To determine differences in 90-day mortality and identify risk factors among different etiological classifications of ischemic stroke using the Trial of ORG 10172 in Acute Stroke Treatment (TOAST) classification.Our retrospective analysis included 538 ischemic stroke patients. The cause of stroke was categorized according to the TOAST criteria, and 90-day mortality rates were obtained through the patient follow-up. Age, sex, previous medical history, and clinical features were used in the analysis of potential risk factors.There were 38 deaths during the 90-day follow-up period. Patients in the undetermined cause subgroups experienced significantly higher mortality rate than those in subgroups with small artery occlusion and large artery atherosclerosis. Factors independently associated with 90-day mortality for patients with the large artery atherosclerosis stroke subtype were age (95% confidence interval [CI], 1.010-1.192, P = .028), history of hypertension (95% CI, 3.030-99.136, P = .001), high blood glucose (95% CI, 1.273-2.354, P < .001), high cholesterol (95% CI, 0.017-0.462, P = .004), high uric acid (95% CI, 2.360-64.389, P = .003), and National Institute of Health Stroke Scale(95% CI, 1.076-1.312, P = .001). Age (95% CI, 1.012-1.358, P = .034) and high cholesterol (95% CI, 0.011-0.496, P = .007) were independently associated with 90-day mortality for patients with the small artery occlusion subtype of stroke.Our analysis identified that certain risk factors and 90-day mortality differ significantly among different stroke subtypes, as classified by the TOAST criteria. These risk factors must be considered carefully to provide the best clinical management of these patients and thus reduce mortality.
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http://dx.doi.org/10.1097/MD.0000000000010412 | DOI Listing |
Am J Respir Crit Care Med
January 2025
Radbound Univeristy Medical Center, Nijmegen, Netherlands;
Rationale: In critically ill patients receiving invasive mechanical ventilation, switching from controlled to assisted ventilation is a crucial milestone towards ventilator liberation. The optimal timing for switching to assisted ventilation has not been studied.
Objectives: Our objective was to determine whether a strategy of early as compared to delayed switching affects the duration of invasive mechanical ventilation, ICU length of stay, and mortality.
BJS Open
December 2024
Department of Gastroenterology, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, São Paulo, Brazil.
Background: Gastric outlet obstruction due to unresectable tumours is usually managed with a gastrojejunostomy. Unfortunately, the unsatisfactory outcomes of this procedure have led to the search for alternatives, including gastric partitioning.
Methods: Monocentric, randomized, parallel, open-label trial that included patients with obstructive, unresectable distal gastric tumours.
Front Med (Lausanne)
January 2025
Nantong Third People's Hospital, Affiliated Nantong Hospital 3 of Nantong University, Nantong, Jiangsu, China.
Objective: To develop a nomogram model based on the albumin-bilirubin (ALBI) score for predicting the 90-day prognosis of patients with acute-on-chronic liver failure (ACLF) and to evaluate its predictive efficacy.
Methods: Clinical data of 290 ACLF patients at the Third People's Hospital of Nantong City, collected from December 2020 to December 2023, were analyzed. The data were divided into a training set ( = 200) and a validation set ( = 90), with August 2022 as the cut-off date.
Front Neurosci
January 2025
Department of Neurology, Affiliated Hospital of Nantong University, Nantong, China.
Background: Ischemic stroke is the second leading cause of death and the third leading cause of combined disability and mortality globally. While reperfusion therapies play a critical role in the management of acute ischemic stroke (AIS), their applicability is limited, leaving many patients with significant neurological deficits and poor prognoses. Neuroprotective agents have garnered attention for their potential as adjunct therapies; however, their relative efficacy remains unclear.
View Article and Find Full Text PDFInt J Stroke
January 2025
Institute for Medical Informatics, Biometry and Epidemiology, Medical Faculty, University of Duisburg-Essen, Essen, Germany.
Background: Hematoma expansion after intracranial hemorrhage (ICH) in anticoagulated patients signifi-cantly influences clinical outcomes and mortality, emphasizing the need for effective reversal agents. Andexanet alfa is a specific reversal agent for factor Xa associated major bleeding.
Aims: The ASTRO-DE study collected real-world evidence on the effect of andexanet alfa on mitigat-ing hematoma expansion and altering prognosis in rivaroxaban- or apixaban-treated patients with ICH.
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