1.Risk Factors for Revision After Artificial Urinary Sphincter Implantation in Male Patients With Stress Urinary Incontinence: A 10-Year Retrospective Study
Celeste MANFREDI ; Pramod KRISHNAPPA ; Esaú FERNÁNDEZ-PASCUAL ; Elena GARCÍA CRIADO ; Diego RENGIFO ; David VÁZQUEZ ALBA ; Joaquín CARBALLIDO ; Davide ARCANIOLO ; Juan Ignacio MARTÍNEZ-SALAMANCA
International Neurourology Journal 2022;26(2):161-168
Purpose:
To evaluate the preoperative and intraoperative risk factors for revision after artificial urinary sphincter (AUS) implantation in male patients with stress urinary incontinence (SUI).
Methods:
A retrospective analysis from a prospectively maintained database was performed. Male patients, with moderate-tosevere SUI, undergoing AUS implantation were included. All patients underwent placement of AMS 800. Cause of revision, type of revision, and time to revision were recorded. Multivariable analyzes were performed using a logistic regression to investigate the risk factors. Competing risk analysis according to Fine-Gray model was used to study time to event data.
Results:
A total of 70 patients were included. Revision surgery was performed in 22 of 70 patients (31.4%), after a median (interquartile range) time of 26.5 months (6.5–39.3 months). Overall, 19 of 22 repairs (86.4%) and 3 of 22 explants (13.6%) were recorded. Mechanical dysfunction, urethral erosion, urethral atrophy, and device infection were the causes of revision in 11 of 22 (50.0%), 6 of 22 (27.3%), 3 of 22 (13.6%), and 2 of 22 patients (9.1%). Vesicourethral anastomosis stenosis (P=0.02), urethral cuff size of 3.5 cm (P=0.029), and dual implantation (P=0.048) were independent predictors for revision. Vesicourethral anastomosis stenosis (P=0.01) and urethral cuff size of 3.5 cm (P=0.029) predicted a lower survival of the AUS.
Conclusions
The vesicourethral anastomosis stenosis, urethral cuff size of 3.5 cm, and dual implantation are independent predictors for revision after AUS implantation. However, only the vesicourethral anastomosis stenosis and urethral cuff size of 3.5 cm predict a lower survival of AUS.
2.Work Ability Index: Psychometric Testing in Aeronautical Industry Workers
María Eugenia GONZÁLEZ-DOMÍNGUEZ ; Elena FERNÁNDEZ-GARCÍA ; Olga PALOMA-CASTRO ; Regina María GONZÁLEZ-LÓPEZ ; María Paz Rivas PÉREZ ; Luis LÓPEZ-MOLINA ; Jesús GARCÍA-JIMÉNEZ ; José Manuel ROMERO-SÁNCHEZ
Safety and Health at Work 2024;15(1):80-86
Background:
The Work Ability Index (WAI) is an instrument that measures work ability. The wide dispersion of the WAI internationally has led to its adaptation for use in different countries. This study aimed to evaluate the psychometric properties of the Spanish version of the WAI.
Methods:
A methodological design was used over an opportunistic sample of 233 workers in the aeronautical industry in Spain. Reliability was evaluated through internal consistency. Factorial validity, known groups, and convergent validity were tested.
Results:
The Cronbach's alpha and item-total correlation indicated an adequate internal consistency. The confirmatory factor analysis, performed to evaluate the factorial validity, found adequate fit indices for a two-factor solution with a high correlation between the factors. Factor 1, “Subjectively estimated work ability and resources”, was composed of 3 subscales and factor 2, “Ill-health-related”, of 2 subscales. Subscales 4 and 6 had loading in both factors. Workers under 45 years of age obtained higher significant scores than older ones. Convergent validity was also evidenced since WAI was highly correlated with self-assessment of health status.
Conclusions
The Spanish version of the WAI has shown evidence of reliability and validity in this study, supporting its use in individual and collective health surveillance by occupational health professionals. The factorial solution that was found has previously been reported in another international context. However, further research is needed to resolve the discrepancies detected in the role of some subscales between other national and international studies.
