1.Age, Comorbidities, and Outcomes following Hip Arthroplasty: A Retrospective Cohort Study from Vietnam
Dao Thi Ngoc NGUYEN ; Vu Ton Ngoc PHAN ; Huy Mach Thai TRAN ; Hung Quoc HA ; Hieu Minh DANG ; Phat Thanh TRAN ; Sang Thanh NGUYEN ; Phuc Tan Nguyen LE
Annals of Geriatric Medicine and Research 2026;30(2):217-227
Background:
While advanced age is a known risk factor for postoperative complications following hip arthroplasty, its role as an independent predictor versus a surrogate for comorbidity remains unclear, particularly in developing countries. This study aimed to investigate the independent impact of age on postoperative outcomes and explore the mediating role of key comorbidities in a resource-limited setting.
Methods:
We retrospectively reviewed 769 adult patients undergoing hip arthroplasty at a Vietnamese tertiary hospital (2021–2024), categorized into three groups: younger adults (18–64 years), older adults (65–79 years), and oldest old (≥80 years). The primary outcome was a composite of major postoperative complications. Multivariable logistic regression and structural equation modeling were used to identify independent predictors and assess mediation effects.
Results:
Among 769 patients, 363 were younger (47.2%), 241 older adults (31.3%), and 165 oldest old (21.5%). Complication rates increased significantly with age (18.7%, 36.9%, and 60.0%, respectively; p<0.001). However, multivariable adjustment showed that age was not an independent predictor. Instead, heart failure (adjusted odds ratio [aOR]=5.49, 95% confidence interval [CI] 2.19–13.74) and preoperative anemia (aOR=1.77, 95% CI 1.21– 2.59) were identified as independent risk factors. Mediation analysis revealed that the effect of age on complications was significantly mediated through preoperative anemia.
Conclusion
Increased postoperative risk in older adults is driven by comorbidity burden rather than chronological age. Preoperative anemia and heart failure are critical, independent predictors, with anemia acting as a key mediator for the effects of age. Individualized correction of modifiable comorbidities may be more beneficial than using age alone to assess surgical risk.
2.Saponins from the Leaves of Panax vietnamensis Ha et Grushv. (Vietnamese ginseng) and Their Inhibitory Activities on α-Glucosidase
Hoang Khang LE ; Thanh Tung PHAN ; Thi Thuy Duong NGO ; Cong Luan TRAN ; Poul Erik HANSEN ; Quang Ton THAT
Natural Product Sciences 2024;30(4):237-243
Vietnam boasts a rich and diverse flora, with many endemic species. Among them, Ngoc Linh ginseng (Vietnamese ginseng; scientific name: Panax vietnamensis Ha et Grushv.), a high-value endemic ginseng species, has been recognized as a national treasure. While numerous studies have been conducted on its rhizomes and roots, research on its leaves remains limited. In this study, six compounds (1–6) were isolated from the methanol extract of the leaves of P. vietnamensis. Their structures were elucidated using ESI-MS, 1D and 2D NMR spectroscopic methods, and comparisons with known literature data. The identified compounds are: 12β,20(R),25-β trihydroxydammara-3-O-β-D-glucopyranoside (1); 12β,20(R),25-trihydroxydammara-3-O-β-D-glucopyranosyl- (1→2)-β-D-glucopyranoside (2); notoginsenoside SFt1 (3); ginsenoside Rh2 (4); ginsenoside Rg3 (5) and notoginsenoside L1 (6). Except for compound 3, which was isolated from the leaves for the first time, the other five compounds are reported from this species for the first time. The α-glucosidase inhibition assay of the pure isolated compounds revealed that compounds 1, 4, and 6 exhibited significant activities, with IC50 values of 133.5, 105.5, and 14.9, respectively. For comparison, the positive control, acarbose, had an IC50 value of 138.2 µM.
