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March 08, 2016; 86 (10) Article

Integrated systems of stroke care and reduction in 30-day mortality

A retrospective analysis

Aravind Ganesh, Patrice Lindsay, Jiming Fang, Moira K. Kapral, Robert Côté, Ian Joiner, Antoine M. Hakim, Michael D. Hill
First published February 5, 2016, DOI: https://doi.org/10.1212/WNL.0000000000002443
Aravind Ganesh
From the Calgary Stroke Program, Department of Clinical Neurosciences (A.G.), and Departments of Clinical Neurosciences, Medicine, Radiology, and Community Health Sciences, Hotchkiss Brain Institute, Faculty of Medicine (M.D.H.), University of Calgary; The Heart & Stroke Foundation of Canada (P.L., I.J.), Ottawa; Institute for Clinical Evaluative Sciences (J.F., M.K.K.), Toronto; Department of Medicine (M.K.K.), University of Toronto; Department of Neurology (R.C.), McGill University, Montréal; and Division of Neurology and Ottawa Hospital Research Institute (A.M.H.), University of Ottawa and The Heart & Stroke Foundation Centre for Stroke Recovery, Ottawa, Canada.
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Patrice Lindsay
From the Calgary Stroke Program, Department of Clinical Neurosciences (A.G.), and Departments of Clinical Neurosciences, Medicine, Radiology, and Community Health Sciences, Hotchkiss Brain Institute, Faculty of Medicine (M.D.H.), University of Calgary; The Heart & Stroke Foundation of Canada (P.L., I.J.), Ottawa; Institute for Clinical Evaluative Sciences (J.F., M.K.K.), Toronto; Department of Medicine (M.K.K.), University of Toronto; Department of Neurology (R.C.), McGill University, Montréal; and Division of Neurology and Ottawa Hospital Research Institute (A.M.H.), University of Ottawa and The Heart & Stroke Foundation Centre for Stroke Recovery, Ottawa, Canada.
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Jiming Fang
From the Calgary Stroke Program, Department of Clinical Neurosciences (A.G.), and Departments of Clinical Neurosciences, Medicine, Radiology, and Community Health Sciences, Hotchkiss Brain Institute, Faculty of Medicine (M.D.H.), University of Calgary; The Heart & Stroke Foundation of Canada (P.L., I.J.), Ottawa; Institute for Clinical Evaluative Sciences (J.F., M.K.K.), Toronto; Department of Medicine (M.K.K.), University of Toronto; Department of Neurology (R.C.), McGill University, Montréal; and Division of Neurology and Ottawa Hospital Research Institute (A.M.H.), University of Ottawa and The Heart & Stroke Foundation Centre for Stroke Recovery, Ottawa, Canada.
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Moira K. Kapral
From the Calgary Stroke Program, Department of Clinical Neurosciences (A.G.), and Departments of Clinical Neurosciences, Medicine, Radiology, and Community Health Sciences, Hotchkiss Brain Institute, Faculty of Medicine (M.D.H.), University of Calgary; The Heart & Stroke Foundation of Canada (P.L., I.J.), Ottawa; Institute for Clinical Evaluative Sciences (J.F., M.K.K.), Toronto; Department of Medicine (M.K.K.), University of Toronto; Department of Neurology (R.C.), McGill University, Montréal; and Division of Neurology and Ottawa Hospital Research Institute (A.M.H.), University of Ottawa and The Heart & Stroke Foundation Centre for Stroke Recovery, Ottawa, Canada.
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Robert Côté
From the Calgary Stroke Program, Department of Clinical Neurosciences (A.G.), and Departments of Clinical Neurosciences, Medicine, Radiology, and Community Health Sciences, Hotchkiss Brain Institute, Faculty of Medicine (M.D.H.), University of Calgary; The Heart & Stroke Foundation of Canada (P.L., I.J.), Ottawa; Institute for Clinical Evaluative Sciences (J.F., M.K.K.), Toronto; Department of Medicine (M.K.K.), University of Toronto; Department of Neurology (R.C.), McGill University, Montréal; and Division of Neurology and Ottawa Hospital Research Institute (A.M.H.), University of Ottawa and The Heart & Stroke Foundation Centre for Stroke Recovery, Ottawa, Canada.
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Ian Joiner
From the Calgary Stroke Program, Department of Clinical Neurosciences (A.G.), and Departments of Clinical Neurosciences, Medicine, Radiology, and Community Health Sciences, Hotchkiss Brain Institute, Faculty of Medicine (M.D.H.), University of Calgary; The Heart & Stroke Foundation of Canada (P.L., I.J.), Ottawa; Institute for Clinical Evaluative Sciences (J.F., M.K.K.), Toronto; Department of Medicine (M.K.K.), University of Toronto; Department of Neurology (R.C.), McGill University, Montréal; and Division of Neurology and Ottawa Hospital Research Institute (A.M.H.), University of Ottawa and The Heart & Stroke Foundation Centre for Stroke Recovery, Ottawa, Canada.
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Antoine M. Hakim
From the Calgary Stroke Program, Department of Clinical Neurosciences (A.G.), and Departments of Clinical Neurosciences, Medicine, Radiology, and Community Health Sciences, Hotchkiss Brain Institute, Faculty of Medicine (M.D.H.), University of Calgary; The Heart & Stroke Foundation of Canada (P.L., I.J.), Ottawa; Institute for Clinical Evaluative Sciences (J.F., M.K.K.), Toronto; Department of Medicine (M.K.K.), University of Toronto; Department of Neurology (R.C.), McGill University, Montréal; and Division of Neurology and Ottawa Hospital Research Institute (A.M.H.), University of Ottawa and The Heart & Stroke Foundation Centre for Stroke Recovery, Ottawa, Canada.
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Michael D. Hill
From the Calgary Stroke Program, Department of Clinical Neurosciences (A.G.), and Departments of Clinical Neurosciences, Medicine, Radiology, and Community Health Sciences, Hotchkiss Brain Institute, Faculty of Medicine (M.D.H.), University of Calgary; The Heart & Stroke Foundation of Canada (P.L., I.J.), Ottawa; Institute for Clinical Evaluative Sciences (J.F., M.K.K.), Toronto; Department of Medicine (M.K.K.), University of Toronto; Department of Neurology (R.C.), McGill University, Montréal; and Division of Neurology and Ottawa Hospital Research Institute (A.M.H.), University of Ottawa and The Heart & Stroke Foundation Centre for Stroke Recovery, Ottawa, Canada.
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Full PDF
Citation
Integrated systems of stroke care and reduction in 30-day mortality
A retrospective analysis
Aravind Ganesh, Patrice Lindsay, Jiming Fang, Moira K. Kapral, Robert Côté, Ian Joiner, Antoine M. Hakim, Michael D. Hill
Neurology Mar 2016, 86 (10) 898-904; DOI: 10.1212/WNL.0000000000002443