3.Sex Differences by Hospital-Level in Performance and Outcomes of Endovascular Treatment for Acute Ischemic Stroke
Soledad PÉREZ-SÁNCHEZ ; Ana BARRAGÁN-PRIETO ; Joaquín ORTEGA-QUINTANILLA ; Ana DOMÍNGUEZ-MAYORAL ; Miguel Ángel GAMERO-GARCÍA ; Elena ZAPATA-ARRIAZA ; Reyes de TORRES-CHACÓN ; Asier de ALBÓNIGA-CHINDURZA ; Montserrat ZAPATA-HIDALGO ; Francisco MONICHE ; Irene ESCUDERO-MARTÍNEZ ; Pablo BAENA ; Juan Antonio CABEZAS ; Juan Miguel OROPESA-RUIZ ; Gema SANZ-FERNÁNDEZ ; Alejandro GONZÁLEZ ; Joan MONTANER
Journal of Stroke 2020;22(2):258-261
4.Comparative study of the efficacy and safety of Abexol (suspension versus tablets) in patients with gastrointestinal symptoms
Alfredo Hierro GONZÁLEZ ; Julio César Fernández TRAVIESO ; Yoandy Hernández CASAS ; Susana Borges GONZÁLEZ ; María de los Angeles Camacho MORALES ; Elena Ferrer BATALLIE ; Anaisa Roja CARRALERA ; Yenney Reyes NUÑEZ ; Sarahi Mendoza CASTAÑO ; Maytee Robaina GARCÍA ; Diana Margarita Rey KABA
The Korean Journal of Internal Medicine 2024;39(1):57-67
Background/Aims:
Abexol is a mixture of primary aliphatic alcohols purified from beeswax (Apis mellifera), that produces anti-inflammatory, antioxidant and gastroprotective effects, as well as it is safe and well tolerated. To investigate and compare the efficacy and safety of Abexol (suspension versus tablets) in patients with gastrointestinal symptoms.
Methods:
Monocentric study, open-label, randomized design, with two parallel groups receiving Abexol tablets (150 mg/d) or Abexol suspension (75 mg/d) for 8 weeks. Primary efficacy variable (significant improvement in the total score of Gastrointestinal Symptom Rating Scale [GSRS]). Significant reduction in the intensity of the gastrointestinal-symptoms and the reduction in the consumption of antacids are considered secondary efficacy variable. Short form-36 (SF-36) quality of life questiongenonaire was evaluated as collateral variable. Data were analyzed as per intention to treat.
Results:
A significantly decrease in the overall score of the survey was observed with respect to the baseline level (p < 0.001) of 81.4% in the Abexol suspension group and 77.9% in the Abexol tablets group. At the end of the trial, most gastrointestinal- symptoms disappeared or reduced significantly. The frequency of consumption of neutralizing antacids was low. The significantly improvement in the perception of the state of health obtained in the Abexol is in correspondence with the improvement achieved in some of the components evaluate in the SF-36 questionnaire. Both treatments were safe and well tolerated.
Conclusions
Abexol suspension showed efficacy and safety similar to Abexol tablets in patients with gastrointestinal symptoms, but using half the dose.
