Neurology. Clinical practice最新文献

{"title":"Referral to a Functional Seizures Clinic Reduces Inpatient and Emergency Department Health Care Utilization and Costs.","authors":"Meagan R Bean, Meagan M Watson, Mackenzi L Moore, Laura A Strom","doi":"10.1212/CPJ.0000000000200393","DOIUrl":"10.1212/CPJ.0000000000200393","url":null,"abstract":"<p><strong>Background and objectives: </strong>People with functional seizures (FSs) experience high health care utilization and costs revolving around the emergency department (ED). Overall, appropriate treatment of FS is underused, and better care pathways are associated with lower ED reattendance. Our objective was to assess changes in total ED and inpatient visits and costs before and after referral to a specialized, comprehensive FS treatment clinic.</p><p><strong>Methods: </strong>We collected data from 100 consecutive patients referred to the University of Colorado (CU) FS Clinic between July 2019 and December 2021. Hospital account data were obtained directly from the electronic health record. Total ED and inpatient visits, charges, and payments 1 year before and 1 year after referral were collected and analyzed using the Wilcoxon signed-rank test.</p><p><strong>Results: </strong>Ninety-four patients were included for analysis. 79% were female, 52% were on Medicaid, and the mean age was 41 (SD 13) years. Total visits after referral (ED and inpatient) were significantly reduced compared with total visits before referral (mean = 1.44 (SD 3.52) vs 1.83 (SD 3.52), <i>p</i> = 0.045). The same test was performed for total charges after and before referral ($15,551 (SD $38,712) vs $30,257 (SD $81,589), <i>p</i> = 0.03) and for total payments after and before referral ($2,469 (SD $6,682) vs $5,199 (SD $15,084), <i>p</i> = 0.02).</p><p><strong>Discussion: </strong>Referral to a specialized FS clinic is associated with reduced health care utilization and costs. This proof-of-concept study reveals that hospitals should implement policies to support efficient care pathways to comprehensive FS treatment programs with potential for cost savings.</p>","PeriodicalId":19136,"journal":{"name":"Neurology. Clinical practice","volume":"15 1","pages":"e200393"},"PeriodicalIF":2.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11588422/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142731160","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk of Epilepsy Following a First Posttraumatic Seizure: A Register-Based Study.","authors":"Markus Karlander, Samuel Håkansson, Johan Ljungqvist, Ann Sörbo, Johan Zelano","doi":"10.1212/CPJ.0000000000200409","DOIUrl":"10.1212/CPJ.0000000000200409","url":null,"abstract":"<p><strong>Background and objectives: </strong>Traumatic brain injury (TBI) is a common cause of epilepsy, and the risk increases with injury severity. Whether a first posttraumatic seizure (PTS) represents epilepsy is a common clinical problem, but often unknown. Prognostication is important for providing correct patient information and consideration of antiseizure medication. Our objective was to understand how trauma severity and latency from the injury affect the risk of epilepsy after a first PTS.</p><p><strong>Methods: </strong>The register-based cohort study including all individuals hospitalized following a TBI in Sweden 2000-2010, in addition to 3 age-matched and sex-matched controls per case. We analyzed the 10-year probability of epilepsy following a first seizure using the Kaplan-Meier estimator.</p><p><strong>Results: </strong>The risk of an epilepsy diagnosis was 41.1% (95% CI 38.6-43.7) following a PTS, higher than the risk of 33.4% (95% CI 30.3-36.5) in those without prior TBI. The risk increased with injury severity, with the highest risk following focal cerebral injuries, 62.3% (95% CI 53.7-70.9). Mild injuries and skull fractures showed a similar risk to the group without previous TBI. In addition, the risk was higher if the seizure occurred <2 years following the trauma.</p><p><strong>Discussion: </strong>Severity of the injury and latency are major modulators of epilepsy risk following a first PTS. The risk was high in the most severe types of TBI, but a substantial proportion did not develop epilepsy, highlighting the need for further research on prognostication and biomarkers, as well as caution in diagnosing epilepsy based on a first PTS.