Sex-Specific Differences in Short-Term and Long-Term Outcomes in Acute Stroke Patients from Qatar

2020 ◽  
Vol 83 (2) ◽  
pp. 154-161 ◽  
Author(s):  
Naveed Akhtar ◽  
Mahesh Kate ◽  
Saadat Kamran ◽  
Rajvir Singh ◽  
Zain Bhutta ◽  
...  
Keyword(s):  
Acute Stroke ◽  
Major Adverse Cardiovascular Events ◽  
Stroke Patients ◽  
Long Term Outcomes ◽  
Short Term ◽  
Term Outcome ◽  
Contributory Factors ◽  
Short Term Outcome

Background: Sex differences may determine presentation, utility of treatment, rehabilitation, and occurrences of major adverse cardiovascular events (MACEs) in acute stroke (AS). Objective:The purpose of the study was to evaluate the short-term prognosis and long-term outcomes in MACEs in Qatari nationals admitted with AS. Methods: All AS patients admitted between January 2014 and February 2019 were included. We evaluated the preadmission modified Rankin scale (mRS) score, etiology and severity of symptoms, complications, and functional recovery at discharge and 90 days. MACEs were recorded for 5 years. Results: There were 891 admissions for AS (mean age 64.0 ± 14.2 years) (male, n = 519 [mean age ± SD 62.9 ± 14.1 years]; female, n = 372 [mean age ± SD 65.6 ± 14.2 years] p = 0.005). There were no differences in the preadmission mRS and severity of symptoms as measured on National Institute of Stroke Scale. At discharge, the outcome was better (mRS 0–2) in men (57.8 vs. 46.0%), p = 0.0001. This difference persisted at the 90-day follow-up (mRS 0–2, male 69.4% vs. female 53.2%, p = 0.0001). At the 90-day follow-up, more women died (total deaths 70; women 38 [10.2%] versus men 32 [6.2%], p = 0.03). MACEs occurred in 25.6% (133/519) males and 30.9% (115/372) females over the 5-year follow-up period (odds ratio 0.77, 95% confidence interval 0.57–1.0, p = 0.83). Conclusions: Female patients have a poor short-term outcome following an AS when corrected for age and comorbidities. While our study cannot explain the reasons for the discrepancies, higher poststroke depression and social isolation in women may be important contributory factors, and requires further studies are required to confirm these findings.

Natural history of longitudinally extensive transverse myelitis in 35 Hispanic patients with systemic lupus erythematosus: good short-term functional outcome and paradoxical increase in long-term mortality

Lupus ◽  
2018 ◽  
Vol 27 (8) ◽  
pp. 1279-1286 ◽  
Author(s):  
F D Flores-Silva ◽  
O Longoria-Lozano ◽  
D Aguirre-Villarreal ◽  
H Sentíes-Madrid ◽  
F Vega-Boada ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Functional Outcome ◽  
Lupus Erythematosus ◽  
Transverse Myelitis ◽  
Systemic Lupus ◽  
Short Term ◽  
Term Outcome ◽  
Short Term Outcome

Background and objective Acute transverse myelitis (TM) is an infrequent neurological complication of systemic lupus erythematosus (SLE). Short-term outcome varies widely between cohorts. Little is known about the epidemiology and long-term functional outcome of TM associated to SLE. Methods Patients with SLE and acute TM were identified during hospital admission, visits to the Emergency Room or the Neurology Outpatient Clinic. We evaluated ambispectively those patients with SLE presenting with clinical myelopathy and corroborated with spinal MRI. Cases were divided as partial (non-paralyzing) or complete (paralyzing). We determined long-term functional outcome as well as mortality in those patients with follow-up periods of at least five years. Results We identified 35 patients (partial, n = 15; complete, n = 20) in which complete clinical and imaging data were available (26 with follow-up ≥ 5 years). Patients with complete TM were significantly older than those with partial forms. Positive antiphospholipid antibodies were observed in 80% of patients, suggesting a possible mechanistical role. Surprisingly, functional recovery at one year was in general good; however, we observed a five-year mortality of 31% because of sepsis (in 10 cases) or pulmonary embolism (in one case). Conclusions Short-term outcome of SLE-related TM is generally good, and recurrence rate is low. However, we observed a long-term fatality rate of 31% for reasons unrelated to TM, suggesting that TM is a manifestation of severe immune dysregulation and a predictor of severity and mortality in patients with SLE.