5.The Value of Transcranial Doppler Sonography in Hyperperfusion Syndrome after Carotid Artery Stenting: A Nationwide Prospective Study
Francisco MONICHE ; Irene ESCUDERO-MARTÍNEZ ; Fernando MANCHA ; Alejandro TOMASELLO ; Marc RIBÓ ; Fernando DELGADO-ACOSTA ; Juán José OCHOA ; Joaquín GIL ; Rosario GIL ; Montserrat GONZÁLEZ-DELGADO ; Eduardo MURIAS ; Alain LUNA ; Alberto GIL ; Sonia MOSTEIRO ; María Dolores FERNÁNDEZ-COUTO ; Luis Fernández de ALARCÓN ; José M. RAMÍREZ-MORENO ; Joaquín ZAMARRO ; Guillermo PARRILLA ; José L. CANIEGO ; Gustavo ZAPATA-WAINBERG ; Andrés GONZÁLEZ-MANDLY ; José A. de las HERAS ; Luis LÓPEZ-MESONERO ; Joaquín ORTEGA ; Juan F. ARENILLAS ; Ernesto GARCÍA ; Pedro P. ALCÁZAR ; Elena ZAPATA-ARRIAZA ; Asier de ALBÓNIGA-CHINDURZA ; Juan Antonio CABEZAS ; Pilar ALGABA ; Aurelio CAYUELA ; Joan MONTANER ; Alejandro González GARCÍA
Journal of Stroke 2020;22(2):254-257
6.Older Adult Patients in the Emergency Department: Which Patients should be Selected for a Different Approach?
Nere Larrea AGUIRRE ; Susana García GUTIÉRREZ ; Oscar MIRO ; Sira AGUILÓ ; Javier JACOB ; Aitor ALQUÉZAR-ARBÉ ; Guillermo BURILLO ; Cesáreo FERNANDEZ ; Pere LLORENS ; Cesar Roza ALONSO ; Ivana Tavasci LOPEZ ; Mónica CAÑETE ; Pedro Ruiz ASENSIO ; Beatriz Paderne DÍAZ ; Teresa Pablos PIZARRO ; Rigoberto Jesús del Rio NAVARRO ; Núria Perelló VIOLA ; Lourdes HERNÁNDEZ-CASTELLS ; Alejandro Cortés SOLER ; Elena SÁNCHEZ FERNÁNDEZ-LINARES ; Jesús Ángel Sánchez SERRANO ; Patxi EZPONDA ; Andrea Martínez LORENZO ; Juan Vicente Ortega LIARTE ; Susana Sánchez RAMÓN ; Asumpta Ruiz ARANDA ; Francisco Javier MARTÍN-SÁNCHEZ ; Juan González DEL CASTILLO ;
Annals of Geriatric Medicine and Research 2024;28(1):9-19
Background:
While multidimensional and interdisciplinary assessment of older adult patients improves their short-term outcomes after evaluation in the emergency department (ED), this assessment is time-consuming and ill-suited for the busy environment. Thus, identifying patients who will benefit from this strategy is challenging. Therefore, this study aimed to identify older adult patients suitable for a different ED approach as well as independent variables associated with poor short-term clinical outcomes.
Methods:
We included all patients ≥65 years attending 52 EDs in Spain over 7 days. Sociodemographic, comorbidity, and baseline functional status data were collected. The outcomes were 30-day mortality, re-presentation, hospital readmission, and the composite of all outcomes.
Results:
During the study among 96,014 patients evaluated in the ED, we included 23,338 patients ≥65 years—mean age, 78.4±8.1 years; 12,626 (54.1%) women. During follow-up, 5,776 patients (24.75%) had poor outcomes after evaluation in the ED: 1,140 (4.88%) died, 4,640 (20.51) returned to the ED, and 1,739 (7.69%) were readmitted 30 days after discharge following the index visit. A model including male sex, age ≥75 years, arrival by ambulance, Charlson Comorbidity Index ≥3, and functional impairment had a C-index of 0.81 (95% confidence interval, 0.80–0.82) for 30-day mortality.
Conclusion
Male sex, age ≥75 years, arrival by ambulance, functional impairment, or severe comorbidity are features of patients who could benefit from approaches in the ED different from the common triage to improve the poor short-term outcomes of this population.
7.Older Adult Patients in the Emergency Department: Which Patients should be Selected for a Different Approach?
