1.Stress hyperglycemia in patients with acute ischemic stroke \t
Ton Duy Mai ; Hao Song Nguyen ; Anh Dat Nguyen
Journal of Medical and Pharmaceutical Information 2005;0(12):18-21
Background: Hyperglycemia is commonly seen in cerebral vascular accidents in general and in acute phase in particular. It is difficult for doctors to treat. Objectives: To evaluate the effect of stress hyperglycemia on mortality risk and disability risk in patient with acute ischemic stroke. Subjects and method: 105 patients with acute ischemic stroke with admission blood glucose level >/= 8.0mmol/l without history of diabetes mellitus from 2004 to 2007. These patients were divided into two groups: group 1 with admission blood glucose level of 8.0-11.0mmol/l; group 2 with that level of >l1.0mmol/l. Results: There was a significant reverse correlation between blood glucose level and the Glasgow score scale on admission and after 24 hours. The mortality risk in hospital of group 2 was higher than that of group 1 and the disability level of group 2 was more severe than that of group 1. Conclusion: Stress hyperglycemia increased the risk of in-hospital mortality in acute ischemic stroke patients and risk of severe disability after leaving hospital. \r\n', u'\r\n', u'
Stress hyperglycemia
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acute ischemic stroke
2.Anesthetic Management and Outcomes of Endovascular Treatment of Basilar Artery Occlusion: Results From the ATTENTION Registry
Chunrong TAO ; Guangxiong YUAN ; Pengfei XU ; Hao WANG ; Peiyang ZHOU ; Tingyu YI ; Kai LI ; Tao CUI ; Jun GAO ; Rui LI ; Jun SUN ; Chao ZHANG ; Li WANG ; Tianlong LIU ; Jianlong SONG ; Yamei YIN ; Thanh N. NGUYEN ; Qing LI ; Wei HU
Journal of Stroke 2023;25(3):399-408
Background:
and Purpose To examine the clinical and safety outcomes after endovascular treatment (EVT) for acute basilar artery occlusion (BAO) with different anesthetic modalities.
Methods:
This was a retrospective analysis using data from the Endovascular Treatment for Acute Basilar Artery Occlusion (ATTENTION) registry. Patients were divided into two groups defined by anesthetic modality performed during EVT: general anesthesia (GA) or non-general anesthesia (non-GA). The association between anesthetic management and clinical outcomes was evaluated in a propensity score matched (PSM) cohort and an inverse probability of treatment weighting (IPTW) cohort to adjust for imbalances between the two groups.
Results:
Our analytic sample included 1,672 patients from 48 centers. The anesthetic modality was GA in 769 (46.0%) and non-GA in 903 (54.0%) patients. In our primary analysis with the PSM-based cohort, non-GA was comparable to GA concerning the primary outcome (adjusted common odds ratio [acOR], 1.01; 95% confidence interval [CI], 0.82 to 1.25; P=0.91). Mortality at 90 days was 38.4% in the GA group and 35.8% in the non-GA group (adjusted risk ratio, 0.95; 95% CI, 0.83 to 1.08; P=0.44). In our secondary analysis with the IPTW-based cohort, the anesthetic modality was significantly associated with the distribution of modified Rankin Scale at 90 days (acOR: 1.45 [95% CI: 1.20 to 1.75]).
Conclusion
In this nationally-representative observational study, acute ischemic stroke patients due to BAO undergoing EVT without GA had similar clinical and safety outcomes compared with patients treated with GA. These findings provide the basis for large-scale randomized controlled trials to test whether anesthetic management provides meaningful clinical effects for patients undergoing EVT.