Robyn Moraney | University of South Carolina (original) (raw)

Papers by Robyn Moraney

Research paper thumbnail of Thrombolytic therapy in ischemic stroke patients with pre-stroke depression in the telestroke vs non-telestroke

Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association, 2020

BACKGROUND AND PURPOSE Thrombolysis therapy remains the gold standard in acute ischemic stroke tr... more BACKGROUND AND PURPOSE Thrombolysis therapy remains the gold standard in acute ischemic stroke treatment, and rates of treatment with rtPA in ischemic stroke patients with comorbid depression has yet to be fully investigated. This study aims to examine clinical risk factors associated with inclusion or exclusion for rtPA in acute ischemic stroke populations with pre-stroke depression in the telestroke versus a non-telestroke setting. METHODS We collected retrospective data from a regional stroke registry for pre-stroke depressed ischemic stroke patients from January 2010 to June 2016. Logistic regression was used to determine demographic and baseline clinical risk factors associated with inclusion and exclusion from rtPA. RESULTS . In the adjusted analysis, increasing age (OR = 1.064, 95% CI, 1.006-1.125, P = 0.029), improved ambulation (OR = 3.513, 95% CI, (0.855-14.436, P = 0.018) and sleep apnea (OR = 4.458, 95% CI, 0.731-27.182, P = 0.05) were associated with inclusion for rtPA,...

Research paper thumbnail of Improvements and deficits progression among ischemic stroke patients with pre-stroke depression and thrombolytic therapy

Neurology, Psychiatry and Brain Research

Abstract Background This study aims to identify predictors of improvement or deficit progression ... more Abstract Background This study aims to identify predictors of improvement or deficit progression in ischemic stroke patients with pre-stroke depression and to evaluate the impact of identified predictors on pre-ischemic stroke depressed patients that received thrombolytic therapy. Methods We performed logistic regression analysis to determine demographic and clinical risk factors that are independently associated with clinical improvement or deficits in ischemic stroke patients with pre-stroke depression that received thrombolytic therapy. Multicollinearity effect in the regression models was controlled using variance inflation factors and the fitness of the models was determined using the Hosmer-Lemeshow test. Results A total of 5469 ischemic stroke patients were identified of which 4748 patients were not diagnosed with depression while 721 were diagnosed with pre-stroke depression. After controlling for all variables with multivariate analysis, we found that the female gender (OR = 2.545, 95 % CI, 1.167–5.553, P = 0.019), coronary artery disease (OR = 2.935, 95 % CI, 1.296–6.645, P = 0.01), heart rate (OR = 1.025, 95 % CI, 1.001–1.049, P = 0.044), and improvement in ambulation (OR = 2.161, 95 % CI, 1.076–4.343, P = 0.03) were associated with neurological deficits while antidepressant medication (OR = 0.226, 95 % CI, 0.075‐0.686, P = 0.009), and direct admission (OR = 0.212, 95 % CI, 0.071‐0.636, P = 0.006) were associated with improvements in pre-stroke depressed patients who received recombinant tissue plasminogen activator (rtPA). Conclusions Our findings indicate that neurological deficits or improvements in hemispheric ischemic stroke patients with pre-stroke depression are associated with baseline stroke severity and that a stratification based on NIHSS scores.

Research paper thumbnail of Gender and functional outcomes in prestroke depressive patients treated with thrombolytic therapy

Future Neurology

Aim: This study investigated the clinical factors associated with functional ambulatory outcomes ... more Aim: This study investigated the clinical factors associated with functional ambulatory outcomes and gender differences in prestroke depressive patients. Materials & methods: Clinical risk factors associated with improved functional outcomes with recombinant tissue plasminogen activator-treated cohorts were determined using binary logistic regression. Results: In the adjusted analysis, improvement in ambulation was associated with male patients that had higher National Institute of Health stroke scale score (p = 0.04), a stroke history (p = 0.026), lower serum creatinine levels (p = 0.049) and were taking cholesterol reducing medication (p = 0.014). Improvement in females was associated with taking antidepressants (p = 0.027) and having lower National Institute of Health stroke scale score (p = 0.002). Conclusion: Our findings indicate gender disparities between male and female prestroke depressive patients.

Research paper thumbnail of Opioid Use After Inguinal and Ventral Hernia Repair

The American Surgeon

Background Recent data on opioid consumption indicate that patients typically require far less th... more Background Recent data on opioid consumption indicate that patients typically require far less than is prescribed. Prisma Health Upstate Hernia Center adopted standardized postoperative prescribing after hernia repair and began tracking patient-reported opioid utilization. The aim of this study is to evaluate patient opioid use after hernia repair in order to guide future prescribing. Methods All patients who underwent primary ventral (umbilical and epigastric), incisional, and inguinal hernia repair between February and May 2019 were reviewed. Patients reported the number of opioid pills taken at their first postoperative visit and documented either in the progress note or in the Americas Hernia Society Quality Collaborative (AHSQC) patient-reported outcomes (PRO) questionnaire. All demographic, operative, and outcomes data were captured prospectively in the AHSQC. Opioid use reported as milligram morphine equivalents (MME). Results A total of 162 surgeries were performed during th...