Heart transplantation in children and infants: Short-term outcome and long-term follow-up

2001 ◽  
Vol 5 (6) ◽  
pp. 457-462 ◽  
Author(s):  
J. Bauer ◽  
J. Thul ◽  
U. Krämer ◽  
K. J. Hagel ◽  
H. Akintürk ◽  
...  
Keyword(s):  
Heart Transplantation ◽  
Short Term ◽  
Term Outcome ◽  
Short Term Outcome ◽  
Long Term Follow Up

scholarly journals Association Between Blood Pressure Variability and Short-Term Outcome After Intra-arterial Thrombectomy in Acute Stroke Patients With Large-Vessel Occlusion

2021 ◽  
Vol 11 ◽  
Author(s):  
Mengqi Yang ◽  
Tao Lu ◽  
Baohui Weng ◽  
Yi He ◽  
Hong Yang
Keyword(s):  
Blood Pressure ◽  
Confidence Interval ◽  
Acute Stroke ◽  
Blood Pressure Variability ◽  
Large Vessel Occlusion ◽  
Stroke Patients ◽  
Short Term ◽  
Vessel Occlusion ◽  
Term Outcome ◽  
Short Term Outcome

The optimal range of blood pressure variability (BPV) for acute stroke patients with large-vessel occlusion (LVO) remains unclear. This study investigated the association between BPV from admission through the first 24 h after intra-arterial thrombectomy (IAT) and short-term outcome in LVO patients. We retrospectively analyzed 257 consecutive patients with LVO stroke who were treated with IAT. BP values were recorded at 2-h intervals from admission through the first 24 h after IAT. BPV, as reflected by pulse pressure variability (PPV), was determined based on standard deviation (SD), coefficient of variation (CV), successive variation (SV), and the difference between maximum and minimum blood pressure (ΔBP; systolic BP minus diastolic BP). The association between BPV and clinical outcome (Modified Rankin Scale score at 90 days) was analyzed by multivariate logistic regression analysis. Of the 257 included patients, 70 had a good outcome at 3 months. PPV from admission through the first 24 h after IAT was independently associated in a graded manner with poor outcome [multivariable-adjusted odds ratios (95% confidence interval) for the highest of PPV were 43.0 (8.7–212.8) for SD, 40.3 (9.8–165.0) for CV, 55.0 (11.2–271.2) for SV, and 40.1 (8.0–201.9) for ΔBP]. The area under the receiver operating characteristic curve (95% confidence interval) of the PPV parameters were 0.924 (0.882–0.965) for SD, 0.886 (0.835–0.938) for CV, 0.932 (0.891–0.973) for SV, and 0.892 (0.845–0.939) for ΔBP, and the Youden index values were 0.740, 0.633, 0.759, and 0.756, respectively. In summary, BPV from admission through the first 24 h after IAT was independently associated with poor outcome at 3 months in patients with LVO, with greater variability corresponding to a stronger association. Thus, PPV may be a clinically useful predictor of functional prognosis in LVO patients treated with IAT.

Abstract TP301: Gender Differences in Short- and Long-Term Outcome of Patients With Suspected Acute Stroke

Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Naveed Akhtar ◽  
Saadat Kamran ◽  
Rajvir Singh ◽  
Zain Bhutta ◽  
Debby Morgan ◽  
...  
Keyword(s):  
Gender Differences ◽  
Regression Analysis ◽  
Acute Stroke ◽  
Short Term ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Poor Outcome ◽  
Significant Difference

