Risultati per: Linee Guida per le cure post-parto

Stroke, Volume 56, Issue Suppl_1, Page ADP13-ADP13, February 1, 2025. Background:People with stroke are at high risk of dementia. There have been reductions in stroke case fatality and disability but temporal trends in the incidence and absolute burden of post-stroke dementia have not been described.Methods:We did a population-wide analysis of over 15 million people in Ontario, Canada between 2002-2022. Using linked administrative databases, we identified all 90-day dementia-free survivors of first acute ischemic stroke or intracerebral hemorrhage (ICH). We evaluated dementia incidence from 90-days after stroke onwards using a validated definition which included hospitalization, physician claims, and dementia medications. We calculated 1-year and 5-year incidence of dementia as percentages and per 100 person-years for each fiscal year, age-/sex-standardized by the 2002 population and with follow-up until March 2022. We stratified incidence trends by sex, stroke type, and severity (90-day home time of

Stroke, Volume 56, Issue Suppl_1, Page ADP41-ADP41, February 1, 2025. Introduction&Objective:Stroke care is fragmented with reported 30-day readmission rates as high as 10-15%. Novel, cost effective strategies to improve care coordination and address social determinants of care are needed. We sought to evaluate the clinical and financial impact of a home-based stroke care delivery model colloquially called Stroke Mobile (SM).Methods:Patients discharged to home, home health, rehab or skilled nursing facility followed by home from an Ochsner Health hospital in the New Orleans region between July 2021 through December 2022 with stroke (ischemic stroke, TIA, ICH) and on a value-based contract were eligible for the study. Patients were seen at home by an RN and health educator within 30 days of discharge followed by monthly for 3 consecutive months. Thereafter, patients were seen periodically as determined by the care team up to a year. Patients seen by the SM team were compared to a propensity matched control group comprising of patients eligible for care service by the SM team but not enrolled in the program during the study period. Propensity score matching was performed using age, gender, race and chronic conditions as covariates and “nearest neighbor” algorithm with 1:3 match ratio. Parametric (independent sample t-test) and non-parametric (Wilcoxon rank sum, Chi-square) tests were used to test the difference in overall cost (per member per month (pmpm)), 30-day readmissions, and cost of readmission between groups with an error rate set to

Stroke, Volume 56, Issue Suppl_1, Page ADP11-ADP11, February 1, 2025. Introduction:We examined whether prestroke cardiovascular risk is associated with faster cognitive decline and higher dementia risk after stroke independent of prestroke cognition.Methods:We included 1,808 dementia-free individuals with incident stroke (91% ischemic, 7% hemorrhagic, 2% other; 52% women, 38% Black, median age 75) from 4 cohorts (1971-2019): Atherosclerosis Risk In Communities Study, Cardiovascular Health Study, Framingham Offspring Study, and REasons for Geographic And Racial Differences in Stroke. We assessed prestroke atherosclerotic cardiovascular disease (ASCVD) risk with the American Heart Association’s Predicting Risk of cardiovascular disease EVENTs (PREVENT) 10-year ASCVD risk score, which has age and sex as risk factors. Outcomes were global cognition (primary), executive function, memory, and dementia. Linear mixed-effects and Cox regression models examined continuous and categorical (quintiles) 10-year ASCVD risk scores and adjusted for mean prestroke cognition, race, education, and cohort. Median (IQR) follow-up was 4.4 (2.0, 7.9) years for global cognition and 5.1 (2.4, 8.8) for dementia. Dementia cases totaled 142 at 5 years and 182 at 10 years.Results:Median (IQR) 10-year prestroke ASCVD risk was 14.0% (9.9%, 18.5%). Higher prestroke 10-year ASCVD risk was associated with lower adjusted initial poststroke global cognition, memory, and executive function (changes to intercept, Table 1). The quintile analysis showed a dose-response relationship between higher prestroke ASCVD risk and lower initial poststroke cognition scores (changes to intercept, Table 1). The overall stroke survivor group had unadjusted mean declines of -0.59 points/year (95%CI, -0.66 to -0.52 points/year; P