3.Saponins from the Leaves of Panax vietnamensis Ha et Grushv. (Vietnamese ginseng) and Their Inhibitory Activities on α-Glucosidase
Hoang Khang LE ; Thanh Tung PHAN ; Thi Thuy Duong NGO ; Cong Luan TRAN ; Poul Erik HANSEN ; Quang Ton THAT
Natural Product Sciences 2024;30(4):237-243
Vietnam boasts a rich and diverse flora, with many endemic species. Among them, Ngoc Linh ginseng (Vietnamese ginseng; scientific name: Panax vietnamensis Ha et Grushv.), a high-value endemic ginseng species, has been recognized as a national treasure. While numerous studies have been conducted on its rhizomes and roots, research on its leaves remains limited. In this study, six compounds (1–6) were isolated from the methanol extract of the leaves of P. vietnamensis. Their structures were elucidated using ESI-MS, 1D and 2D NMR spectroscopic methods, and comparisons with known literature data. The identified compounds are: 12β,20(R),25-β trihydroxydammara-3-O-β-D-glucopyranoside (1); 12β,20(R),25-trihydroxydammara-3-O-β-D-glucopyranosyl- (1→2)-β-D-glucopyranoside (2); notoginsenoside SFt1 (3); ginsenoside Rh2 (4); ginsenoside Rg3 (5) and notoginsenoside L1 (6). Except for compound 3, which was isolated from the leaves for the first time, the other five compounds are reported from this species for the first time. The α-glucosidase inhibition assay of the pure isolated compounds revealed that compounds 1, 4, and 6 exhibited significant activities, with IC50 values of 133.5, 105.5, and 14.9, respectively. For comparison, the positive control, acarbose, had an IC50 value of 138.2 µM.
4.Saponins from the Leaves of Panax vietnamensis Ha et Grushv. (Vietnamese ginseng) and Their Inhibitory Activities on α-Glucosidase
Hoang Khang LE ; Thanh Tung PHAN ; Thi Thuy Duong NGO ; Cong Luan TRAN ; Poul Erik HANSEN ; Quang Ton THAT
Natural Product Sciences 2024;30(4):237-243
Vietnam boasts a rich and diverse flora, with many endemic species. Among them, Ngoc Linh ginseng (Vietnamese ginseng; scientific name: Panax vietnamensis Ha et Grushv.), a high-value endemic ginseng species, has been recognized as a national treasure. While numerous studies have been conducted on its rhizomes and roots, research on its leaves remains limited. In this study, six compounds (1–6) were isolated from the methanol extract of the leaves of P. vietnamensis. Their structures were elucidated using ESI-MS, 1D and 2D NMR spectroscopic methods, and comparisons with known literature data. The identified compounds are: 12β,20(R),25-β trihydroxydammara-3-O-β-D-glucopyranoside (1); 12β,20(R),25-trihydroxydammara-3-O-β-D-glucopyranosyl- (1→2)-β-D-glucopyranoside (2); notoginsenoside SFt1 (3); ginsenoside Rh2 (4); ginsenoside Rg3 (5) and notoginsenoside L1 (6). Except for compound 3, which was isolated from the leaves for the first time, the other five compounds are reported from this species for the first time. The α-glucosidase inhibition assay of the pure isolated compounds revealed that compounds 1, 4, and 6 exhibited significant activities, with IC50 values of 133.5, 105.5, and 14.9, respectively. For comparison, the positive control, acarbose, had an IC50 value of 138.2 µM.
5.Saponins from the Leaves of Panax vietnamensis Ha et Grushv. (Vietnamese ginseng) and Their Inhibitory Activities on α-Glucosidase
Hoang Khang LE ; Thanh Tung PHAN ; Thi Thuy Duong NGO ; Cong Luan TRAN ; Poul Erik HANSEN ; Quang Ton THAT
Natural Product Sciences 2024;30(4):237-243
Vietnam boasts a rich and diverse flora, with many endemic species. Among them, Ngoc Linh ginseng (Vietnamese ginseng; scientific name: Panax vietnamensis Ha et Grushv.), a high-value endemic ginseng species, has been recognized as a national treasure. While numerous studies have been conducted on its rhizomes and roots, research on its leaves remains limited. In this study, six compounds (1–6) were isolated from the methanol extract of the leaves of P. vietnamensis. Their structures were elucidated using ESI-MS, 1D and 2D NMR spectroscopic methods, and comparisons with known literature data. The identified compounds are: 12β,20(R),25-β trihydroxydammara-3-O-β-D-glucopyranoside (1); 12β,20(R),25-trihydroxydammara-3-O-β-D-glucopyranosyl- (1→2)-β-D-glucopyranoside (2); notoginsenoside SFt1 (3); ginsenoside Rh2 (4); ginsenoside Rg3 (5) and notoginsenoside L1 (6). Except for compound 3, which was isolated from the leaves for the first time, the other five compounds are reported from this species for the first time. The α-glucosidase inhibition assay of the pure isolated compounds revealed that compounds 1, 4, and 6 exhibited significant activities, with IC50 values of 133.5, 105.5, and 14.9, respectively. For comparison, the positive control, acarbose, had an IC50 value of 138.2 µM.