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Article Information

vol. 86 no. 10 898-904
DOI: 
https://doi.org/10.1212/WNL.0000000000002443
PubMed: 
26850979

Published By: 
Wolters Kluwer Health, Inc. on behalf of the American Academy of Neurology
Print ISSN: 
0028-3878
Online ISSN: 
1526-632X
History: 
  • Received April 15, 2015
  • Accepted in final form October 7, 2015
  • First Published February 5, 2016.

Article Versions

  • Previous version (February 5, 2016 - 13:00).
  • You are viewing the most recent version of this article.
Copyright & Usage: 
© 2016 American Academy of Neurology

Author Disclosures

    1. Aravind Ganesh, MD,
    2. Patrice Lindsay, RN, PhD,
    3. Jiming Fang, PhD,
    4. Moira K. Kapral, MD, MSc, FRCPC,
    5. Robert Côté, MD,
    6. Ian Joiner,
    7. Antoine M. Hakim, MD, PhD and
    8. Michael D. Hill, MD, MSc, FRCPC
  1. Aravind Ganesh, MD,
  2. Scientific Advisory Boards:
    1. NONE

    Gifts:
    1. NONE

    Funding for travel or speaker honoraria:
    1. (1) The Meritas Seminar Series, Oxford: speaker honorarium (2) University of Calgary Post-Graduate Medical Education (PGME): travel funding for conferences

    Editorial Boards:
    1. (1) Neurology Resident & Fellow Section, Editorial Board Member, 2014-present