Stroke, Volume 56, Issue Suppl_1, Page ATP62-ATP62, February 1, 2025. Introduction:Education for post-acute stroke patients is crucial for several reasons: recovery and rehabilitation, prevention of recurrence, empowerment, caregiver support, and health literacy. Education equips patents and their families with the knowledge/tools needed to manage the long-term effects of a stroke and overall well-being.Background:Mary Greeley Medical Center (MGMC) leadership identified a lack of compliance in patient education in the post-acute setting for stoke survivors. In 2019, only 60% of stoke patients in the MGMC Acute Rehabilitation Unit (ARU) received the necessary education to be successful at discharge.Objective:To use the best practices outlined by the American Heart Association’s (AHA) guidelines and increase our compliance to greater than 75% of all stroke patients in the ARU setting receiving education on; stroke warning signs, individualized risk factors, prevention, medication management, caregiver education, and after visit follow up.Methods:Our intervention involved implementing a standardized checklist in stroke patients’ rooms, clearly outlining essential educational components. This streamlined approach facilitated real-time assessment of education needs by both staff and patients. Upon admission, stroke patients received an informative packet containing AHA materials. We upgraded patient entertainment systems to include stroke-related educational videos. All educational documentation was integrated into the electronic medical record, enhancing accessibility for both staff and patients via MyChart. Caregivers can access this education via mobile devices. Nursing leaders engaged with patients during rounds to ensure effective utilization of these educational tools.Results:Over a five-year period, the implementation of improved patient education strategies led to a consistent increase in the proportion of patients receiving stroke education in the MGMC ARU. Starting from a baseline of 60% in 2019, the rate rose to 84% during 2020/2021, and further to 91% in 2022. The data for 2023 reflects a continuation of this positive trend. Leadership played a pivotal role by regularly assessing adherence to the education protocol and making continuous enhancements to the educational delivery process.Conclusions:The standardization of educational requirements and increasing the accessibility of a variety of learning platforms has increased staff compliance with providing the necessary education to stroke patients in the MGMC ARU.

Stroke, Volume 56, Issue Suppl_1, Page ATP34-ATP34, February 1, 2025. Background:Elevated blood pressure variability (BPV) has been associated with worse outcomes in stroke survivors. This study aimed to investigate the relationship between systolic and diastolic BPV and post-stroke cognitive impairment (PSCI) in patients with acute cardioembolic stroke due to atrial fibrillation.Methods:Using data from a prospective stroke registry, we consecutively enrolled 143 patients with acute cardioembolic stroke. Cognitive function was evaluated three months post-stroke using the Korean version of the Vascular Cognitive Impairment Harmonization Standards. PSCI was defined as a z-score of less than -2 standard deviations for age, sex, and education-adjusted means in at least one cognitive domain. Multiple logistic regression was used to assess the association between BPV during the first 7 days of admission and PSCI, adjusting for age, sex, education, vascular risk factors, initial stroke severity, and neuroimaging characteristics.Results:Among the 143 participants (mean age 70 years; 60.1% male; median initial NIHSS score of 5), PSCI was identified in 67 patients (46.9%). The standard deviations of both systolic and diastolic blood pressures were significant predictors of PSCI (aOR 1.09; 95% CI 1.01–1.17 and aOR 1.14; 95% CI 1.01–1.29, respectively). The mean values of both SBP and DBP were also significantly associated with PSCI.Conclusions:Our findings demonstrate that both systolic and diastolic BPV in the acute phase of cardioembolic ischemic stroke are independently associated with PSCI at three months. These results underscore the importance of monitoring and managing blood pressure variability in the acute stroke setting to reduce the risk of cognitive decline.

