{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,15]],"date-time":"2026-05-15T01:55:52Z","timestamp":1778810152334,"version":"3.51.4"},"reference-count":26,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2020,7,31]],"date-time":"2020-07-31T00:00:00Z","timestamp":1596153600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["The Neurohospitalist"],"published-print":{"date-parts":[[2021,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background and Purpose:<\/jats:title>\n                    <jats:p>It is unclear whether it is clinically necessary or cost-effective to routinely obtain a transthoracic echocardiogram (TTE) during inpatient admission for ischemic stroke.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>We assessed consecutive patients presenting with acute ischemic stroke at a comprehensive stroke center from 2015 to 2017 who underwent TTE. We assessed for findings on TTE that would warrant urgent intervention including cardiac thrombus, atrial myxoma, mitral stenosis, valve vegetation, valve dysfunction requiring surgery, and low ejection fraction. Subsequent changes in management included changes in anticoagulation, antibiotics, or valve surgery. We calculated in-hospital resource utilization and associated costs for inpatient TTE using individual direct cost details within a case-costing system.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Of 695 patients admitted with acute ischemic stroke, 516 (74%) had a TTE and were included in our analysis. TTE findings were potentially clinically significant in 30 patients (5.8%) and changed management in 17 patients (3.3%). Inpatient admission was prolonged to expedite TTE in 24 patients, while TTE occurred after discharge in 76 patients. After correcting for the cost of TTE, the mean difference in cost to prolong an admission for TTE was $555.52 (USD), or $16 832 per change in management.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Given the low clinical utility of inpatient TTE after acute ischemic stroke and the costs associated with prolonging admission, discharge from hospital should not be delayed solely to obtain TTE.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/1941874420946513","type":"journal-article","created":{"date-parts":[[2020,7,31]],"date-time":"2020-07-31T08:25:15Z","timestamp":1596183915000},"page":"12-17","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":4,"title":["Clinical Utility and Cost of Inpatient Transthoracic Echocardiography Following Acute Ischemic Stroke"],"prefix":"10.1177","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7702-6944","authenticated-orcid":false,"given":"Margaret","family":"Moores","sequence":"first","affiliation":[{"name":"Department of Medicine (Neurology), Ottawa Hospital Research Institute, University of Ottawa, Ottawa, Ontario, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vignan","family":"Yogendrakumar","sequence":"additional","affiliation":[{"name":"Department of Medicine (Neurology), Ottawa Hospital Research Institute, University of Ottawa, Ottawa, Ontario, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Olena","family":"Bereznyakova","sequence":"additional","affiliation":[{"name":"Department of Neurology and Neurosurgery, Montreal Neurological Institute and Hospital and Faculty of Medicine, McGill University, Montreal, Quebec, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Walid","family":"Alesefir","sequence":"additional","affiliation":[{"name":"Department of Neurology, CHUM (Centre hospitalier de l\u2019Universit\u00e9 de Montr\u00e9al), Montreal, Quebec, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kednapa","family":"Thavorn","sequence":"additional","affiliation":[{"name":"Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada"},{"name":"School of Epidemiology and Public Health, Ottawa, Ontario, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hailey","family":"Pettem","sequence":"additional","affiliation":[{"name":"Champlain Regional Stroke Network, Ottawa, Ontario, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Grant","family":"Stotts","sequence":"additional","affiliation":[{"name":"Department of Medicine (Neurology), Ottawa Hospital Research Institute, University of Ottawa, Ottawa, Ontario, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dar","family":"Dowlatshahi","sequence":"additional","affiliation":[{"name":"Department of Medicine (Neurology), Ottawa Hospital Research Institute, University of Ottawa, Ottawa, Ontario, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michel","family":"Shamy","sequence":"additional","affiliation":[{"name":"Department of Medicine (Neurology), Ottawa Hospital Research Institute, University of Ottawa, Ottawa, Ontario, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2020,7,31]]},"reference":[{"key":"bibr1-1941874420946513","doi-asserted-by":"publisher","DOI":"10.1016\/j.jstrokecerebrovasdis.2006.07.002"},{"key":"bibr2-1941874420946513","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.0000170636.08554.49"},{"key":"bibr3-1941874420946513","doi-asserted-by":"publisher","DOI":"10.1136\/postgradmedj-2013-132220"},{"key":"bibr4-1941874420946513","doi-asserted-by":"publisher","DOI":"10.1016\/j.jstrokecerebrovasdis.2011.01.005"},{"key":"bibr5-1941874420946513","doi-asserted-by":"publisher","DOI":"10.1016\/j.jocn.2009.09.016"},{"key":"bibr6-1941874420946513","doi-asserted-by":"publisher","DOI":"10.1016\/j.jstrokecerebrovasdis.2008.09.004"},{"key":"bibr7-1941874420946513","doi-asserted-by":"publisher","DOI":"10.1503\/cmaj.190111"},{"issue":"6","key":"bibr8-1941874420946513","first-page":"e233","volume":"49","year":"2018","journal-title":"Stroke"},{"key":"bibr9-1941874420946513","doi-asserted-by":"publisher","DOI":"10.1177\/0272989X06297388"},{"key":"bibr10-1941874420946513","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-127-9-199711010-00001"},{"key":"bibr11-1941874420946513","doi-asserted-by":"publisher","DOI":"10.3310\/hta18160"},{"key":"bibr12-1941874420946513","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.24.1.35"},{"key":"bibr13-1941874420946513","volume-title":"Ontario Case Costing Guide, Version 9.0. 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