    Patents:
    1. NONE

    Publishing Royalties:
    1. NONE

    Employment, Commercial Entity:
    1. NONE

    Consultancies:
    1. NONE

    Speakers' Bureaus:
    1. NONE

    Other Activities:
    1. NONE

    Clinical Procedures or Imaging Studies:
    1. NONE

    Research Support, Commercial Entities:
    1. NONE

    Research Support, Government Entities:
    1. NONE

    Research Support, Academic Entities:
    1. NONE

    Research Support, Foundations and Societies:
    1. (1) The Rhodes Trust

    Stock/Stock Options/Board of Directors Compensation:
    1. (1) SnapDx (2) TheRounds.ca (3) The Self-Care People

    License Fee Payments, Technology or Inventions:
    1. NONE

    Royalty Payments, Technology or Inventions:
    1. NONE

    Stock/Stock Options, Research Sponsor:
    1. NONE

    Stock/Stock Options, Medical Equipment & Materials:
    1. NONE

    Legal Proceedings:
    1. NONE

  3. Patrice Lindsay, RN, PhD,
  4. Scientific Advisory Boards:
    1. NONE

    Gifts:
    1. NONE

    Funding for travel or speaker honoraria:
    1. Hotel costs and honorarium of $500 from Young Stroke Inc., a stroke survivor organization in the USA, for speaking at conference in June 2015. Topic unrelated to this manuscript.

    Editorial Boards:
    1. International Journal of Stroke: Section Editor, Clinical Guidelines (2014-present). No financial compensation received.

    Patents:
    1. NONE

    Publishing Royalties:
    1. NONE

    Employment, Commercial Entity:
    1. NONE

    Consultancies:
    1. NONE

    Speakers' Bureaus:
    1. NONE

    Other activities:
    1. Employee of the Heart and Stroke Foundation of Canada; Member, Board of Directors for World Stroke Organization

    Clinical Procedures or Imaging Studies:
    1. NONE

    Research Support, Commercial Entities:
    1. NONE

    Research Support, Government Entities:
    1. NONE

    Research Support, Academic Entities:
    1. NONE

    Research Support, Foundations and Societies:
    1. I am an employee of the Heart and Stroke Foundation of Canada. Data analysis for this study was funded by the HSFC alone and no industry funds were used.

    Stock/Stock Options/Board of Directors Compensation:
    1. NONE

    License Fee Payments, Technology or Inventions:
    1. NONE

    Royalty Payments, Technology or Inventions:
    1. NONE

    Stock/Stock Options, Research Sponsor:
    1. NONE

    Stock/Stock Options, Medical Equipment & Materials:
    1. NONE

    Legal Proceedings:
    1. NONE

  5. Jiming Fang, PhD,
  6. Scientific Advisory Boards:
    1. NONE

    Gifts:
    1. NONE

    Funding for Travel or Speaker Honoraria:
    1. NONE

    Editorial Boards:
    1. NONE

    Patents:
    1. NONE

    Publishing Royalties:
    1. NONE

    Employment, Commercial Entity:
    1. NONE

    Consultancies:
    1. NONE

    Speakers' Bureaus:
    1. NONE

    Other Activities:
    1. NONE

    Clinical Procedures or Imaging Studies:
    1. NONE

    Research Support, Commercial Entities:
    1. NONE

    Research Support, Government Entities:
    1. NONE

    Research Support, Academic Entities:
    1. NONE

    Research Support, Foundations and Societies:
    1. NONE

    Stock/Stock Options/Board of Directors Compensation:
    1. NONE

    License Fee Payments, Technology or Inventions:
    1. NONE

    Royalty Payments, Technology or Inventions:
    1. NONE

    Stock/Stock Options, Research Sponsor:
    1. NONE

    Stock/Stock Options, Medical Equipment & Materials:
    1. NONE

    Legal Proceedings:
    1. NONE

  7. Moira K. Kapral, MD, MSc, FRCPC,
  8. Scientific Advisory Boards:
    1. NONE

    Gifts:
    1. NONE

    Funding for Travel or Speaker Honoraria:
    1. NONE

    Editorial Boards:
    1. Stroke journal - editorial board Circulation Cardiovascular Quality and Outcomes - guest editor

    Patents:
    1. NONE

    Publishing Royalties:
    1. NONE

    Employment, Commercial Entity:
    1. NONE

    Consultancies:
    1. NONE

    Speakers' Bureaus:
    1. NONE

    Other Activities:
    1. NONE

    Clinical Procedures or Imaging Studies:
    1. NONE

    Research Support, Commercial Entities:
    1. NONE

    Research Support, Government Entities:
    1. NONE

    Research Support, Academic Entities:
    1. NONE

    Research Support, Foundations and Societies:
    1. Heart and Stroke Foundation of Canada, Ontario Provincial Office - Career Investigator Award, 2011 to present

