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Biomedical subjects

Charles Warlow

Publications and source records attributed to Charles Warlow.

11 recordsLinked to original sources
PubMed2003

Stroke.

Stroke is a major public-health burden worldwide. Prevention programmes are essential to reduce the incidence of stroke and to prevent the all but inevitable stroke epidemic, which will hit less developed countries particularly hard as their populations age and adopt lifestyles of the more developed countries. Efficient, effective, and rapid diagnosis of stroke and transient ischaemic attack is crucial. The diagnosis of the exact type and cause of stroke, which requires brain imaging as well as traditional clinical skills, is also important when it will influence management. The treatment of acute stroke, the prevention and management of the many complications of stroke, and the prevention of recurrent stroke and other serious vascular events are all improving rapidly. However, stroke management will only be most effective when delivered in the context of an organised, expert, educated, and enthusiastic stroke service that can react quickly to the needs of patients at all stages from onset to recovery.

Acute Disease↗
PubMed2002

Predicting outcome after acute and subacute stroke: development and validation of new prognostic models.

BACKGROUND AND PURPOSE: Statistical models to predict the outcome of patients with acute and subacute stroke could have several uses, but no adequate models exist. We therefore developed and validated new models. METHODS: Regression models to predict survival to 30 days after stroke and survival in a nondisabled state at 6 months were produced with the use of established guidelines on 530 patients from a stroke incidence study. Three models were produced for each outcome with progressively more detailed sets of predictor variables collected within 30 days of stroke onset. The models were externally validated and compared on 2 independent cohorts of stroke patients (538 and 1330 patients) by calculating the area under receiver operating characteristic curves (AUC) and by plotting calibration graphs. RESULTS: Models that included only 6 simple variables (age, living alone, independence in activities of daily living before the stroke, the verbal component of the Glasgow Coma Scale, arm power, ability to walk) generally performed as well as more complex models in both validation cohorts (AUC 0.84 to 0.88). They had good calibration but were overoptimistic in patients with the highest predicted probabilities of being independent. There were no differences in AUCs between patients seen within 48 hours of stroke onset and those seen later; between ischemic and hemorrhagic strokes; and between those with and without a previous stroke. CONCLUSIONS: The simple models performed well enough to be used for epidemiological purposes such as stratification in trials or correction for case mix. However, clinicians should be cautious about using these models, especially in hyperacute stroke, to influence individual patient management until they have been further evaluated. Further research is required to test whether additional information from brain imaging improves predictive accuracy.

Acute Disease↗
PubMedDate not supplied

UK neurologists and the care of adults with acute neurological problems.

In the UK, most patients admitted to hospital with acute neurological problems are not looked after or even seen by a consultant neurologist. As a result, the outcome of their care may be suboptimal. The Association of British Neurologists believes that, in order to provide a reasonable service, the number of consultant neurologists will have to increase more than threefold, to about 1,400. This should be achievable in the next 10-15 years and would bring UK neurological services up to the standards that already obtain in comparable European countries.

Clinical Competence↗