Background: There are gender differences in the short-term prognosis following acute stroke suggesting that outcome is less favorable in women. Factors contributing to this poor outcome include preexisting morbidity, stroke severity and higher age. Most previous studies have looked at short-term prognosis. PURPOSE: We investigated whether gender differences have a differential impact on incidence of short-term outcome and long-term major adverse cardiovascular events (MACE) including stroke, myocardial infarction, unstable angina, coronary revascularization procedure, and death in patients with suspected acute stroke. Methods: The study used a prospective cohort of Qatari patients with suspected acute stroke between January 2014 and February 2019. We calculated the modified Rankin score (mRS) at discharge and 90-days (short-term) and MACE (long-term) outcomes in both genders. To determine the independent predictor for MACE, the Cox proportional hazards regression analysis was used and summarized as hazard ratio and 95% confidential interval. Results: A total of 1372 patients identified. At 90-days, women found to have significantly poorer outcome (34.0% vs 23.4%, p<0.001) mortality (8.5% vs 5.2%, p<0.03) overall. MACE was present in 30.5% (418/1372) during follow-up (57.2% males and 54.3% females, p=0.32). Median follow-up was 44.6 months for females and 47.2 months for males. Mean age in MACE group was significantly higher (65.5±15.3 vs 60.1±15.9, p< 0.001). Hypertension, diabetes, prior history of stroke, coronary artery disease, and atrial fibrillation on admission was more significant in MACE group, while obesity (BMI ≥ 30 kg/m2) was more common in non-MACE group. Patients with MACE had higher NIHSS on admission (6.1±7.4 vs 3.5±5.3, p<0.001), HbA1c (7.7±2.3 vs 7.4±2.3, p=0.02) and poorer prognosis (44.5% vs 18.6%, p<0.001) and higher mortality at 90-days. Once corrected, the hazard regression analysis showed that no difference in MACE between the two genders. Conclusion: Our results show that despite higher mortality and poor outcome at 90-days, the long-term outcome in women did not show any significant difference from men in this cohort. This may be related to older age and presence of cardiovascular risk factors.

Characteristics of Coronary Artery Stenting in the Elderly over 70 Years Old: Short-Term Outcome and Long-Term Angiographic and Clinical Follow-Up

2001 ◽  
Vol 31 (10) ◽  
pp. 996 ◽  
Author(s):  
Wook Sung Chung ◽  
Chong Jin Kim ◽  
Ki Bae Seung ◽  
Eun Joo Cho ◽  
Keon Woong Moon ◽  
...  
Keyword(s):  
Coronary Artery ◽  
The Elderly ◽  
Short Term ◽  
Term Outcome ◽  
Short Term Outcome ◽  
Coronary Artery Stenting

Short-term outcome and long-term follow-up following coronary angioplasty in the young patient: An 8-year experience

1989 ◽  
Vol 118 (5) ◽  
pp. 873-877 ◽  
Author(s):  
Gregg W Stone ◽  
Robert W Ligon ◽  
Barry D Rutherford ◽  
David R McConahay ◽  
Geoffrey O Hartzler
Keyword(s):  
Young Patient ◽  
Coronary Angioplasty ◽  
Short Term ◽  
Term Outcome ◽  
Short Term Outcome ◽  
Long Term Follow Up

scholarly journals Coronary artery stenting in the elderly: short-term outcome and long-term angiographic and clinical follow-up

1998 ◽  
Vol 32 (3) ◽  
pp. 577-583 ◽  
Author(s):  
Joseph De Gregorio ◽  
Yoshio Kobayashi ◽  
Remo Albiero ◽  
Bernhard Reimers ◽  
Carlo Di Mario ◽  
...  
Keyword(s):  
Coronary Artery ◽  
The Elderly ◽  
Short Term ◽  
Term Outcome ◽  
Short Term Outcome ◽  
Coronary Artery Stenting

Outcome of ventriculoperitoneal shunt placement in Grade IV tubercular meningitis with hydrocephalus: a retrospective analysis in 95 patients

2009 ◽  
Vol 4 (2) ◽  
pp. 176-183 ◽  
Author(s):  
Umesh Srikantha ◽  
Jagadeesh V. Morab ◽  
Savitr Sastry ◽  
Rojin Abraham ◽  
Anandh Balasubramaniam ◽  
...  
Keyword(s):  
Long Term Outcomes ◽  
Short Term ◽  
Tubercular Meningitis ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Vp Shunt ◽  
Shunt Placement ◽  
Short Term Outcome ◽  
Short And Long Term

