Blood Pressure After Endovascular Thrombectomy

Background and Purpose— The optimal level for blood pressure after endovascular thrombectomy in acute ischemic stroke is not well established. We sought to evaluate the association of post-endovascular thrombectomy systolic blood pressure (SBP) levels with clinical outcomes. Methods— We included endovascular thrombectomy–treated patients registered from 2014 to 2017 in the Safe Implementation of Treatments in Stroke International Thrombectomy Registry. The mean 24-hour SBP after endovascular thrombectomy treatment was analyzed both as a continuous variable and in intervals. The primary outcome was 3-month functional independence (modified Rankin Scale score of 0–2). The secondary outcomes were symptomatic intracerebral hemorrhage (SICH) and 3-month mortality. The SBP interval with the highest proportion of functional independence was chosen as reference. All analyses were performed for successful or unsuccessful recanalization (modified Treatment in Cerebral Ischemia score ≥2b or <2b, respectively). The results were adjusted for known confounders in logistic regression models. Results— In the multivariable analyses, a higher SBP value as a continuous variable was associated unfavorably with all outcomes in patients with successful recanalization (n=2920) and with more SICH in patients with unsuccessful recanalization (n=711). SBP interval ≥160 mm Hg was associated with less functional independence (adjusted odds ratio, 0.28 [95% CIs, 0.15–0.53]) and more SICH (adjusted odds ratio, 6.82 [95% CIs, 1.53–38.09]) compared with reference 100 to 119 mm Hg in patients with successful recanalization. SBP ≥160 mm Hg was associated with more SICH (adjusted odds ratio, 6.62 [95% CIs, 1.07–51.05]) compared with reference 120 to 139 mm Hg in patients with unsuccessful recanalization. Conclusions— Higher SBP values were associated with less functional independence at 3 months in patients with successful recanalization and with more SICH regardless of recanalization status.

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EXPRESS: Impact of renal impairment on short-term outcomes following endovascular thrombectomy for acute ischemic stroke: A systematic review and meta-analysis

International Journal of Stroke ◽

10.1177/17474930211047337 ◽

2021 ◽

pp. 174749302110473

Author(s):

Jin Pyeong Jeon ◽

Chih-Hao Chen ◽

Fon-Yih Tsuang ◽

Jianming Liu ◽

Michael D Hill ◽

...

Keyword(s):

Systematic Review ◽

Ischemic Stroke ◽

Renal Impairment ◽

Acute Ischemic Stroke ◽

Meta Analysis ◽

Functional Independence ◽

Continuous Variable ◽

Endovascular Thrombectomy ◽

Symptomatic Intracerebral Hemorrhage ◽

The Impact

Background. The impact of renal impairment (RI) on the outcomes of patients with acute ischemic stroke (AIS) treated with endovascular thrombectomy (EVT) was relatively limited and contradictory. We performed a systematic review and meta-analysis to investigate this. Aims. We registered a protocol on September 2020 and searched MEDLINE, EMBASE, and Google Scholar accordingly. RI was defined as an estimated glomerular filtration rate (eGFR) < 60 mL/min/1.73 m2. Predefined outcomes included functional independence (defined as a modified Rankin Scale of 0, 1, or 2) at 3 months, successful reperfusion, mortality, and symptomatic intracerebral hemorrhage (sICH). Summary of review. Eleven studies involving 3453 patients were included. For the unadjusted outcomes, RI was associated with fewer functional independence (odds ratio (OR), 0.49; 95% confidence interval (CI), 0.39â0.62) and higher mortality (OR, 2.55; 95% CI, 2.03â3.21). RI was not associated with successful reperfusion (OR, 0.80; 95% CI 0.63â1.00) and sICH (OR, 1.41; 95% CI, 0.95â2.10). For the adjusted outcomes, results derived from a multivariate meta-analysis were consistent with the respective unadjusted outcomes: functional independence (OR, 0.59; 95% CI, 0.45â0.77), mortality (OR, 2.23, 95% CI, 1.45â3.43), and sICH (OR, 1.34; 95% CI, 0.85â2.10). Conclusions. We presented the first systematic review to demonstrate that RI is associated with fewer functional independence and higher mortality. Future EVT studies should publish complete renal eGFR data to facilitate prognostic studies and permit eGFR to be analyzed in a continuous variable. Systematic Review Registration: PROSPERO CRD42020191309

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Association of Serum Bisphenol A with Hypertension in Thai Population

