The primary objective of the patient access core is to maintain our current high volume of acute strokepatients treated with intravenous tissue-plasminogen activator (iv tPA) within 2 hours of onset of symptoms.We have developed an efficient and reliable internal system for the triage and treament of patients with acuteischemic stroke, as well as an extensive community network involving both hospitals and emergency medicalsystems (EMS) providers. This effort has been a collaborative process involving physicians and nursesfrom stroke neurology, the emergency department, and radiology, as well as hospital administration andother support staff these departments and the pharmacy. This infrastructure will be utilized to accomplishthe objectives of the patient access core. In addition, we have developed a comprehensive stroke patientregistry, aspects of which will be integrated into the SPOTRIAS network. The Patient Access Core has 4major purposes. The first is to ensure that we treat at least 12 patients with iv tPA per year within 2 hours ofonset of symptoms. This has been and will continue to be accomplished through continuous qualityassurance efforts led by the Emergency Department Acute Stroke Committee, as well as continuingeducational outreach efforts to EMS and referring hospitals and physicians. We have strong preliminarydata that these efforts are necessary. The second purpose is to identify, recruit and enroll patients forprojects 2 and 3. We will train emergency room staff, neurology and emergency department residents toidentify patients eligible for these two protocols. SPOTRIAS research coordinators will recruit and enrollpatients into these studies. The third purpose is to enroll stroke patients into the Cognitive Rehabilitation andRecovery Group (CRRG) database. This is our comprehensive registry of stroke patients seen at ourinstitution. The database has been a valuable resource for preliminary data for the development of researchprotocols, including acute stroke intervention, secondary stroke prevention, and rehabilitation studies. Inaddition it has been used to identify patients eligible for secondary stroke prevention studies and trials ofrehabilitation interventions. The fourth purpose is to collect serum and DMA samples (Core E) from patientsenrolled in the CRRG for storage and possible further analysis by intramural and extramural SPOTRIASinvestigators.

Agency
National Institute of Health (NIH)
Institute
National Institute of Neurological Disorders and Stroke (NINDS)
Type
Specialized Center (P50)
Project #
1P50NS055977-01A2
Application #
7524110
Study Section
Special Emphasis Panel (ZNS1-SRB-G (24))
Project Start
Project End
Budget Start
2008-04-01
Budget End
2009-03-31
Support Year
1
Fiscal Year
2008
Total Cost
$447,654
Indirect Cost
Name
Washington University
Department
Type
DUNS #
068552207
City
Saint Louis
State
MO
Country
United States
Zip Code
63130
Chen, Yasheng; Dhar, Rajat; Heitsch, Laura et al. (2016) Automated quantification of cerebral edema following hemispheric infarction: Application of a machine-learning algorithm to evaluate CSF shifts on serial head CTs. Neuroimage Clin 12:673-680
Diringer, Michael N; Dhar, Rajat; Scalfani, Michael et al. (2016) Effect of High-Dose Simvastatin on Cerebral Blood Flow and Static Autoregulation in Subarachnoid Hemorrhage. Neurocrit Care 25:56-63
Goyal, Manu S; Hoff, Brian G; Williams, Jennifer et al. (2016) Streamlined Hyperacute Magnetic Resonance Imaging Protocol Identifies Tissue-Type Plasminogen Activator-Eligible Stroke Patients When Clinical Impression Is Stroke Mimic. Stroke 47:1012-7
An, Hongyu; Ford, Andria L; Eldeniz, Cihat et al. (2016) Reperfusion Beyond 6 Hours Reduces Infarct Probability in Moderately Ischemic Brain Tissue. Stroke 47:99-105
An, Hongyu; Ford, Andria L; Chen, Yasheng et al. (2015) Defining the ischemic penumbra using magnetic resonance oxygen metabolic index. Stroke 46:982-8
Dhar, Rajat; Diringer, Michael N (2015) Relationship between angiographic vasospasm, cerebral blood flow, and cerebral infarction after subarachnoid hemorrhage. Acta Neurochir Suppl 120:161-5
Curfman, David; Connor, Lisa Tabor; Moy, Hawnwan Philip et al. (2014) Accuracy of emergency medical services-reported last known normal times in patients suspected with acute stroke. Stroke 45:1275-9
Rubin, Michael A; Dhar, Rajat; Diringer, Michael N (2014) Racial differences in withdrawal of mechanical ventilation do not alter mortality in neurologically injured patients. J Crit Care 29:49-53
Sanelli, P C; Sykes, J B; Ford, A L et al. (2014) Imaging and treatment of patients with acute stroke: an evidence-based review. AJNR Am J Neuroradiol 35:1045-51
Vellimana, Ananth K; Yarbrough, Chester K; Blackburn, Spiros et al. (2014) Intravenous tissue-type plasminogen activator therapy is an independent risk factor for symptomatic intracerebral hemorrhage after carotid endarterectomy. Neurosurgery 74:254-61

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