    Stock/Stock Options/Board of Directors Compensation:
    1. NONE

    License Fee Payments, Technology or Inventions:
    1. NONE

    Royalty Payments, Technology or Inventions:
    1. NONE

    Stock/Stock Options, Research Sponsor:
    1. NONE

    Stock/Stock Options, Medical Equipment & Materials:
    1. NONE

    Legal Proceedings:
    1. NONE

  9. Robert Côté, MD,
  10. Scientific Advisory Boards:
    1. 1))DSMB for National Institute of Health (POINT study) 2)Outcomes committee for the IRIS trial (NIH funded)

    Gifts:
    1. NONE

    Funding for Travel or Speaker Honoraria:
    1. 1)Bristol Myers Squibb,speaker honoraria 2)Pfizer,speaker honoraria

    Editorial Boards:
    1. NONE

    Patents:
    1. NONE

    Publishing Royalties:
    1. NONE

    Employment, Commercial Entity:
    1. NONE

    Consultancies:
    1. NONE

    Speakers' Bureaus:
    1. NONE

    Other Activities:
    1. NONE

    Clinical Procedures or Imaging Studies:
    1. NONE

    Research Support, Commercial Entities:
    1. NONE

    Research Support, Government Entities:
    1. NONE

    Research Support, Academic Entities:
    1. NONE

    Research Support, Foundations and Societies:
    1. NONE

    Stock/Stock Options/Board of Directors Compensation:
    1. NONE

    License Fee Payments, Technology or Inventions:
    1. NONE

    Royalty Payments, Technology or Inventions:
    1. NONE

    Stock/Stock Options, Research Sponsor:
    1. NONE

    Stock/Stock Options, Medical Equipment & Materials:
    1. NONE

    Legal Proceedings:
    1. NONE

  11. Ian Joiner,
  12. Scientific Advisory Boards:
    1. NONE

    Gifts:
    1. NONE

    Funding for Travel or Speaker Honoraria:
    1. NONE

    Editorial Boards:
    1. NONE

    Patents:
    1. NONE

    Publishing Royalties:
    1. NONE

    Employment, Commercial Entity:
    1. NONE

    Consultancies:
    1. NONE

    Speakers' Bureaus:
    1. NONE

    Other activities:
    1. I was an employee of the Heart and Stroke Foundation of Canada when this was submitted.