International Journal of Hypertension ◽

10.1155/2015/594189 ◽

2015 ◽

Vol 2015 ◽

pp. 1-8 ◽

Cited By ~ 16

Author(s):

Wichai Aekplakorn ◽

La-or Chailurkit ◽

Boonsong Ongphiphadhanakul

Keyword(s):

Blood Pressure ◽

Body Mass Index ◽

Odds Ratio ◽

Adjusted Odds Ratio ◽

Premenopausal Women ◽

Continuous Variable ◽

Estradiol Level ◽

Health Examination ◽

Thai Population ◽

Fourth Quartile

Objective. The present study aimed to examine the association between serum BPA and hypertension and evaluated whether it was influenced by estradiol level.Methods. A subsample of 2588 sera randomly selected from the Thai National Health Examination Survey IV, 2009, was measured for serum BPA and estradiol. Logistic regression was used to examine the association controlling for age, sex, diabetes, body mass index, and estradiol level.Results. Compared with the lowest quartile, the adjusted odds ratio (AOR) of hypertension for the fourth quartile of serum BPA was 2.16 (95% CI 1.31, 3.56) in women and 1.44 (0.99, 2.09) in men. There was no interaction between serum BPA and estradiol level. For analysis using log(BPA) as a continuous variable, the AOR per unit change in log(BPA) was 1.09 (95% CI 1.02, 1.16). Among postmenopausal women, the AOR for the fourth quartile of BPA was 2.33 (95% CI 1.31, 4.15) and, for premenopausal women, it was 2.12 (95% CI 0.87, 5.19).Conclusion. Serum BPA was independently associated with hypertension in women and was not likely to be affected by estrogen; however, its mechanism related to blood pressure needs further investigation.

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Outcome after stroke thrombolysis in patients >80 years treated within 3 hours vs >3–4.5 hours

Neurology ◽

10.1212/wnl.0000000000004499 ◽

2017 ◽

Vol 89 (15) ◽

pp. 1561-1568 ◽

Cited By ~ 11

Author(s):

Niaz Ahmed ◽

Kennedy R. Lees ◽

Peter A. Ringleb ◽

Christopher Bladin ◽

David Collas ◽

...

Keyword(s):

Scale Score ◽

Odds Ratio ◽

Adjusted Odds Ratio ◽

Time Window ◽

Functional Independence ◽

Absolute Difference ◽

Modified Rankin Scale ◽

Treatment Groups ◽

Symptomatic Intracerebral Hemorrhage ◽

Stroke Thrombolysis

Objective:To determine outcomes and risks of IV thrombolysis (IVT) in patients with acute ischemic stroke (AIS) >80 years of age within 3 hours compared to >3 to 4.5 hours recorded in the Safe Implementation of Treatment in Stroke (SITS) International Stroke Thrombolysis Registry.Methods:A total of 14,240 (year 2003–2015) patients >80 years of age with AIS were treated with IVT ≤4.5 hours of stroke onset (3,558 in >3–4.5 hours). Of these, 8,658 (2,157 in >3–4.5 hours) were treated otherwise according to the European Summary of Product Characteristics (EU SmPC) criteria for alteplase. Outcomes were 3-month functional independence (modified Rankin Scale score 0–2), mortality, and symptomatic intracerebral hemorrhage (SICH)/SITS. Results were compared between the groups treated in >3 to 4.5 and ≤3 hours.Results:Median age was 84 years; 61% were female in both groups. Median NIH Stroke Scale score was 12 vs 14 in the >3- to 4.5- and ≤3-hour group, respectively. Three-month functional independence was 34% vs 35% (adjusted odds ratio [aOR] 0.78, 95% confidence interval [CI] 0.69–0.89, p < 0.001); mortality was 31% vs 32% (aOR 1.10, 95% CI 0.97–1.25, p = 0.13); and SICH/SITS was 2.7% vs 1.6% (aOR 1.72, 95% CI 1.25–2.35, p = 0.001). In EU SmPC–compliant patients, 3-month functional independence was 36 vs 37% (aOR 0.79, 95% CI 0.68–0.92, p = 0.002), mortality was 29% vs 29.6% (aOR 1.10, 95% CI 0.95–1.28, p = 0.20), and SICH/SITS was 2.7% vs 1.6% (aOR 1.62, 95% CI 1.12–2.34, p = 0.01).Conclusions:In this observational study, unselected patients >80 years of age treated with IVT after 3 hours vs earlier had a slightly higher rate of SICH and similar unadjusted functional outcome but poorer adjusted outcome. The absolute difference between the treatment groups is small, and elderly patients should not be denied IVT in the later time window solely because of age without other contraindications.