</p>","PeriodicalId":19136,"journal":{"name":"Neurology. Clinical practice","volume":"15 1","pages":"e200409"},"PeriodicalIF":2.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11588421/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142731162","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Burnout in Practicing Neurologists: A Systematic Review and Meta-Analysis.","authors":"Janet Guo, Senay Gokcebel, Parneet Grewal, Sasha Alick-Lindstrom, Kelly Holder, Mathew J Gregoski, Neishay Ayub","doi":"10.1212/CPJ.0000000000200422","DOIUrl":"10.1212/CPJ.0000000000200422","url":null,"abstract":"<p><strong>Purpose of review: </strong>Burnout is a context-dependent, global issue among physicians in the medical field who often face job-related stressors, high workloads, and limited or lack of social support or autonomy. Within medicine, neurology is a specialty with high levels of burnout and low levels of work-life satisfaction. We, therefore, conducted this study to evaluate burnout rates among neurologists globally and identify the tools used to evaluate it.</p><p><strong>Recent findings: </strong>Among the 14 articles analyzed, the mean burnout prevalence rate among neurologists ranged from 18.1% to 94% (N = 8,735) across 6 countries (the United States, China, Philippines, Spain, Greece, and Brazil). Assessment of burnout using the Maslach Burnout Inventory (MBI) revealed that almost two-thirds (65.9%) of neurologists (N = 7,816) report experiencing burnout. Ten studies (71.4%) assessed burnout by using the MBI; the other 4 studies used the Copenhagen Burnout Inventory, a survey questionnaire generated by the American Academy of Neurology Stroke Practice Resources Workgroup, the Mini-Z survey, and a single question from the Physician Work Life Study. Among the 5 studies that used the same tool for measuring burnout (22-item MBI) and burnout criteria cutoff (emotional exhaustion [EE] ≥ 27 and/or depersonalization (DP) ≥ 10 subscale), the mean burnout rate ranged from 45% to 67% (<i>p</i> < 0.05, N = 7,816) across 3 countries (China, the United States, and Brazil). Of the studies that used the MBI and reported the 3 subscales of EE, DP, and personal accomplishment (PA), only the mean EE score was statistically different between studies. There were no significant differences detected in burnout rates among residents, among attending physicians, or residents compared with attendings.</p><p><strong>Summary: </strong>This meta-analysis of burnout among practicing neurologists reveals that available published data span different levels of training, different sample sizes, and different survey tools with different cutoffs used for burnout within the same tool. Although burnout rates among neurologists were found to differ by country, it is evident from this systematic review that a great deal of neurology physicians are experiencing burnout across the globe. This systematic review may inform future approaches to reduce burnout among neurologists.</p>","PeriodicalId":19136,"journal":{"name":"Neurology. Clinical practice","volume":"15 1","pages":"e200422"},"PeriodicalIF":2.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11651536/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142864911","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Characterizing Prodrome (Premonitory Phase) in Migraine: Results From the PRODROME Trial Screening Period.","authors":"Todd J Schwedt, Richard B Lipton, Peter J Goadsby, Chia-Chun Chiang, Brad C Klein, Cory Hussar, Chengcheng Liu, Sung Yun Yu, Michelle Finnegan, Joel M Trugman","doi":"10.1212/CPJ.0000000000200359","DOIUrl":"https://doi.org/10.1212/CPJ.0000000000200359","url":null,"abstract":"<p><strong>Background and objective: </strong>Limited data are available describing the frequency, severity, and consistency of prodromal symptoms followed by headache. This analysis of the PRODROME trial screening period characterized prodromal symptoms in people with migraine, including the most common symptoms and their severity, and the frequency and consistency with which prodromal symptoms were followed by headache.