Nere Larrea AGUIRRE ; Susana García GUTIÉRREZ ; Oscar MIRO ; Sira AGUILÓ ; Javier JACOB ; Aitor ALQUÉZAR-ARBÉ ; Guillermo BURILLO ; Cesáreo FERNANDEZ ; Pere LLORENS ; Cesar Roza ALONSO ; Ivana Tavasci LOPEZ ; Mónica CAÑETE ; Pedro Ruiz ASENSIO ; Beatriz Paderne DÍAZ ; Teresa Pablos PIZARRO ; Rigoberto Jesús del Rio NAVARRO ; Núria Perelló VIOLA ; Lourdes HERNÁNDEZ-CASTELLS ; Alejandro Cortés SOLER ; Elena SÁNCHEZ FERNÁNDEZ-LINARES ; Jesús Ángel Sánchez SERRANO ; Patxi EZPONDA ; Andrea Martínez LORENZO ; Juan Vicente Ortega LIARTE ; Susana Sánchez RAMÓN ; Asumpta Ruiz ARANDA ; Francisco Javier MARTÍN-SÁNCHEZ ; Juan González DEL CASTILLO ;
Annals of Geriatric Medicine and Research 2024;28(1):9-19
Background:
While multidimensional and interdisciplinary assessment of older adult patients improves their short-term outcomes after evaluation in the emergency department (ED), this assessment is time-consuming and ill-suited for the busy environment. Thus, identifying patients who will benefit from this strategy is challenging. Therefore, this study aimed to identify older adult patients suitable for a different ED approach as well as independent variables associated with poor short-term clinical outcomes.
Methods:
We included all patients ≥65 years attending 52 EDs in Spain over 7 days. Sociodemographic, comorbidity, and baseline functional status data were collected. The outcomes were 30-day mortality, re-presentation, hospital readmission, and the composite of all outcomes.
Results:
During the study among 96,014 patients evaluated in the ED, we included 23,338 patients ≥65 years—mean age, 78.4±8.1 years; 12,626 (54.1%) women. During follow-up, 5,776 patients (24.75%) had poor outcomes after evaluation in the ED: 1,140 (4.88%) died, 4,640 (20.51) returned to the ED, and 1,739 (7.69%) were readmitted 30 days after discharge following the index visit. A model including male sex, age ≥75 years, arrival by ambulance, Charlson Comorbidity Index ≥3, and functional impairment had a C-index of 0.81 (95% confidence interval, 0.80–0.82) for 30-day mortality.
Conclusion
Male sex, age ≥75 years, arrival by ambulance, functional impairment, or severe comorbidity are features of patients who could benefit from approaches in the ED different from the common triage to improve the poor short-term outcomes of this population.
8.Older Adult Patients in the Emergency Department: Which Patients should be Selected for a Different Approach?
Nere Larrea AGUIRRE ; Susana García GUTIÉRREZ ; Oscar MIRO ; Sira AGUILÓ ; Javier JACOB ; Aitor ALQUÉZAR-ARBÉ ; Guillermo BURILLO ; Cesáreo FERNANDEZ ; Pere LLORENS ; Cesar Roza ALONSO ; Ivana Tavasci LOPEZ ; Mónica CAÑETE ; Pedro Ruiz ASENSIO ; Beatriz Paderne DÍAZ ; Teresa Pablos PIZARRO ; Rigoberto Jesús del Rio NAVARRO ; Núria Perelló VIOLA ; Lourdes HERNÁNDEZ-CASTELLS ; Alejandro Cortés SOLER ; Elena SÁNCHEZ FERNÁNDEZ-LINARES ; Jesús Ángel Sánchez SERRANO ; Patxi EZPONDA ; Andrea Martínez LORENZO ; Juan Vicente Ortega LIARTE ; Susana Sánchez RAMÓN ; Asumpta Ruiz ARANDA ; Francisco Javier MARTÍN-SÁNCHEZ ; Juan González DEL CASTILLO ;
Annals of Geriatric Medicine and Research 2024;28(1):9-19
Background:
While multidimensional and interdisciplinary assessment of older adult patients improves their short-term outcomes after evaluation in the emergency department (ED), this assessment is time-consuming and ill-suited for the busy environment. Thus, identifying patients who will benefit from this strategy is challenging. Therefore, this study aimed to identify older adult patients suitable for a different ED approach as well as independent variables associated with poor short-term clinical outcomes.