Research paper thumbnail of Thrombolytic therapy in ischemic stroke patients with pre-stroke depression in the telestroke vs non-telestroke

Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association, 2020

BACKGROUND AND PURPOSE Thrombolysis therapy remains the gold standard in acute ischemic stroke tr... more BACKGROUND AND PURPOSE Thrombolysis therapy remains the gold standard in acute ischemic stroke treatment, and rates of treatment with rtPA in ischemic stroke patients with comorbid depression has yet to be fully investigated. This study aims to examine clinical risk factors associated with inclusion or exclusion for rtPA in acute ischemic stroke populations with pre-stroke depression in the telestroke versus a non-telestroke setting. METHODS We collected retrospective data from a regional stroke registry for pre-stroke depressed ischemic stroke patients from January 2010 to June 2016. Logistic regression was used to determine demographic and baseline clinical risk factors associated with inclusion and exclusion from rtPA. RESULTS . In the adjusted analysis, increasing age (OR = 1.064, 95% CI, 1.006-1.125, P = 0.029), improved ambulation (OR = 3.513, 95% CI, (0.855-14.436, P = 0.018) and sleep apnea (OR = 4.458, 95% CI, 0.731-27.182, P = 0.05) were associated with inclusion for rtPA,...

Research paper thumbnail of Improvements and deficits progression among ischemic stroke patients with pre-stroke depression and thrombolytic therapy

Neurology, Psychiatry and Brain Research

Abstract Background This study aims to identify predictors of improvement or deficit progression ... more Abstract Background This study aims to identify predictors of improvement or deficit progression in ischemic stroke patients with pre-stroke depression and to evaluate the impact of identified predictors on pre-ischemic stroke depressed patients that received thrombolytic therapy. Methods We performed logistic regression analysis to determine demographic and clinical risk factors that are independently associated with clinical improvement or deficits in ischemic stroke patients with pre-stroke depression that received thrombolytic therapy. Multicollinearity effect in the regression models was controlled using variance inflation factors and the fitness of the models was determined using the Hosmer-Lemeshow test. Results A total of 5469 ischemic stroke patients were identified of which 4748 patients were not diagnosed with depression while 721 were diagnosed with pre-stroke depression. After controlling for all variables with multivariate analysis, we found that the female gender (OR = 2.545, 95 % CI, 1.167–5.553, P = 0.019), coronary artery disease (OR = 2.935, 95 % CI, 1.296–6.645, P = 0.01), heart rate (OR = 1.025, 95 % CI, 1.001–1.049, P = 0.044), and improvement in ambulation (OR = 2.161, 95 % CI, 1.076–4.343, P = 0.03) were associated with neurological deficits while antidepressant medication (OR = 0.226, 95 % CI, 0.075‐0.686, P = 0.009), and direct admission (OR = 0.212, 95 % CI, 0.071‐0.636, P = 0.006) were associated with improvements in pre-stroke depressed patients who received recombinant tissue plasminogen activator (rtPA). Conclusions Our findings indicate that neurological deficits or improvements in hemispheric ischemic stroke patients with pre-stroke depression are associated with baseline stroke severity and that a stratification based on NIHSS scores.

Research paper thumbnail of Gender and functional outcomes in prestroke depressive patients treated with thrombolytic therapy

Future Neurology

Aim: This study investigated the clinical factors associated with functional ambulatory outcomes ... more Aim: This study investigated the clinical factors associated with functional ambulatory outcomes and gender differences in prestroke depressive patients. Materials & methods: Clinical risk factors associated with improved functional outcomes with recombinant tissue plasminogen activator-treated cohorts were determined using binary logistic regression. Results: In the adjusted analysis, improvement in ambulation was associated with male patients that had higher National Institute of Health stroke scale score (p = 0.04), a stroke history (p = 0.026), lower serum creatinine levels (p = 0.049) and were taking cholesterol reducing medication (p = 0.014). Improvement in females was associated with taking antidepressants (p = 0.027) and having lower National Institute of Health stroke scale score (p = 0.002). Conclusion: Our findings indicate gender disparities between male and female prestroke depressive patients.

Research paper thumbnail of Opioid Use After Inguinal and Ventral Hernia Repair

The American Surgeon

Background Recent data on opioid consumption indicate that patients typically require far less th... more Background Recent data on opioid consumption indicate that patients typically require far less than is prescribed. Prisma Health Upstate Hernia Center adopted standardized postoperative prescribing after hernia repair and began tracking patient-reported opioid utilization. The aim of this study is to evaluate patient opioid use after hernia repair in order to guide future prescribing. Methods All patients who underwent primary ventral (umbilical and epigastric), incisional, and inguinal hernia repair between February and May 2019 were reviewed. Patients reported the number of opioid pills taken at their first postoperative visit and documented either in the progress note or in the Americas Hernia Society Quality Collaborative (AHSQC) patient-reported outcomes (PRO) questionnaire. All demographic, operative, and outcomes data were captured prospectively in the AHSQC. Opioid use reported as milligram morphine equivalents (MME). Results A total of 162 surgeries were performed during th...