalities used in the investigation of stroke or transient ischemic attack (TIA). Imaging decisions may be influenced by factors ranging from location-based resource considerations to patient characteristics. The aim this study was investigate disparities utilization subsequent carotid revascularization over 7 years a Canadian province (Alberta, population:4.4 million). Methods: We...
Although a decrease in stroke admissions during the SARS-CoV-2 pandemic has been observed, detailed analyses of evolution metrics are lacking. We analyzed changes presentation, in-hospital systems-of-care, and treatment time at two representative Comprehensive Stroke Centers (CSCs) first year Coronavirus disease 2019 pandemic. From January 2018 to May 2021, data from presentations CSCs were obtained. The study duration was split into: period 0 (prepandemic), 1 (Wave 1), 2 (Lull), 3 2). Acute...
The benefit of endovascular thrombectomy (EVT) in stroke patients with a low baseline Alberta Stroke Program Early CT Score (ASPECTS, ≤5) is uncertain. We aim to use random forest regression modeling predict 90 day home time ASPECTS.We used the Quality Improvement and Clinical Research (QuICR) provincial registry administrative data from southern identify who underwent EVT our center July 2015 November 2020. Baseline ASPECTS on non-contrast angiography were scored by two physician consensus....
Background and Purpose— Multiple studies have shown the 90-day risk of stroke following an emergency department (ED) diagnosis transient ischemic attack (TIA) or minor is significant, with greatest recurrence being within first 24 to 48 hours initial symptom onset. This study explored regional differences in ED disposition, neuroimaging, subsequent patients diagnosed TIA Alberta. Methods— We used administrative databases identify visits, return visits for Alberta from April 2011 March 2016...
Background and Purpose- Endovascular therapy has been shown to be highly efficacious based on 90-day modified Rankin Scale score. We examined actual daily healthcare utilization from stroke onset 1 year afterward the ESCAPE trial (Endovascular Treatment for Small Core Anterior Circulation Proximal Occlusion With Emphasis Minimizing CT Recanalization Time) registry data. Methods- patients Alberta, Canada, that was enrolled into Quality Improvement Clinical Research in 2016/2017 fiscal year....
The Passive Surveillance Stroke Severity (PaSSV) Indicator was derived to estimate stroke severity from variables in administrative datasets but has not been externally validated.We used linked identify patients with first hospitalization for acute between 2007-2018 Alberta, Canada. We the PaSSV indicator severity. Cox proportional hazard models and evaluated change ratios model discrimination 30-day 1-year case fatality without PaSSV. Similar comparisons were made 90-day home time...
We examined the return on investment (ROI) from Endovascular Reperfusion Alberta (ERA) project, a provincially funded population-wide strategy to improve access endovascular therapy (EVT), inform policy regarding sustainability.We calculated net benefit (NB) as minus cost and ROI divided by cost. Patients treated with EVT their controls were identified ESCAPE trial. Using provincial administrative databases, health services utilization (HSU), including inpatient, outpatient, physician,...
ABSTRACT Objective: To examine the association of co-morbidity with home-time after acute stroke and whether is influenced by age. Methods: We conducted a province-wide study using linked administrative databases to identify all admissions for first ischemic or intracerebral hemorrhage between 2007 2018 in Alberta, Canada. used stroke-weighted Charlson Co-morbidity Index 3 more those severe co-morbidity. zero-inflated negative binomial models determine 90-day 1-year home-time, logistic...
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Background The benefit of endovascular thrombectomy for medium‐vessel occlusion (MeVO) strokes is unclear. We used 90‐day home time to explore outcomes in patients with MeVO versus large‐vessel occlusions treated thrombectomy. Methods Data are from the QuICR (Quality Improvement and Clinical Research) provincial stroke registry linked administrative data identify who underwent our center January 2015 December 2020. Imaging were scored by 2‐physician consensus. defined as beyond including...
An abstract is not available for this content so a preview has been provided. As you have access to content, full PDF via the ‘Save PDF’ action button.
Background: 90-day home-time, the number of days a patient is back at their premorbid living situation without an increase in level care first 90 post stroke, routinely collected administrative data. We evaluated prediction home-time using machine learning modelling patients undergoing endovascular treatment (EVT). Methods: used QuICR provincial stroke registry and data from Southern Alberta Jan 2015-Dec 2019 to identify who underwent EVT. Imaging were scored by 2-physician consensus. The...
Background: The outcome in stroke patients with ASPECTS of ≤5 who undergo Endovascular Thrombectomy(EVT) Large Vessel Occlusion (LVO) is uncertain. We used machine learning models to predict 90-day home-time these patients. Methods: the QuICR provincial registry and administrative data from Southern Alberta identify underwent EVT Jan 2015-Dec 2019. Imaging were scored by 2-physician consensus. primary was predicted home-time(number days a patient back at their premorbid living situation...
Hyperacute treatment of acute stroke may lead to thrombolysis in mimics (SM). Our aim was determine the frequency SM primary centers (PSC) dependent on telestroke versus comprehensive (CSC).Retrospective review prospectively collected data from Quality improvement and Clinical Research (QuICR) registry, Discharge Abstract Database (DAD), The National Ambulatory Care Reporting System (NACRS) consecutive patients treated with intravenous for ischemic Alberta (Canada) April 2016 March 2021.A...
Objective: To understand the effect of COVID-19 pandemic on presentation and treatment acute ischemic stroke. Background: Pandemics may result in hospital avoidance among patients with emergencies, added demands precautions during stroke codes exacerbate delays. There is a paucity population-based data these phenomena. Design/Methods: We extracted from Quality Improvement Clinical Research(QuICR) Alberta Stroke Program, Canadian registry capturing stroke-related entire population Alberta,...
ABSTRACT Background Pandemics may promote hospital avoidance among patients with emergencies, and added precautions exacerbate treatment delays. There is a paucity of population-based data on these phenomena for stroke. We examined the effect COVID-19 pandemic presentation ischemic stroke in an entire population. Methods used linked provincial administrative from Quality Improvement Clinical Research Alberta Stroke Program – registry capturing stroke-related population Alberta(4.3 million)–...