</p><p><strong>Methods: </strong>PRODROME was a multicenter, randomized, double-blind, placebo-controlled, crossover trial conducted in the United States that enrolled adults with 2-8 migraine attacks per month who stated they could identify prodromal symptoms that were reliably followed by a headache. The trial included a 60-day screening period designed to test the predictive validity of \"qualifying prodrome events\" before the onset of headache. Participants used an eDiary to report qualifying prodrome events, defined as prodromal symptoms whereby the participant was confident a headache would follow within 1-6 hours. This analysis evaluated common prodromal symptoms and their severity, time from prodrome onset to headache onset, and the percentage of participants who identified prodromal symptoms that were followed by a headache ≥75% of the time over the 60-day screening period.</p><p><strong>Results: </strong>A total of 920 participants entered eDiary data, with a mean of 5.2 qualifying prodrome events during the 60-day screening period. A total of 4,802 qualifying prodrome events were recorded. The most common prodromal symptoms identified were sensitivity to light (57.2%; 2,748/4,802), fatigue (50.1%; 2,408/4,802), neck pain (41.9%; 2,013/4,802), sensitivity to sound (33.9%; 1,630/4,802), either difficulty thinking or concentrating (30.0%; 1,442/4,802), and dizziness (27.8%; 1,333/4,802). Of all qualifying prodrome events reported, 81.5% (3,913/4,802) were followed by headache of any intensity within 1-6 hours. For each participant, a mean of 84.4% of their qualifying prodrome events were followed by a headache within 1-6 hours, with 76.9% of participants identifying qualifying prodrome events that were followed by headache within 1-6 hours ≥75% of the time.</p><p><strong>Discussion: </strong>Participants were able to identify migraine attacks in which prodromal symptoms were reliably followed by a headache within 1-6 hours. These findings suggest the potential for initiating treatment during the prodrome to prevent headache.</p><p><strong>Trial registration information: </strong>ClinicalTrials.gov NCT04492020. Submitted: July 27, 2020; First patient enrolled: August 21, 2020. clinicaltrials.gov/study/NCT04492020.</p>","PeriodicalId":19136,"journal":{"name":"Neurology. Clinical practice","volume":"15 1","pages":"e200359"},"PeriodicalIF":2.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11464217/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142470864","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Erratum: Missing Full Disclosures.","authors":"","doi":"10.1212/CPJ.0000000000200416","DOIUrl":"https://doi.org/10.1212/CPJ.0000000000200416","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.1212/cpj.0000000000200192.][This corrects the article DOI: 10.1212/cpj.0000000000200200.][This corrects the article DOI: 10.1212/cpj.0000000000200184.][This corrects the article DOI: 10.1212/cpj.0000000000200201.][This corrects the article DOI: 10.1212/cpj.0000000000200206.][This corrects the article DOI: 10.1212/cpj.0000000000200198.][This corrects the article DOI: 10.1212/cpj.0000000000200195.][This corrects the article DOI: 10.1212/cpj.0000000000200204.][This corrects the article DOI: 10.1212/cpj.0000000000200213.][This corrects the article DOI: 10.1212/cpj.0000000000200203.][This corrects the article DOI: 10.1212/cpj.0000000000200207.][This corrects the article DOI: 10.1212/cpj.0000000000200194.].</p>","PeriodicalId":19136,"journal":{"name":"Neurology. Clinical practice","volume":"15 1","pages":"e200416"},"PeriodicalIF":2.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11606146/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142770748","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Systematic Review of Sleep Disturbance in Idiopathic Intracranial Hypertension.","authors":"Sabrina Kentis, Jacob S Shaw, Lisa N Richey, Lisa Young, Natalia Kosyakova, Barry R Bryant, Aaron I Esagoff, Luis F Buenaver, Rachel Marie E Salas, Matthew E Peters","doi":"10.1212/CPJ.0000000000200372","DOIUrl":"10.1212/CPJ.0000000000200372","url":null,"abstract":"<p><strong>Purpose of review: </strong>Sleep disturbances, particularly obstructive sleep apnea (OSA), may have a significant impact on the outcomes of patients with idiopathic intracranial hypertension (IIH). We conducted a PRISMA-compliant systematic literature review to study sleep disturbance in adult patients with IIH.</p><p><strong>Recent findings: </strong>The current literature on the relationship between IIH and sleep is quite limited. Research has found that sleep disturbances are associated with lower quality of life and may worsen several symptoms associated with IIH, such as headache, cognitive deficits, and neuropsychiatric issues.