Methods:
We included all patients ≥65 years attending 52 EDs in Spain over 7 days. Sociodemographic, comorbidity, and baseline functional status data were collected. The outcomes were 30-day mortality, re-presentation, hospital readmission, and the composite of all outcomes.
Results:
During the study among 96,014 patients evaluated in the ED, we included 23,338 patients ≥65 years—mean age, 78.4±8.1 years; 12,626 (54.1%) women. During follow-up, 5,776 patients (24.75%) had poor outcomes after evaluation in the ED: 1,140 (4.88%) died, 4,640 (20.51) returned to the ED, and 1,739 (7.69%) were readmitted 30 days after discharge following the index visit. A model including male sex, age ≥75 years, arrival by ambulance, Charlson Comorbidity Index ≥3, and functional impairment had a C-index of 0.81 (95% confidence interval, 0.80–0.82) for 30-day mortality.
Conclusion
Male sex, age ≥75 years, arrival by ambulance, functional impairment, or severe comorbidity are features of patients who could benefit from approaches in the ED different from the common triage to improve the poor short-term outcomes of this population.
9.Older Adult Patients in the Emergency Department: Which Patients should be Selected for a Different Approach?
Nere Larrea AGUIRRE ; Susana García GUTIÉRREZ ; Oscar MIRO ; Sira AGUILÓ ; Javier JACOB ; Aitor ALQUÉZAR-ARBÉ ; Guillermo BURILLO ; Cesáreo FERNANDEZ ; Pere LLORENS ; Cesar Roza ALONSO ; Ivana Tavasci LOPEZ ; Mónica CAÑETE ; Pedro Ruiz ASENSIO ; Beatriz Paderne DÍAZ ; Teresa Pablos PIZARRO ; Rigoberto Jesús del Rio NAVARRO ; Núria Perelló VIOLA ; Lourdes HERNÁNDEZ-CASTELLS ; Alejandro Cortés SOLER ; Elena SÁNCHEZ FERNÁNDEZ-LINARES ; Jesús Ángel Sánchez SERRANO ; Patxi EZPONDA ; Andrea Martínez LORENZO ; Juan Vicente Ortega LIARTE ; Susana Sánchez RAMÓN ; Asumpta Ruiz ARANDA ; Francisco Javier MARTÍN-SÁNCHEZ ; Juan González DEL CASTILLO ;
Annals of Geriatric Medicine and Research 2024;28(1):9-19
Background:
While multidimensional and interdisciplinary assessment of older adult patients improves their short-term outcomes after evaluation in the emergency department (ED), this assessment is time-consuming and ill-suited for the busy environment. Thus, identifying patients who will benefit from this strategy is challenging. Therefore, this study aimed to identify older adult patients suitable for a different ED approach as well as independent variables associated with poor short-term clinical outcomes.
Methods:
We included all patients ≥65 years attending 52 EDs in Spain over 7 days. Sociodemographic, comorbidity, and baseline functional status data were collected. The outcomes were 30-day mortality, re-presentation, hospital readmission, and the composite of all outcomes.
Results:
During the study among 96,014 patients evaluated in the ED, we included 23,338 patients ≥65 years—mean age, 78.4±8.1 years; 12,626 (54.1%) women. During follow-up, 5,776 patients (24.75%) had poor outcomes after evaluation in the ED: 1,140 (4.88%) died, 4,640 (20.51) returned to the ED, and 1,739 (7.69%) were readmitted 30 days after discharge following the index visit. A model including male sex, age ≥75 years, arrival by ambulance, Charlson Comorbidity Index ≥3, and functional impairment had a C-index of 0.81 (95% confidence interval, 0.80–0.82) for 30-day mortality.
Conclusion
Male sex, age ≥75 years, arrival by ambulance, functional impairment, or severe comorbidity are features of patients who could benefit from approaches in the ED different from the common triage to improve the poor short-term outcomes of this population.