Stroke, Volume 56, Issue Suppl_1, Page ATP36-ATP36, February 1, 2025. Stroke, the leading cause of adult disability, necessitates new therapeutic strategies informed by a deeper understanding of brain repair mechanisms. This pilot study investigates the role of parvalbumin inhibitory interneurons (PV-INs) in post-stroke recovery using wide-field optical imaging (WFOI) and optogenetics. PV-INs, the largest subclass of GABAergic interneurons, are crucial in regulating cortical excitability and mediating activity-dependent plasticity. However, their specific function in stroke recovery remains unclear.Here we use 5 aged mice expressing Channelrhodopsin (ChR2) in PV-INs and the red-shifted genetically encoded calcium indicator, jRGECO1a, driven by the Thy1 promoter to allow for simultaneous optogenetic targeting of PV-INs and mesoscopic imaging of excitatory activity. Photothrombosis was induced in the left primary somatosensory forepaw cortex and subsequent optogenetic photostimulation of PV-INs, calcium, and hemodynamic imaging was conducted pre- and post-stroke to map PV-IN circuitry and assess changes in cortical activity.Preliminary results revealed significant disruptions in homotopic resting-state functional connectivity and cortical activity one-week post-stroke. Power maps indicated reduced activity in the somatosensory, hindpaw, and parietal cortices, with electrical forepaw stimulation showing decreased activity in both left and right primary somatosensory forepaw regions. Contralesional excitation increased in the retrosplenial and parietal cortices during forepaw stimulation. Further, optogenetic stimulation of PV-INs pre-stroke showed increased inhibition, while post-stroke stimulation resulted in less ipsilesional inhibition and more global excitation. Behavioral assessments using the cylinder rearing test indicated a 26% decrease in right forepaw use post-stroke, aligning with imaging findings.Ongoing studies aim to extend these observations by including a larger cohort of aged mice and a cohort of young mice at 1-, 4-, and 8- weeks post-stroke to examine age-related differences in PV-IN-mediated plasticity during stroke recovery. These studies will elucidate the critical contributions of PV-INs to post-stroke plasticity and recovery, potentially guiding new therapeutic approaches for stroke rehabilitation.

Stroke, Volume 56, Issue Suppl_1, Page ATP298-ATP298, February 1, 2025. Background:Post stroke depression (PSD) affects over 33% of stroke survivors with the highest incidence occurring in the first year after stroke. Predictors of PSD include stroke severity, cognitive impairment, age, and physical disability. Antidepressant prescribing patterns during acute ischemic stroke (AIS) hospitalization may be inconsistent. This study evaluated antidepressant prescribing patterns at hospital discharge in acute AIS and hemorrhagic (ICH) stroke patients.Methods:We retrospectively examined prospectively collected data from an IRB-approved stroke registry at two academic Comprehensive Stroke Centers (CSC) between 1/1/2013 and 6/30/2024. We included patients with new diagnosis of AIS or ICH with motor hemiparesis. Patients with initial NIHSS 0 and baseline mRS >2 were excluded. A correlation matrix was constructed followed by stepwise linear regression. Logistic regression modeling was then used for any variables with p

Stroke, Volume 56, Issue Suppl_1, Page ATP32-ATP32, February 1, 2025. Background:Periodontal disease and dental caries are a leading cause of tooth loss which has been correlated with stroke in the REGARDS study. We investigated the correlation between tooth loss and post-stroke cognitive impairment (PSCI) assessed by Montreal Cognitive Assessment (MoCA).Methods:The MoCA was conducted in consecutive ischemic stroke and TIA patients (N=280) enrolled in PREMIERS trial (ClinicalTrials.gov NCT#02541032) based on presence of moderately severe periodontal disease. These patients were categorized as having normal/mild cognitive impairment (MoCA >19) or severe cognitive impairment (MoCA ≤19). Regarding tooth loss, patients were categorized into two separate groups based on the number of teeth lost as noted during initial assessment. The groups were categorized into those reporting significant tooth loss (≥8) and no significant tooth loss of

Stroke, Volume 56, Issue Suppl_1, Page A123-A123, February 1, 2025. Introduction:Neurology follow-up appointments are an essential part of post-stroke care, treatment and secondary stroke prevention. We aimed to determine factors contributing to patient attendance at neurology appointments and its impact on 90-day outcomes and readmissions.Methods:Retrospective analysis on acute ischemic stroke (AIS) patients with care coordinated by a nurse navigator from 7 hospitals (January 2021-March 2024). Patients excluded if: died during index hospitalization, discharged to hospice or long term acute care hospitals, or had incomplete data. Primary outcome: factors contributing to patients attending post-discharge neurology appointments and secondary outcome: 90 day all cause readmission rates utilizing binomial stepwise logistic regression models. Ninety-day utility weighted modified rankin scale (UWmRS) evaluated using hierarchical linear regression. Sensitivity analyses examined secondary outcomes in patients discharged home. Subgroup analysis compared latency of patient follow up and association of 90 day all cause readmission rates using a binomial stepwise logistic regression. All outcome analyses were adjusted for potential confounding variables as identified in the univariate analyses.Results:A total of 6121 AIS patients were evaluated, after exclusions 3450 were included in this study. Patients were more likely to attend a neurology appointment if discharged home,OR=1.47 [95%CI,1.23, 1.74],p