6.Saponins from the Leaves of Panax vietnamensis Ha et Grushv. (Vietnamese ginseng) and Their Inhibitory Activities on α-Glucosidase
Hoang Khang LE ; Thanh Tung PHAN ; Thi Thuy Duong NGO ; Cong Luan TRAN ; Poul Erik HANSEN ; Quang Ton THAT
Natural Product Sciences 2024;30(4):237-243
Vietnam boasts a rich and diverse flora, with many endemic species. Among them, Ngoc Linh ginseng (Vietnamese ginseng; scientific name: Panax vietnamensis Ha et Grushv.), a high-value endemic ginseng species, has been recognized as a national treasure. While numerous studies have been conducted on its rhizomes and roots, research on its leaves remains limited. In this study, six compounds (1–6) were isolated from the methanol extract of the leaves of P. vietnamensis. Their structures were elucidated using ESI-MS, 1D and 2D NMR spectroscopic methods, and comparisons with known literature data. The identified compounds are: 12β,20(R),25-β trihydroxydammara-3-O-β-D-glucopyranoside (1); 12β,20(R),25-trihydroxydammara-3-O-β-D-glucopyranosyl- (1→2)-β-D-glucopyranoside (2); notoginsenoside SFt1 (3); ginsenoside Rh2 (4); ginsenoside Rg3 (5) and notoginsenoside L1 (6). Except for compound 3, which was isolated from the leaves for the first time, the other five compounds are reported from this species for the first time. The α-glucosidase inhibition assay of the pure isolated compounds revealed that compounds 1, 4, and 6 exhibited significant activities, with IC50 values of 133.5, 105.5, and 14.9, respectively. For comparison, the positive control, acarbose, had an IC50 value of 138.2 µM.
7.Push forward LC-MS-based therapeutic drug monitoring and pharmacometabolomics for anti-tuberculosis precision dosing and comprehensive clinical management.
Nguyen Quang THU ; Nguyen Tran Nam TIEN ; Nguyen Thi Hai YEN ; Thuc-Huy DUONG ; Nguyen Phuoc LONG ; Huy Truong NGUYEN
Journal of Pharmaceutical Analysis 2024;14(1):16-38
The spread of tuberculosis (TB), especially multidrug-resistant TB and extensively drug-resistant TB, has strongly motivated the research and development of new anti-TB drugs. New strategies to facilitate drug combinations, including pharmacokinetics-guided dose optimization and toxicology studies of first- and second-line anti-TB drugs have also been introduced and recommended. Liquid chromatography-mass spectrometry (LC-MS) has arguably become the gold standard in the analysis of both endo- and exo-genous compounds. This technique has been applied successfully not only for therapeutic drug monitoring (TDM) but also for pharmacometabolomics analysis. TDM improves the effectiveness of treatment, reduces adverse drug reactions, and the likelihood of drug resistance development in TB patients by determining dosage regimens that produce concentrations within the therapeutic target window. Based on TDM, the dose would be optimized individually to achieve favorable outcomes. Pharmacometabolomics is essential in generating and validating hypotheses regarding the metabolism of anti-TB drugs, aiding in the discovery of potential biomarkers for TB diagnostics, treatment monitoring, and outcome evaluation. This article highlighted the current progresses in TDM of anti-TB drugs based on LC-MS bioassay in the last two decades. Besides, we discussed the advantages and disadvantages of this technique in practical use. The pressing need for non-invasive sampling approaches and stability studies of anti-TB drugs was highlighted. Lastly, we provided perspectives on the prospects of combining LC-MS-based TDM and pharmacometabolomics with other advanced strategies (pharmacometrics, drug and vaccine developments, machine learning/artificial intelligence, among others) to encapsulate in an all-inclusive approach to improve treatment outcomes of TB patients.