Object Hydrocephalus is the most common complication of tubercular meningitis (TBM). Relieving hydrocephalus by ventriculoperitoneal (VP) shunt placement has been considered beneficial in patients in Palur Grade II or III. The role of VP shunt placement in those of Grade IV is controversial and the general tendency is to avoid its use. Some authors have suggested that patients in Grade IV should receive a shunt only if their condition improves with a trial placement of an external ventricular drain (EVD). In the present study, the authors assessed the outcome of VP shunt placement in patients in Grade IV TBM with hydrocephalus to examine the factors predicting outcome and to determine whether a trial with an EVD is absolutely necessary prior to shunt placement. Methods Ninety-five consecutive cases of TBM with hydrocephalus in which the patients underwent VP shunt placement were retrospectively analyzed, and direct VP shunts were placed whenever possible. An EVD was placed first only in the presence of deranged blood parameters. Outcomes were assessed both in the short and long term. Results The mean patient age was 17.5 years (range 1–55 years). Fifty-two patients underwent direct VP shunt placement, and the remaining 43 received EVDs first. Overall, 33 and 45% of patients had favorable short- and long-term outcomes, respectively. Age older than 3 years and duration of altered sensorium ≤ 3 days were predictive of a favorable short-term outcome. Glasgow Coma Scale score at presentation was predictive of long-term outcome. Of the patients who did not improve with placement of an EVD prior to VP shunt insertion, 24 and 18% had favorable short- and long-term outcomes, respectively; this was not significantly different from the outcome in the patients who underwent direct VP shunt placement. Conclusions Direct VP shunt placement is an effective option in patients with Grade IV TBM with hydrocephalus. Age and duration of altered sensorium are predictive of short-term outcome, while Glasgow Coma Scale score at presentation predicts long-term outcome. Ventriculoperitoneal shunts should be considered even in patients who do not improve with an EVD.

scholarly journals Short-term Outcome and Long-term Follow-up of Percutaneous Coronary Intervention in Patients Aged 40 Years or Younger.

1995 ◽  
Vol 59 (6) ◽  
pp. 323-328
Author(s):  
Kazuhiro Hara ◽  
Yuji Ikari ◽  
Masao Yamasaki ◽  
Fumihiko Saeki ◽  
Tsutomu Tamura ◽  
...  
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Coronary Intervention ◽  
Short Term ◽  
Term Outcome ◽  
Short Term Outcome ◽  
Percutaneous Coronary ◽  
Long Term Follow Up

scholarly journals Comparative short-term and long-term outcomes between internal and external intestinal plication in the management of small bowel obstruction

BMC Surgery ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Song Liu ◽  
Qiongyuan Hu ◽  
Lihua Shao ◽  
Xiaofeng Lu ◽  
Xiaofei Shen ◽  
...  
Keyword(s):  
Small Bowel ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Short Term ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Gut Dysfunction ◽  
Gut Function

Abstract Background Small bowel obstruction (SBO) is common and usually requires surgical intervention. Intestinal plication is a traditional but critical strategy for SBO in certain scenarios. This study is to compare the short-term and long-term outcome between internal and external plications in the management of SBO. Methods All patients receiving intestinal plication in our hospital were retrospectively collected. Short-term outcome including postoperative complications, reoperation, postoperative ICU stay, starting day of liquid diet and postoperative hospitalization, as well as long-term outcome including recurrence of obstruction, readmission, reoperation and death were compared between groups. Gut function at annual follow-up visits was evaluated as well. Results Nine internal and 11 external candidates were recruited into each group. The major causes of plication were adhesive obstruction, abdominal cocoon, volvulus and intussusception. Lower incidence of postoperative complication (p = 0.043) and shorter postoperative hospitalization (p = 0.049) was observed in internal group. One patient receiving external plication died from anastomosis leakage. During the 5-year follow-up period, the readmission rate was low in both groups (22.2 % vs. 9.1 %), and none of patients required reoperation or deceased. None of patients exhibited gut dysfunction, and all patients restored normal gut function after 4 years. Patients in external group demonstrated accelerated recovery of gut function after surgery. Conclusions This study compares short-term and long-term outcome of patients receiving internal or external intestinal plication. We suggest a conservative attitude toward external plication strategy. Surgical indication for intestinal plication is critical and awaits future investigations.

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