Stroke, Volume 56, Issue Suppl_1, Page ATP70-ATP70, February 1, 2025. Introduction:A significant proportion of stroke patients are lost to follow up (LTFU) after discharge, which may be associated with increased risk of morbidity, mortality, and unnecessary hospitalization. We aimed to identify predictors of post-discharge LTFU and unplanned hospitalizations in a cohort of patients with acute stroke from a large academic hospital system.Methods:Using our institutional AHA Get With the Guidelines quality registry, we conducted a retrospective analysis of all patients who were hospitalized for acute stroke between January 1, 2016, and December 31, 2020 at a tertiary-care hospital in New York City. Our primary outcome was post-discharge LTFU, defined as having zero post-discharge encounters within 12 months. Our secondary outcomes included having one or more outpatient visits with a provider, unplanned hospitalizations, and emergency department (ED) visits within 30 days post-discharge. Multiple logistic regression was used to identify factors that were significantly associated with our primary and secondary outcomes, adjusted for confounding demographic and clinical factors.Results:We identified 2,597 patients hospitalized for acute stroke, of which 878 (33.8%) were LTFU. Of the 1,719 patients not LTFU, 974 (56.7%) had a provider visit, 405 (23.6%) had an unplanned admission, and 257 (14.9%) had an unplanned ED visit within 30 days post-discharge. Patients who were LTFU were significantly more likely to be male (52.9% vs. 47.4%); have an intracerebral (12.1% vs. 8.9%) hemorrhage; discharged to a skilled nursing facility (19.8% vs. 17.0%); and transferred from another hospital (48.0% vs. 40.7%). Clinically, these patients are more likely to have a history of DVT/PE (3.9% vs. 1.3%); receive catheter-based treatment (12.8% vs. 10.0%); and have a modified Rankin scale (mRS) score of 3 or greater at discharge. In the multivariable logistic regression, patients who were discharged to an acute care facility (adjusted odds ratio (aOR) 3.3), had a history of DVT/PE (aOR 3.1) or a discharge mRS of 3 (aOR 1.8) had significantly higher odds of LTFU, whereas patients who were discharged to an inpatient rehabilitation facility (aOR 0.65), had a family history of stroke (aOR 0.60) or depression (aOR 0.64) had significantly decreased odds of LTFU.Conclusions:In this study, patients LTFU after a stroke were more likely to have severe clinical conditions and specific discharge dispositions.

Stroke, Volume 56, Issue Suppl_1, Page ATP98-ATP98, February 1, 2025. Objectives:We evaluate the potential link between post-acute care, particularly care provided at inpatient rehabilitation facilities (IRF) (vs. home discharge or discharge to a skilled nursing facility [SNF]), and major adverse cardiovascular events (MACE) among ICH survivors.Methods:Using inpatient and emergency department data from Florida, New York, Maryland, Washington, and Georgia, we identified adult (≥18 years) spontaneous ICH survivors discharged to home (with or without home health), IRF, or SNF between April 2016 and December 2018. We fit multivariable logistic regression models and report the adjusted odds ratio (aOR) and 95% confidence intervals (CI) for the independent association of discharge disposition (IRF versus home, and IRF versus SNF) with MACE (a composite outcome of stroke, acute myocardial infarction [AMI], systemic embolism, or vascular death), recurrent primary ICH [rICH], acute ischemic stroke (AIS), AMI, and all-cause mortality within 1-year of initial ICH admission. We assessed for interaction between age and discharge disposition and performed stratified analysis among patients aged < 65 years and older patients ≥ 65 years.Results:A total of 17 647 ICH patients alive at discharge (median age [IQR]: 69[57-79]; 45.2% female; 55.5% non-Hispanic White; 23.2% non-Hispanic Black; 10.4% Hispanic; 4.9% Asian) were included, of which 8 194(46.4%), 4 506 (25.5%), and 4 947(28%) were discharged to home, IRF, and SNF, respectively. Within 1-year of follow-up, 7.4% of ICH survivors experienced MACE, while 2.5%, 3.2%, 0.6%, and 3.5%, respectively, experienced rICH, AIS, AMI, and mortality. Overall, patients discharged to IRF had lower odds of MACE (vs. home [aOR, CI: 0.79, 0.68-0.92]; vs. SNF [0.82, 0.70-0.97]; Table 1), rICH (vs. home [0.68, 0.52-0.89]; and vs. SNF [0.66, 0.49-0.88]), AMI (vs. home [0.57, 0.35-0.94]) and mortality (vs. SNF [0.57, 0.45-0.72]). A significant interaction between age and discharge destination was observed (P