10.Global Impact of the COVID-19 Pandemic on Cerebral Venous Thrombosis and Mortality
Thanh N. NGUYEN ; Muhammad M. QURESHI ; Piers KLEIN ; Hiroshi YAMAGAMI ; Mohamad ABDALKADER ; Robert MIKULIK ; Anvitha SATHYA ; Ossama Yassin MANSOUR ; Anna CZLONKOWSKA ; Hannah LO ; Thalia S. FIELD ; Andreas CHARIDIMOU ; Soma BANERJEE ; Shadi YAGHI ; James E. SIEGLER ; Petra SEDOVA ; Joseph KWAN ; Diana Aguiar DE SOUSA ; Jelle DEMEESTERE ; Violiza INOA ; Setareh Salehi OMRAN ; Liqun ZHANG ; Patrik MICHEL ; Davide STRAMBO ; João Pedro MARTO ; Raul G. NOGUEIRA ; ; Espen Saxhaug KRISTOFFERSEN ; Georgios TSIVGOULIS ; Virginia Pujol LEREIS ; Alice MA ; Christian ENZINGER ; Thomas GATTRINGER ; Aminur RAHMAN ; Thomas BONNET ; Noémie LIGOT ; Sylvie DE RAEDT ; Robin LEMMENS ; Peter VANACKER ; Fenne VANDERVORST ; Adriana Bastos CONFORTO ; Raquel C.T. HIDALGO ; Daissy Liliana MORA CUERVO ; Luciana DE OLIVEIRA NEVES ; Isabelle LAMEIRINHAS DA SILVA ; Rodrigo Targa MARTÍNS ; Letícia C. REBELLO ; Igor Bessa SANTIAGO ; Teodora SADELAROVA ; Rosen KALPACHKI ; Filip ALEXIEV ; Elena Adela CORA ; Michael E. KELLY ; Lissa PEELING ; Aleksandra PIKULA ; Hui-Sheng CHEN ; Yimin CHEN ; Shuiquan YANG ; Marina ROJE BEDEKOVIC ; Martin ČABAL ; Dusan TENORA ; Petr FIBRICH ; Pavel DUŠEK ; Helena HLAVÁČOVÁ ; Emanuela HRABANOVSKA ; Lubomír JURÁK ; Jana KADLČÍKOVÁ ; Igor KARPOWICZ ; Lukáš KLEČKA ; Martin KOVÁŘ ; Jiří NEUMANN ; Hana PALOUŠKOVÁ ; Martin REISER ; Vladimir ROHAN ; Libor ŠIMŮNEK ; Ondreij SKODA ; Miroslav ŠKORŇA ; Martin ŠRÁMEK ; Nicolas DRENCK ; Khalid SOBH ; Emilie LESAINE ; Candice SABBEN ; Peggy REINER ; Francois ROUANET ; Daniel STRBIAN ; Stefan BOSKAMP ; Joshua MBROH ; Simon NAGEL ; Michael ROSENKRANZ ; Sven POLI ; Götz THOMALLA ; Theodoros KARAPANAYIOTIDES ; Ioanna KOUTROULOU ; Odysseas KARGIOTIS ; Lina PALAIODIMOU ; José Dominguo BARRIENTOS GUERRA ; Vikram HUDED ; Shashank NAGENDRA ; Chintan PRAJAPATI ; P.N. SYLAJA ; Achmad Firdaus SANI ; Abdoreza GHOREISHI ; Mehdi FARHOUDI ; Elyar SADEGHI HOKMABADI ; Mazyar HASHEMILAR ; Sergiu Ionut SABETAY ; Fadi RAHAL ; Maurizio ACAMPA ; Alessandro ADAMI ; Marco LONGONI ; Raffaele ORNELLO ; Leonardo RENIERI ; Michele ROMOLI ; Simona SACCO ; Andrea SALMAGGI ; Davide SANGALLI ; Andrea ZINI ; Kenichiro SAKAI ; Hiroki FUKUDA ; Kyohei FUJITA ; Hirotoshi IMAMURA ; Miyake KOSUKE ; Manabu SAKAGUCHI ; Kazutaka SONODA ; Yuji MATSUMARU ; Nobuyuki OHARA ; Seigo SHINDO ; Yohei TAKENOBU ; Takeshi YOSHIMOTO ; Kazunori TOYODA ; Takeshi UWATOKO ; Nobuyuki SAKAI ; Nobuaki YAMAMOTO ; Ryoo YAMAMOTO ; Yukako YAZAWA ; Yuri SUGIURA ; Jang-Hyun BAEK ; Si Baek LEE ; Kwon-Duk SEO ; Sung-Il SOHN ; Jin Soo LEE ; Anita Ante ARSOVSKA ; Chan Yong CHIEH ; Wan Asyraf WAN ZAIDI ; Wan Nur Nafisah WAN YAHYA ; Fernando GONGORA-RIVERA ; Manuel MARTINEZ-MARINO ; Adrian INFANTE-VALENZUELA ; Diederik DIPPEL ; Dianne H.K. VAN DAM-NOLEN ; Teddy Y. WU ; Martin PUNTER ; Tajudeen Temitayo ADEBAYO ; Abiodun H. BELLO ; Taofiki Ajao SUNMONU ; Kolawole Wasiu WAHAB ; Antje SUNDSETH ; Amal M. AL HASHMI ; Saima AHMAD ; Umair RASHID ; Liliana RODRIGUEZ-KADOTA ; Miguel Ángel VENCES ; Patrick Matic YALUNG ; Jon Stewart Hao DY ; Waldemar BROLA ; Aleksander DĘBIEC ; Malgorzata DOROBEK ; Michal Adam KARLINSKI ; Beata M. LABUZ-ROSZAK ; Anetta LASEK-BAL ; Halina SIENKIEWICZ-JAROSZ ; Jacek STASZEWSKI ; Piotr SOBOLEWSKI ; Marcin WIĄCEK ; Justyna ZIELINSKA-TUREK ; André Pinho ARAÚJO ; Mariana ROCHA ; Pedro CASTRO ; Patricia FERREIRA ; Ana Paiva NUNES ; Luísa FONSECA ; Teresa PINHO E MELO ; Miguel RODRIGUES ; M Luis SILVA ; Bogdan CIOPLEIAS ; Adela DIMITRIADE ; Cristian FALUP-PECURARIU ; May Adel HAMID ; Narayanaswamy VENKETASUBRAMANIAN ; Georgi KRASTEV ; Jozef HARING ; Oscar AYO-MARTIN ; Francisco HERNANDEZ-FERNANDEZ ; Jordi BLASCO ; Alejandro RODRÍGUEZ-VÁZQUEZ ; Antonio CRUZ-CULEBRAS ; Francisco MONICHE ; Joan MONTANER ; Soledad PEREZ-SANCHEZ ; María Jesús GARCÍA SÁNCHEZ ; Marta GUILLÁN RODRÍGUEZ ; Gianmarco BERNAVA ; Manuel BOLOGNESE ; Emmanuel CARRERA ; Anchalee CHUROJANA ; Ozlem AYKAC ; Atilla Özcan ÖZDEMIR ; Arsida BAJRAMI ; Songul SENADIM ; Syed I. HUSSAIN ; Seby JOHN ; Kailash KRISHNAN ; Robert LENTHALL ; Kaiz S. ASIF ; Kristine BELOW ; Jose BILLER ; Michael CHEN ; Alex CHEBL ; Marco COLASURDO ; Alexandra CZAP ; Adam H. DE HAVENON ; Sushrut DHARMADHIKARI ; Clifford J. ESKEY ; Mudassir FAROOQUI ; Steven K. FESKE ; Nitin GOYAL ; Kasey B. GRIMMETT ; Amy K. GUZIK ; Diogo C. HAUSSEN ; Majesta HOVINGH ; Dinesh JILLELA ; Peter T. KAN ; Rakesh KHATRI ; Naim N. KHOURY ; Nicole L. KILEY ; Murali K. KOLIKONDA ; Stephanie LARA ; Grace LI ; Italo LINFANTE ; Aaron I. LOOCHTAN ; Carlos D. LOPEZ ; Sarah LYCAN ; Shailesh S. MALE ; Fadi NAHAB ; Laith MAALI ; Hesham E. MASOUD ; Jiangyong MIN ; Santiago ORGETA-GUTIERREZ ; Ghada A. MOHAMED ; Mahmoud MOHAMMADEN ; Krishna NALLEBALLE ; Yazan RADAIDEH ; Pankajavalli RAMAKRISHNAN ; Bliss RAYO-TARANTO ; Diana M. ROJAS-SOTO ; Sean RULAND ; Alexis N. SIMPKINS ; Sunil A. SHETH ; Amy K. STAROSCIAK ; Nicholas E. TARLOV ; Robert A. TAYLOR ; Barbara VOETSCH ; Linda ZHANG ; Hai Quang DUONG ; Viet-Phuong DAO ; Huynh Vu LE ; Thong Nhu PHAM ; Mai Duy TON ; Anh Duc TRAN ; Osama O. ZAIDAT ; Paolo MACHI ; Elisabeth DIRREN ; Claudio RODRÍGUEZ FERNÁNDEZ ; Jorge ESCARTÍN LÓPEZ ; Jose Carlos FERNÁNDEZ FERRO ; Niloofar MOHAMMADZADEH ; Neil C. SURYADEVARA, MD ; Beatriz DE LA CRUZ FERNÁNDEZ ; Filipe BESSA ; Nina JANCAR ; Megan BRADY ; Dawn SCOZZARI