    Clinical Procedures or Imaging Studies:
    1. NONE

    Research Support, Commercial Entities:
    1. NONE

    Research Support, Government Entities:
    1. NONE

    Research Support, Academic Entities:
    1. NONE

    Research Support, Foundations and Societies:
    1. NONE

    Stock/Stock Options/Board of Directors Compensation:
    1. NONE

    License Fee Payments, Technology or Inventions:
    1. NONE

    Royalty Payments, Technology or Inventions:
    1. NONE

    Stock/Stock Options, Research Sponsor:
    1. NONE

    Stock/Stock Options, Medical Equipment & Materials:
    1. NONE

    Legal Proceedings:
    1. NONE

  13. Antoine M. Hakim, MD, PhD and
  14. Scientific Advisory Boards:
    1. NONE

    Gifts:
    1. NONE

    Funding for Travel or Speaker Honoraria:
    1. NONE

    Editorial Boards:
    1. NONE

    Patents:
    1. NONE

    Publishing Royalties:
    1. NONE

    Employment, Commercial Entity:
    1. NONE

    Consultancies:
    1. NONE

    Speakers' Bureaus:
    1. NONE

    Other Activities:
    1. NONE

    Clinical Procedures or Imaging Studies:
    1. NONE

    Research Support, Commercial Entities:
    1. NONE

    Research Support, Government Entities:
    1. NONE

    Research Support, Academic Entities:
    1. NONE

    Research Support, Foundations and Societies:
    1. NONE

    Stock/Stock Options/Board of Directors Compensation:
    1. NONE

    License Fee Payments, Technology or Inventions:
    1. NONE

    Royalty Payments, Technology or Inventions:
    1. NONE

    Stock/Stock Options, Research Sponsor:
    1. NONE

    Stock/Stock Options, Medical Equipment & Materials:
    1. NONE

    Legal Proceedings:
    1. NONE

  15. Michael D. Hill, MD, MSc, FRCPC
  16. Scientific Advisory Boards:
    1. Vernalis Group Ltd Advisory board - 2008 Genentech Ltd Advisory board - 2007 Sanofi Canada Ltd Advisory board - 2009 Hoffmann-La Roche Canada Ltd advisory board - 2010 Bayer Canada Advisory Board - 2011 Boehringer-Ingelheim Canada Advisory Board - 2011 BMS-Pfizer Alliance Advisory Board - 2015 ARUBA study DSMB - ended 2013 SHINE study DSMB - ongoing Aldagen study DSMB - ended 2014 BRAIN-AF study DSMB - ongoing ARTESIA study DSMB - ongoing

    Gifts:
    1. NONE

    Funding for Travel or Speaker Honoraria:
    1. NONE

    Editorial Boards:
    1. Editorial board - Stroke (ongoing), Can J Neurological, Sciences (ongoing), International Journal of Stroke (ongoing), Neurology (ended 2010) Editor - Stroke Rounds (Canada) (ended 2010)

    Patents:
    1. Patent pending. 62/086,077 Systems and Methods for Assisting in Decision-Making and Triaging for Acute Stroke Patients

    Publishing Royalties:
    1. NONE

    Employment, Commercial Entity:
    1. NONE

    Consultancies:
    1. Heart & Stroke Foundation Alberta/NWT/NU Board of Directors - 2009-2011 [Charitable sector] Heart & Stroke Foundation Alberta/NWT/NU Advisory Board of Directors (Past-Chair) - 2011-2015 [Charitable sector] Canadian Neuroscience Federation - 2012-2016 Board of Directors [Not-for-profit sector] QuikFLO Health Inc. - 2015-present - Board of Directors [For profit sector]

    Speakers' Bureaus:
    1. NONE

    Other Activities:
    1. NONE

    Clinical Procedures or Imaging Studies:
    1. NONE

    Research Support, Commercial Entities:
    1. Grant funding from industry - Hoffmann-La Roche Canada 2004 & 2009, Bayer Canada 2007, Merck Canada 2003-2007, Covidien(Medtronic) 2013-2015

    Research Support, Government Entities:
    1. NIH (NINDS) (2001-ongoing) CIHR (1999-ongoing) Alberta Heritage Foundation for Medical Research (2007-2014) Alberta Innovates Health Solutions 2014-2019

    Research Support, Academic Entities:
    1. Canadian Stroke Network (2008-2013) [Public funding sector]

    Research Support, Foundations and Societies:
    1. Heart & Stroke Foundation Alberta (1999-ongoing) [Charitable funding sector]

    Stock/Stock Options/Board of Directors Compensation:
    1. QuikFLO Health Incorporated (hold stock, hold stock options)

    License Fee Payments, Technology or Inventions:
    1. NONE

    Royalty Payments, Technology or Inventions:
    1. NONE

    Stock/Stock Options, Research Sponsor:
    1. NONE

    Stock/Stock Options, Medical Equipment & Materials:
    1. Calgary Scientific Incorporated (hold stock).

    Legal Proceedings:
    1. NONE

    Non-financial disclosures:
    1. Executive committee of IMS-3 trial CoPI/executive committee of the ALIAS trial PI of ENACT trial PI of ESCAPE trial

  1. From the Calgary Stroke Program, Department of Clinical Neurosciences (A.G.), and Departments of Clinical Neurosciences, Medicine, Radiology, and Community Health Sciences, Hotchkiss Brain Institute, Faculty of Medicine (M.D.H.), University of Calgary; The Heart & Stroke Foundation of Canada (P.L., I.J.), Ottawa; Institute for Clinical Evaluative Sciences (J.F., M.K.K.), Toronto; Department of Medicine (M.K.K.), University of Toronto; Department of Neurology (R.C.), McGill University, Montréal; and Division of Neurology and Ottawa Hospital Research Institute (A.M.H.), University of Ottawa and The Heart & Stroke Foundation Centre for Stroke Recovery, Ottawa, Canada.
  1. Correspondence to Dr. Hill: michael.hill{at}ucalgary.ca
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Neurology | Print ISSN:0028-3878
Online ISSN:1526-632X

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