ABSTRACT
BACKGROUND: Large vessel occlusions (LVO) stroke is associated with cancer. Whether this association differs among patients with LVO that undergo endovascular thrombectomy (EVT) according to cancer type remains unknown. PATIENTS AND METHODS: Data from consecutive patients that underwent EVT for LVO at three academic centers were pulled and analyzed retrospectively. Patients with LVO and solid tumors were compared to those with hematological tumors. Associations of cancer type with 90-day functional outcome and mortality were calculated in multivariable analyses. RESULTS: Of the 154 patients with cancer and LVO that underwent EVT (mean age 74±11, 43% men, median NIHSS 15), 137 had solid tumors (89%) and 17 (11%) had hematologic tumors. Patients with solid cancer did not significantly differ from those with hematological malignancy in demographics, risk factor profile, stroke severity and subtype, and procedural variables. Outcome parameters including rates of favorable target recanalization and favorable outcome or mortality at discharge and 90 days post stroke were similar. Safety parameters including rates of symptomatic intracranial hemorrhage also did not differ between the groups. On regression analyses, controlling for various prognostic variables cancer type was not associated with mortality or favorable outcomes. CONCLUSIONS: Our study suggests that the safety and efficacy of EVT in patients with malignancy does not depend on cancer type. Patients with malignancy should be considered for EVT regardless of cancer type.
Subject(s)
Brain Ischemia , Endovascular Procedures , Ischemic Stroke , Neoplasms , Stroke , Vascular System Injuries , Male , Humans , Middle Aged , Aged , Aged, 80 and over , Female , Retrospective Studies , Treatment Outcome , Endovascular Procedures/adverse effects , Stroke/diagnosis , Stroke/etiology , Stroke/therapy , Thrombectomy/adverse effects , Ischemic Stroke/etiology , Vascular System Injuries/etiology , Neoplasms/complications , Neoplasms/diagnosis , Neoplasms/therapy , Brain Ischemia/etiologyABSTRACT
Since the 1950s, the elderly population of Israel has been steadily increasing and is currently 10% of the total Jewish population. However, because of less immigration, the rate of increase is expected to slow down in the next 20 years, although the proportion of the elderly greater than or equal to 75 years will increase. Women comprise a high proportion of this population. This report analyzes the hospitalization patterns of the elderly population in general hospitals in Israel during the 1960s and 1970s, including discharge rates, length of stay, diagnoses, mortality, etc. The author provides a partial data base necessary for planning an optimal scheme for medical care for the elderly.
Subject(s)
Aged , Hospitals, General/statistics & numerical data , Hospital Departments/statistics & numerical data , Hospitalization/economics , Hospitalization/trends , Hospitals, General/trends , Humans , Israel , Jews , Length of Stay , Morbidity , Mortality , Patient DischargeABSTRACT
Hospital discharge rates among the total and the aged Jewish populations in Israel from 1954 to 1972 were studied in relation to the main diagnosis. The disease entities studied included selected acute and chronic diseases, and diseases of old age. The hospital discharge rates for acute diseases did not change throughout the period surveyed, but the rates for chronic diseases and for those disorders that are prevalent in old age did increase gradually from 1954-72, and more markedly among the aged than among the total population. These increasing rates may result from higher expectations of modern medicine, reluctance to care for the elderly within the family, and the vacuum in hospital bed occupancy caused by the decline in infectious diseases. In view of the increasing costs of hospital services, we suggest that at least some of the patients with chronic diseases should receive the care they need at home, in nursing homes, or through other less expensive extended-care facilities.
Subject(s)
Health Services for the Aged/statistics & numerical data , Hospitals/statistics & numerical data , Patient Discharge/trends , Acute Disease , Adolescent , Adult , Age Factors , Aged , Child , Child, Preschool , Chronic Disease , Female , Health Services Needs and Demand , Hospitalization/trends , Humans , Israel , Jews , Male , Middle Aged , MortalityABSTRACT
Since Israel's inception, it has faced many problems that have a high priority in the national consciousness. Problems of defense and national security are outstanding among these, and problems such as absorption of immigrants, education, land reclamation and water supply are next. This creates heavy pressure on scarce resources, and is reflected in the share of specific items in Government and national expenditures. An analysis of developments since the early 1950s shows how health expenditure has been given a high priority in the evaluation of the nation's needs on one hand, and has been influenced by defense needs and other pressing requests on the other hand. It may be concluded that health receives a fair share of the nation's resources, but, in view of the strained economic situation in the country, careful planning for future health services in coordination, cooperation and integration with other welfare services is essential.