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Blood Pressure Trajectory Groups and Outcome After Endovascular Thrombectomy: A Multicenter Study

Stroke ◽

10.1161/strokeaha.121.034408 ◽

2021 ◽

Author(s):

Nils H. Petersen ◽

Sreeja Kodali ◽

Can Meng ◽

Fangyong Li ◽

Cindy Khanh Nguyen ◽

...

Keyword(s):

Blood Pressure ◽

Ischemic Stroke ◽

Odds Ratio ◽

Functional Outcomes ◽

Adjusted Odds Ratio ◽

Hemorrhagic Transformation ◽

Endovascular Thrombectomy ◽

Increased Risk ◽

Symptomatic Intracranial Hemorrhage ◽

Trajectory Group

Background and Purpose: Elevated blood pressure after endovascular thrombectomy (EVT) has been associated with an increased risk of hemorrhagic transformation and poor functional outcomes. However, the optimal hemodynamic management after EVT remains unknown, and the blood pressure course in the acute phase of ischemic stroke has not been well characterized. This study aimed to identify patient subgroups with distinct blood pressure trajectories after EVT and study their association with radiographic and functional outcomes. Methods: This multicenter retrospective cohort study included consecutive patients with anterior circulation large-vessel occlusion ischemic stroke who underwent EVT. Repeated time-stamped blood pressure data were recorded for the first 72 hours after thrombectomy. Latent variable mixture modeling was used to separate subjects into five groups with distinct postprocedural systolic blood pressure (SBP) trajectories. The primary outcome was functional status, measured on the modified Rankin Scale 90 days after stroke. Secondary outcomes included hemorrhagic transformation, symptomatic intracranial hemorrhage, and death. Results: Two thousand two hundred sixty-eight patients (mean age [±SD] 69±15, mean National Institutes of Health Stroke Scale 15±7) were included in the analysis. Five distinct SBP trajectories were observed: low (18%), moderate (37%), moderate-to-high (20%), high-to-moderate (18%), and high (6%). SBP trajectory group was independently associated with functional outcome at 90 days ( P <0.0001) after adjusting for potential confounders. Patients with high and high-to-moderate SBP trajectories had significantly greater odds of an unfavorable outcome (adjusted odds ratio, 3.5 [95% CI, 1.8–6.7], P =0.0003 and adjusted odds ratio, 2.2 [95% CI, 1.5–3.2], P <0.0001, respectively). Subjects in the high-to-moderate group had an increased risk of symptomatic intracranial hemorrhage (adjusted odds ratio, 1.82 [95% CI, 1–3.2]; P =0.04). No significant association was found between trajectory group and hemorrhagic transformation. Conclusions: Patients with acute ischemic stroke demonstrate distinct SBP trajectories during the first 72 hours after EVT that have differing associations with functional outcome. These findings may help identify potential candidates for future blood pressure modulation trials.

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Pulmonary restriction predicts long-term pulmonary impairment in people with HIV and tuberculosis

BMC Pulmonary Medicine ◽

10.1186/s12890-020-01368-4 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Sara C. Auld ◽

Hardy Kornfeld ◽

Pholo Maenetje ◽

Mandla Mlotshwa ◽

William Chase ◽

...

Keyword(s):

Lung Function ◽

Confidence Interval ◽

Odds Ratio ◽

Adjusted Odds Ratio ◽

Chronic Obstructive ◽

Obstructive Pulmonary Disease ◽

Logistic Regression Models ◽

Pulmonary Impairment ◽

Mixed Pattern

Abstract Background While tuberculosis is considered a risk factor for chronic obstructive pulmonary disease, a restrictive pattern of pulmonary impairment may actually be more common among tuberculosis survivors. We aimed to determine the nature of pulmonary impairment before and after treatment among people with HIV and tuberculosis and identify risk factors for long-term impairment. Methods In this prospective cohort study conducted in South Africa, we enrolled adults newly diagnosed with HIV and tuberculosis who were initiating antiretroviral therapy and tuberculosis treatment. We measured lung function and symptoms at baseline, 6, and 12 months. We compared participants with and without pulmonary impairment and constructed logistic regression models to identify characteristics associated with pulmonary impairment. Results Among 134 participants with a median CD4 count of 110 cells/μl, 112 (83%) completed baseline spirometry at which time 32 (29%) had restriction, 13 (12%) had obstruction, and 9 (7%) had a mixed pattern. Lung function was dynamic over time and 30 (33%) participants had impaired lung function at 12 months. Baseline restriction was associated with greater symptoms and with long-term pulmonary impairment (adjusted odds ratio 5.44, 95% confidence interval 1.16–25.45), while baseline obstruction was not (adjusted odds ratio 1.95, 95% confidence interval 0.28–13.78). Conclusions In this cohort of people with HIV and tuberculosis, restriction was the most common, symptomatic, and persistent pattern of pulmonary impairment. These data can help to raise awareness among clinicians about the heterogeneity of post-tuberculosis pulmonary impairment, and highlight the need for further research into mediators of lung injury in this vulnerable population.