Stroke, Volume 56, Issue Suppl_1, Page A119-A119, February 1, 2025. Background:The deleterious effects of intensive blood pressure (BP) lowering in patients who achieved successful reperfusion may result from high BP variability (BPV). However, there is still uncertainty regarding whether the association between high BPV and poor outcomes indicates a causal relationship or if high BPV is merely a bystander or consequence of various factors associated with poor outcomes. We investigated whether the association between intensive BP management after endovascular therapy (EVT) and unfavorable functional outcomes is mediated by BPV.Methods:This is a secondary analysis of OPTIMAL-BP (The Outcome in Patients Treated with Intra-Arterial Thrombectomy-Optimal Blood Pressure Control), comparing intensive and conventional systolic BP (SBP) management for functional outcomes in patients with successful reperfusion post-EVT. Multivariable logistic regression analysis was conducted for the association between BPV and outcomes including 90-day modified Rankin Scale (mRS), symptomatic intracranial hemorrhage (sICH), and final infarction volume. Mediation analysis was performed to evaluate the causal inference whether the relationship between intensive BP management and the 90-day mRS is mediated by BPV.Results:The 24-hour time rate (TR) of SBP was significantly higher in the intensive BP management group. Higher TR was significantly associated with an unfavorable ordinal shift of the 90-day mRS (adjusted OR [aOR] 1.19, 95% CI 1.06–1.33, P=0.003). High TR significantly increased the final infarction volume (coefficient 24.03, 95% CI 6.50–41.56, P=0.007), but did not increase the risk of sICH. TR fully mediated the association between intensive BP management and functional outcomes. The proportions of the association explained by TR was 32.15%.Conclusions:TR mediated the association of intensive BP management for 24 hours and poor functional outcome in successfully reperfused ischemic stroke patients. Efforts to modulate BPV after EVT may be helpful in improving clinical outcomes.

Stroke, Volume 56, Issue Suppl_1, Page ATP53-ATP53, February 1, 2025. Background:Post-discharge phone calls to stroke patients are a valuable tool to assess medication compliance, stroke education retention and prevention of emergency room visits. However, there is no optimal time frame defined by The Joint Commission for post-discharge follow-up calls. The purpose of this study was to determine if there is an optimal time frame to call patients and whether call fatigue affects call completion rate.Methods:Ischemic and hemorrhagic stroke patients discharged to home with and without home health from 2/2024 to 6/2024 were included. Participants received phone calls from a Stroke Certified Registered Nurse at 7 days (Group 1), 14 days (Group 2), and 21 days (Group 3) post-discharge. Two call attempts were made. Data collected included baseline demographics, call completion rates, stroke education and validation of knowledge retention. Call fatigue was assessed by capturing the number of times patient was contacted after discharge by health care team. Patients received a Knowledge Score of 0-6 based on recall of knowledge of diagnosis, stroke type, signs and symptoms of stroke, risk factors, medication knowledge and stroke prevention. R *** was used for data analysis.Results:178 patients were called, 64 (36%) Group 1, 61 (34%) Group 2, 53 (30%) Group 3. There were no differences in baseline demographics. 74% (131) of patients were reached successfully. There were no differences in completion among each group (49 {75%} Group 1, 42 {69%} Group 2, 40 {75%} Group 3) p=0.6 despite more calls being made by healthcare team members early on (7.09±4.55 in Group 1, 4.12±3.27 in Group 2, 3±2.89 in Group 3). There were no differences in Knowledge Score regardless of time phone call was made. Patients who were discharged home with home health had better Knowledge Score than those discharged home without home health (5.87(±0.61) vs 5.48(±1.36)) p=0.03.Conclusion:Implementing a post-discharge phone call program up to 21 days is feasible. There was no difference in call completion rates and retention of stroke knowledge despite a heavier call burden earlier on suggesting no call fatigue.