Journal of Stroke 2022;24(2):256-265
Background:
and Purpose Recent studies suggested an increased incidence of cerebral venous thrombosis (CVT) during the coronavirus disease 2019 (COVID-19) pandemic. We evaluated the volume of CVT hospitalization and in-hospital mortality during the 1st year of the COVID-19 pandemic compared to the preceding year.
Methods:
We conducted a cross-sectional retrospective study of 171 stroke centers from 49 countries. We recorded COVID-19 admission volumes, CVT hospitalization, and CVT in-hospital mortality from January 1, 2019, to May 31, 2021. CVT diagnoses were identified by International Classification of Disease-10 (ICD-10) codes or stroke databases. We additionally sought to compare the same metrics in the first 5 months of 2021 compared to the corresponding months in 2019 and 2020 (ClinicalTrials.gov Identifier: NCT04934020).
Results:
There were 2,313 CVT admissions across the 1-year pre-pandemic (2019) and pandemic year (2020); no differences in CVT volume or CVT mortality were observed. During the first 5 months of 2021, there was an increase in CVT volumes compared to 2019 (27.5%; 95% confidence interval [CI], 24.2 to 32.0; P<0.0001) and 2020 (41.4%; 95% CI, 37.0 to 46.0; P<0.0001). A COVID-19 diagnosis was present in 7.6% (132/1,738) of CVT hospitalizations. CVT was present in 0.04% (103/292,080) of COVID-19 hospitalizations. During the first pandemic year, CVT mortality was higher in patients who were COVID positive compared to COVID negative patients (8/53 [15.0%] vs. 41/910 [4.5%], P=0.004). There was an increase in CVT mortality during the first 5 months of pandemic years 2020 and 2021 compared to the first 5 months of the pre-pandemic year 2019 (2019 vs. 2020: 2.26% vs. 4.74%, P=0.05; 2019 vs. 2021: 2.26% vs. 4.99%, P=0.03). In the first 5 months of 2021, there were 26 cases of vaccine-induced immune thrombotic thrombocytopenia (VITT), resulting in six deaths.
Conclusions
During the 1st year of the COVID-19 pandemic, CVT hospitalization volume and CVT in-hospital mortality did not change compared to the prior year. COVID-19 diagnosis was associated with higher CVT in-hospital mortality. During the first 5 months of 2021, there was an increase in CVT hospitalization volume and increase in CVT-related mortality, partially attributable to VITT.