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Sex Differences in the Association between Internet Usage and Overweight/Obesity: Evidence from a Nationally Representative Survey in Nepal

Sexes ◽

10.3390/sexes2010011 ◽

2021 ◽

Vol 2 (1) ◽

pp. 132-143

Author(s):

Juwel Rana ◽

Md. Momin Islam ◽

John Oldroyd ◽

Nandeeta Samad ◽

Rakibul Islam

Keyword(s):

Odds Ratio ◽

Regression Models ◽

Internet Use ◽

Adjusted Odds Ratio ◽

Internet Usage ◽

The Internet ◽

Logistic Regression Models ◽

Biological Sex ◽

Obesity Interventions ◽

Nationally Representative

Objective: To examine the associations between internet use and overweight/obesity in people aged 15–49 years in Nepal and the extent to which these associations differ by biological sex. Materials and methods: The study analyzed the nationally representative Nepal Demographic and Health Survey (NDHS) 2016 data. Multivariable ordinal logistic regression models were fitted to estimate the total effects of internet use (IU) in the last 12 months and frequency of internet use (FIU) in the last month on overweight/obesity adjusted for potential confounders. Results: Of the 10,380 participants, the prevalence of overweight/obesity by IU was 38% (95% confidence interval (CI): 35.9%, 40.1%) for males and 44.1% (95% CI: 41.6%, 46.6%) for female. The likelihood of overweight/obesity was significantly higher (adjusted odds ratio (aOR): 1.55; 95% CI: 1.40, 1.73; p < 0.001) among those participants who used the internet compared to the participants who did not use the internet in the last 12 months. Similar associations were observed when using the augmented measure of exposure-FIU in the last month. We observed the modification effect of sex in the associations of IU (p-difference < 0.001) and FIU (p-difference < 0.002) with overweight/obesity in Nepal. Conclusions: Our findings suggest that future overweight/obesity interventions in Nepal discourage unnecessary internet use, particularly among males.

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Racial Disparities in Invasive Management for Patients With Acute Myocardial Infarction With Chronic Kidney Disease

Circulation Cardiovascular Interventions ◽

10.1161/circinterventions.121.011171 ◽

2021 ◽

Author(s):

Jennifer A. Rymer ◽

Shuang Li ◽

Patrick H. Pun ◽

Laine Thomas ◽

Tracy Y. Wang

Keyword(s):

Myocardial Infarction ◽

Chronic Kidney Disease ◽

Kidney Disease ◽

Racial Disparities ◽

Odds Ratio ◽

Adjusted Odds Ratio ◽

Logistic Regression Models ◽

Black Patients ◽

Invasive Management ◽

White Patients

Background: Due to increased risks of contrast nephropathy, chronic kidney disease (CKD) can deter consideration of invasive management for patients with myocardial infarction (MI). Black patients have a higher prevalence of CKD. Whether racial disparities exist in the use of invasive MI management for patients with CKD presenting with MI is unknown. Methods: We examined 717 012 White and 99 882 Black patients with MI treated from 2008 to 2017 at 914 hospitals in the National Cardiovascular Data Registry Chest Pain—MI Registry. CKD status was defined as estimated glomerular filtration rate (eGFR) ≥90 mL/(min·1.73 m 2 ; no CKD), eGFR <90 but ≥60 (mild), eGFR <60 but ≥30 (moderate), and eGFR <30 or dialysis (severe). We used multivariable logistic regression models to examine the interaction of race and CKD severity in invasive MI management. Results: Among those with MI, Black patients were more likely than White patients to have CKD (eGFR <90; 61.4% versus 58.5%; P <0.001). Among those with MI and CKD, Black patients were more likely than White patients to have severe CKD (21.2% versus 12.4%; P <0.001). Patients with CKD were more likely than those without CKD to have diabetes or heart failure; Black patients with CKD were more likely to have these comorbidities when compared with White patients with CKD (all P <0.0001). Black race and CKD were associated with a lower likelihood of invasive management (adjusted odds ratio, 0.78 [95% CI, 0.75–0.81]; adjusted odds ratio, 0.72 [95% CI, 0.70–0.74]; P <0.001 for both). At eGFR levels ≥10, Black patients were significantly less likely than White patients to undergo invasive management. Conclusions: Black patients with MI and mild or moderate CKD were less likely to undergo invasive management compared with White patients with similar CKD severity. National efforts are needed to address racial disparities that may remain in the invasive management of MI.