8.Evaluation of the positivity of the fecal occult blood test compared to the microscopic detection of red blood cells
Chi Cao LE ; Nu Phuong Anh TON ; Thi Minh Chau NGO ; Phuoc Vinh NGUYEN ; Thi Bich Thao DO ; Thi Ngoc Thuy HA ; Minh Tiep VO ; Thi Giang TRAN ; That Dong Duong TON
Hue Journal of Medicine and Pharmacy 2023;13(7):31-38
Backgrounds: Fecal occult blood testing (FOBT) is commonly used in colorectal cancer screening programs. Many studies have compared different FOBT methods, but the correlation between traditional red cell microscopy and FOBT remains unclear. Objectives: 1) To evaluate the rate of positive FOBT in patients with different disease groups; 2) To compare the sensitivity and specificity of red blood cells detection in fresh stool by microscopy technique and FOBT. Materials and methods: This was a cross-sectional study involving 120 patients from Hue University of Medicine and Pharmacy Hospital who requested a stool test from 4/2021 to 4/2022. Fresh stool samples were examined for the presence of red blood cells using traditional microscopy and FOBT technique. Results: The overall positivity rate of FOBT was 20%, and in the group of gastrointestinal diseases (n = 24), clinical anemia (n = 21), hepatobiliary diseases (n = 26) and other diseases (n = 49), it was 37.5%, 23.8%, 11.5% and 14.3%, respectively. In comparison with the FOBT technique, microscopic RBC detection had a sensitivity of 33.3% and a specificity of 100%. Conclusions: A high rate of fecal occult blood tests was observed in patients with gastrointestinal disorders. Microscopic erythrocyte detection has low sensitivity and many disadvantages compared to the rapid test. This rapid test should be widely used in clinical practice to aid in the diagnosis of gastrointestinal bleeding
9.Study on the effective control of postpreal blood glucose of resistant starch cakes in patients with type 2 diabetes
Huu Dung TRAN ; Quang Hung LE ; Bao Dung VO ; Hoang Vu NGUYEN ; Thanh Bao Yen LUONG ; That Hy TON ; Phuoc Hieu DOAN ; Thi Bich Hien PHAM ; Huu Tien NGUYEN ; Hai Thuy NGUYEN
Hue Journal of Medicine and Pharmacy 2023;13(7):52-58
Background: This study was conducted on 93 volunteers with type 2 diabetes to investigate the ability of acetylated wheat starch cake containing 32.1% resistant starch to control postprandial blood glucose levels. Material and methods: The study was designed using a crossover, double-blind trial method. During each testing day, after a minimum of 12 hours of overnight fasting, each participant consumed two identical cakes containing either 80 g of acetylated wheat starch or 80 g natural wheat starch with 330ml of water within 15 minutes. Blood glucose levels were measured at baseline, 60 mins (G1), and 120 mins (G2) after ingestion. The predictive value of factors that contribute to the ability of resistant starch to control postprandial blood glucose was determined by the area under the receiver operating characteristic (ROC) curve based on the combined effect of the cake weight-to-BMI ratio (g/m²BMI) and HbA1c. Results: 60 mins and 120 mins postprandial capillary glucose levels after consuming acetylated wheat starch cake (10.4 ± 1.2 và 9.2 ± 1.2 mmol/L, respectively) were significantly lower compared with natural wheat starch cake (13.3 ± 1.8 và 11.2 ± 1.8 mmol/L, respectively) (p < 0.05). For good control of postprandial blood glucose levels, a maximum of 80 g of acetylated wheat starch can be used per serving for patients with type 2 diabetes with HbA1c ≤ 7.25 without blood glucose-lowering medication is required. Conclusion: acetylated wheat starch has better ontroled of postprandial blood glucose compared with natural wheat starch in patients with type 2 diabetes. This is very suitable in the processing of diets including resistant starch for patients with type 2 diabetes for the purpose of both supporting treatment and improving quality of life.
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.

Result Analysis
Print
Save
E-mail