Stroke, Volume 56, Issue Suppl_1, Page AWP250-AWP250, February 1, 2025. Background:Subarachnoid hemorrhage (SAH) following endovascular thrombectomy (EVT) is a poorly understood phenomenon, and whether it is associated with clinical detriment is unclear.Methods:This was an explorative analysis of a national database of real-world hospitalizations in the United States. Patients who underwent EVT were included. Patients were divided into SAH and non-SAH groups, and hospitalization outcomes were compared using multivariable logistic regression models. Regression models were also used to identify significant predictors for post-EVT SAH, and significant modulators of SAH’s association with hospitalization outcomes were also assessed.Results:99,219 EVT patients were identified; 6,174 (6.2%) had SAH. Overall, SAH was independently associated with increased odds of in-hospital mortality (21.5% vs. 10.6%, adjusted OR 2.53 [95%CI 2.23-2.87], p

Stroke, Volume 56, Issue Suppl_1, Page AWP269-AWP269, February 1, 2025. Introduction:All-cause dementia remains a significant public health concern, with stroke recognized as a key risk factor. Few studies have applied Machine Learning (ML) models to accurately predict cognitive impairment and dementia, yet none have specifically focused on post-stroke dementia risk prediction. This study aims to compare the efficacy of ML approaches and traditional biostatistical methods for predicting the incidence of one-year post-stroke all-cause dementia using electronic health record (EHR) data.Methods:We analyzed de-identified data extracted from the TriNetX network, covering 60 healthcare organizations. This study included patients aged 20+ who experienced their first stroke (any type) in 2018 (baseline). We excluded those with dementia history, lacking data 3 years after stroke onset, or without relevant health data within 3 years preceding stroke. We developed four models: Logistic regression (LR) with backward selection, regularized LR (LASSO and Ridge regression), and Random Forest (RF). The primary outcome was the incidence of all-cause dementia within one year post-stroke. Covariates included demographics, comorbidities, medications, laboratory measures, and vital signs. Model performance was evaluated using accuracy and the area under the curve (AUC) of the receiver operating characteristic (ROC).Results:The final cohort comprised 55,888 adults, of whom 8% developed all-cause dementia within the subsequent year. The sample was 48.4% female, with a distribution of 8.7% aged 20-44, 37.2% aged 45-64, and 54.0% aged 65+. About 64% were non-Hispanic Whites. Among those who developed dementia, 49.7% were female and 80.5% were 65+. They had slightly higher systolic blood pressure, lower BMI, higher rates of comorbidities, and medication use (Table 1). Performance metrics for the models were as follows: LR with backward selection (accuracy: 92.07%; AUC: 0.8033), LASSO regression (92.09%;0.8000), Ridge regression (92.04%; 0.8026), and RF (92.20%; 0.7828) (Table 2).Conclusion:This study demonstrated the feasibility of using ML models to accurately predict post-stroke all-cause dementia incidence. All models showed high accuracy and robust discriminative ability, with the RF model achieving the best accuracy and traditional LR displaying the highest AUC. ML approaches can effectively learn from the data to identify individuals at higher risk of post-stroke dementia, potentially enabling targeted interventions and improved patient care.

Stroke, Volume 56, Issue Suppl_1, Page AWP234-AWP234, February 1, 2025. Introduction:Education, a key modifiable social determinant of health, plays a significant role in shaping outcomes related to ischemic stroke. Higher educational attainment has been linked to improved management of risk factors and greater adherence to medical treatments. However, the impact of education on patients suffering from intracerebral hemorrhage (ICH) remains underexplored.Methods:We conducted a post-hoc analysis of the Ethnic/Racial Variations of Intracerebral Hemorrhage (ERICH) study to examine the impact of educational attainment on good functional outcome (modified Rankin Scale score of 0-3 at 90 days after ICH). A logistic regression model was adjusted for age, sex, race/ethnicity, insurance status, mechanical ventilation, systolic blood pressure, smoking status, diabetes mellitus, atrial fibrillation, hypertension, congestive heart failure, Glasgow Coma Scale, ICH location (side and deep), ICH volume on CT, and presence of intraventricular hemorrhage.Results:Among 1894 individuals included in this study, 584 patients (30.8%) had less than a high school (HS) education, 539 patients (28.5%) had a HS education, 641 patients (33.8%) had more than HS or a college education, and 130 patients (6.9%) had postgraduate education. See Table 1 for demographics by education group. The predicted probability of good outcome by education level was significantly different (Figure 1). Compared to those with