</p><p><strong>Summary: </strong>OSA was more prevalent in patients with IIH than in healthy controls. Several studies found that OSA was associated with worse IIH symptoms and treatment of OSA helped improve these parameters. Limitations included available literature and heterogeneity in sleep metrics and OSA diagnostic criteria between studies. Overall, further study of sleep disturbances in patients with IIH may encourage earlier screening, improved treatment options, and long-term improvements in quality of life.</p>","PeriodicalId":19136,"journal":{"name":"Neurology. Clinical practice","volume":"15 1","pages":"e200372"},"PeriodicalIF":2.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11464263/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142470859","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Functional Connectivity Relationships to Longitudinal Motor Outcomes Differ in Very Preterm Children With and Without Brain Injury.","authors":"Peppar E P Cyr, Rachel E Lean, Jeanette K Kenley, Sydney Kaplan, Dominique Meyer, Jeffrey J Neil, Dimitrios Alexopoulos, Rebecca G Brady, Joshua S Shimony, Thomas L Rodebaugh, Cynthia E Rogers, Christopher D Smyser","doi":"10.1212/CPJ.0000000000200397","DOIUrl":"10.1212/CPJ.0000000000200397","url":null,"abstract":"<p><strong>Background and objectives: </strong>Children born very preterm (VPT) have high rates of motor disability, but mechanisms for early identification remain limited, especially for children who fall behind in early childhood. This study examines the relationship between functional connectivity (FC) measured at term-equivalent age and motor outcomes at 2 and 5 years.</p><p><strong>Methods: </strong>In this longitudinal observational cohort study, VPT children (gestational age 30 weeks and younger) with and without high-grade brain injury underwent FC MRI at term-equivalent age. Motor development was assessed using the Bayley Scales of Infant Development, Third Edition, at corrected age 2 years and Movement Assessment Battery for Children, Second Edition, at age 5 years. Logistic and negative binomial/Poisson regression models examined relationships between FC measures and 5-year task scores, with and without 2-year scores as covariates. Infants were categorized as \"injured\" or \"uninjured\" based on structural MRI findings at term-equivalent age.</p><p><strong>Results: </strong>In the injured group (n = 34), each 1 SD decrease in neonatal left-right motor cortex FC was related to approximately 4× increased odds of being unable to complete a fine motor task at age 5 (log odds = -1.34, <i>p</i> < 0.05). In the uninjured group (n = 41), stronger basal ganglia-motor cortex FC was related to poorer fine motor scores (Est = -0.40, <i>p</i> < 0.05) and stronger cerebellum-motor cortex FC was related to poorer balance and fine motor scores (Est = -0.05 to -0.23, <i>p</i> < 0.05), with balance persisting with adjustment for 2-year scores.</p><p><strong>Discussion: </strong>In VPT children with brain injury, interhemispheric motor cortex FC was related to motor deficits at 5-year assessment, similar to previous findings at 2 years. In uninjured children, FC-measured disruption of the motor system during the neonatal period was associated with motor planning/coordination difficulties that were not apparent on 2-year assessment but emerged at 5 years, suggesting that the neural basis of these deficits was established very early in life. Subsequently, 2-year follow-up may not be sufficient to detect milder motor deficits in VPT children, and they should be monitored for motor difficulties throughout the preschool years. For all VPT children, FC at term-equivalent age has the potential to improve our ability to predict disability before it presents behaviorally.</p>","PeriodicalId":19136,"journal":{"name":"Neurology. Clinical practice","volume":"15 1","pages":"e200397"},"PeriodicalIF":2.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11492901/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142504827","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Erratum: Dysphagia in Epilepsy Patients: The Silent Enemy.","authors":"","doi":"10.1212/CPJ.0000000000200423","DOIUrl":"https://doi.org/10.1212/CPJ.0000000000200423","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.1212/CPJ.0000000000200362.].