Invited Commentary

Commentary on “Hospital Discharge Disposition of Stroke Patients in the State of Tennessee”

Authors: Michael G. Abraham, MD

Abstract

In this issue of the Southern Medical Journal, Cho and colleagues assessed the hospital discharge location for patients with stroke and attempted to develop a tool to help determine the discharge location early in the clinical course.1 The treatment for acute ischemic stroke has come a long way since the approval of intravenous tissue plasminogen activator in 1995 to the advent and use of stent retrievers and large-bore aspiration catheters in the last 7 years. In 2015 the American Heart Association and the American Stroke Association released revised class 1A guidelines approving endovascular therapy for large-vessel occlusion in the anterior circulation in patients presenting within 6 hours of symptom onset, which has been proven to be superior to intravenous tissue plasminogen activator alone.2

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References

1. Cho JS, Hu Z, Fell N, et al. Hospital discharge disposition of stroke patients in the state of Tennessee. South Med J 2017;110:594-600.
 
2. Powers WJ, Derdeyn CP, Biller J, et al. 2015 American Heart Association/American Stroke Association focused update of the 2013 Guidelines for the Early Management of Patients With Acute Ischemic Stroke Regarding Endovascular Treatment: A Guideline for Healthcare Professionals From the American Heart Association/American Stroke Association. Strok e 2015;46:3020-3035.
 
3. Lloyd-Jones D, Adams RJ, Brown TM, et al. Heart disease and stroke statistics-2010 update: a report from the American Heart Association. Circulation 2010121:e46-e215.
 
4. Turk AS, Turner R, Spiotta A, et al. Comparison of endovascular treatment approaches for acute ischemic stroke: cost effectiveness, technical success, and clinical outcomes. J Neurointerv Surg 2015;7:666-670.
 
5. Tseng HP, Lin FJ, Chen PT, et al. Derivation and validation of a discharge disposition predicting model after acute stroke. J Stroke Cerebrovasc Dis 2015;24:1179-1186.