</p>","PeriodicalId":19136,"journal":{"name":"Neurology. Clinical practice","volume":"15 1","pages":"e200423"},"PeriodicalIF":2.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11547828/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142624852","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anti-Myelin-Associated Glycoprotein Neuropathy: Recent Developments.","authors":"Jennifer Morganroth, Chafic Karam","doi":"10.1212/CPJ.0000000000200368","DOIUrl":"10.1212/CPJ.0000000000200368","url":null,"abstract":"<p><strong>Background: </strong>The purpose of this review is to give an update on myelin-associated glycoprotein (MAG) neuropathy.</p><p><strong>Recent findings: </strong>There are several recent developments in anti-MAG neuropathy, with the major one being the retrospective analysis of 50 clinical trials that showed that at least a 50% reduction in anti-MAG levels is associated with a therapeutic response. Other updates address antibody levels needed for a positive test, response, and exacerbations to therapy and the type of antibody more associated with malignancy.</p><p><strong>Implications for practice: </strong>Anti-MAG neuropathy is heterogeneous, and the natural history of the disease continues to be refined. Treatment options are being explored for refractory disease.</p>","PeriodicalId":19136,"journal":{"name":"Neurology. Clinical practice","volume":"15 1","pages":"e200368"},"PeriodicalIF":2.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11464236/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142470861","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association Between LACE+ Index Risk Category and 90-Day Mortality After Stroke.","authors":"Adalia Jun-O'Connell, Brian Silver, Eliza Grigoriciuc, Akanksha Gulati, Kimiyoshi J Kobayashi, Nils Henninger","doi":"10.1212/CPJ.0000000000200363","DOIUrl":"10.1212/CPJ.0000000000200363","url":null,"abstract":"<p><strong>Background and objectives: </strong>A higher LACE+ index risk category (defined as LACE+ score ≥78) typically calculated before hospital discharge has been associated with increased risk of unplanned 30-day hospital readmissions and early death after hospital discharge. However, its utility to predict poststroke mortality is unknown. Here, we examined whether the LACE+ index risk category assessed at both discharge (dLACE+) and admission (aLACE+) was associated with 90-day mortality after stroke.</p><p><strong>Methods: </strong>We retrospectively analyzed 2,729 consecutive patients who presented with ischemic or hemorrhagic strokes, included in an institutional stroke registry between January 2018 and December 2021. The primary outcome of interest was 90-day mortality after the index hospitalization. Patients were categorized as high-risk (≥78), medium-to-high-risk (59-77), and low-to-medium-risk (0-58) according to the LACE+ as automatically calculated at admission and discharge. Analyses were performed on the entire cohort, as well as stratified according to acute ischemic stroke and hemorrhagic stroke diagnosis.</p><p><strong>Results: </strong>Among patients who completed 90-day follow-up, the mortality rate was 24.3% (576/2368). In the Kaplan-Meier analysis, the high-risk aLACE+ group had the highest 90-day mortality rate as compared with low-to-medium-risk and medium-to-high-risk groups (<i>p</i> < 0.001). In a fully adjusted multivariable Cox-regression, the 90-day hazards of death were significantly greater among participants in a high-risk aLACE+ (aHR 1.7, 95% CI 1.080-2.742, <i>p</i> = 0.022) and medium-to-high-risk aLACE+ categories (aHR 1.4, 95% CI 1.141-1.778, <i>p</i> = 0.002) as compared with participants in the low-to-medium-risk aLACE+ category. Results were overall similar for dLACE+.</p><p><strong>Discussion: </strong>The LACE+ calculated at both admission and discharge admission identified patients with stroke at increased risk for 90-day mortality. Future studies are warranted to determine whether LACE+ score-based risk stratification can be used to devise early interventions to mitigate the risk for death.</p>","PeriodicalId":19136,"journal":{"name":"Neurology. Clinical practice","volume":"15 1","pages":"e200363"},"PeriodicalIF":2.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11464223/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142470863","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}