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Impact of remote biometric monitoring on cost and hospitalization outcomes in peritoneal dialysis

Journal of Telemedicine and Telecare ◽

10.1177/1357633x18784417 ◽

2018 ◽

Vol 25 (10) ◽

pp. 581-586 ◽

Cited By ~ 11

Author(s):

Susie Q Lew ◽

Neal Sikka ◽

Clinton Thompson ◽

Manya Magnus

Keyword(s):

Blood Pressure ◽

Peritoneal Dialysis ◽

Confidence Interval ◽

Odds Ratio ◽

Adjusted Odds Ratio ◽

Hospital Length ◽

Cost Of Care ◽

Hospital Length Of Stay ◽

Inpatient Setting ◽

Post Intervention

IntroductionPeritoneal dialysis is a home-based therapy for individuals with end-stage renal disease. Telehealth, and in particular – remote monitoring, is making inroads in managing this cohort.MethodsWe examined whether daily remote biometric monitoring (RBM) of blood pressure and weight among peritoneal dialysis patients was associated with changes in hospitalization rate and hospital length of stay, as well as outpatient, inpatient and overall cost of care.ResultsOutpatient visit claim payment amounts (in US dollars derived from CMS data) decreased post-intervention relative to pre-intervention for those at age 18-54 years. For certain subgroups, non- or nearly-significant changes were found among female and Black participants. There was no change in inpatient costs post-intervention relative to pre-intervention for females and while the overall visit claim payment amounts increased in the outpatient setting slightly (US$511.41 (1990.30) vs. US$652.61 (2319.02), p = 0.0783) and decreased in the inpatient setting (US$10,835.30 (6488.66) vs. US$10,678.88 (15,308.17), p = 0.4588), these differences were not statistically significant. Overall cost was lower if RBM was used for assessment of blood pressure and/or weight (US$–734.51, p < 0.05). Use of RBM collected weight was associated with fewer hospitalizations (adjusted odds ratio 0.54, 95% confidence interval 0.33–0.89) and fewer days hospitalized (adjusted odds ratio 0.46, 95% confidence interval 0.26–0.81). Use of RBM collected blood pressure was associated with increased days of hospitalization and increased odds of hospitalization.ConclusionsRBM offers a powerful opportunity to provide care to those receiving home therapies such as peritoneal dialysis. RBM may be associated with reduction in both inpatient and outpatient costs for specific sub-groups receiving peritoneal dialysis.

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Blood pressure reduction and outcome after endovascular therapy with successful reperfusion: a multicenter study

Journal of NeuroInterventional Surgery ◽

10.1136/neurintsurg-2019-015561 ◽

2019 ◽

Vol 12 (10) ◽

pp. 932-936 ◽

Cited By ~ 3

Author(s):

Mohammad Anadani ◽

Adam S Arthur ◽

Ali Alawieh ◽

Yser Orabi ◽

Andrei Alexandrov ◽

...

Keyword(s):

Blood Pressure ◽

Blood Pressure Reduction ◽

Final Analysis ◽

Mixed Linear Model ◽

Continuous Variable ◽

Anterior Circulation ◽

Poor Outcome ◽

Symptomatic Intracerebral Hemorrhage ◽

Elevated Systolic Blood Pressure ◽

Safety Outcomes

BackgroundElevated systolic blood pressure (SBP) after mechanical thrombectomy (MT) correlates with worse outcome. However, the association between SBP reduction (SBPr) and outcome after successful reperfusion with MT is not well established.ObjectiveTo investigate the association between SBPr in the first 24 hours after successful reperfusion and the functional and safety outcomes of MT.MethodsA multicenter retrospective study, which included 10 comprehensive stroke centers, was carried out. Patients with acute ischemic stroke and anterior circulation large vessel occlusions who achieved successful reperfusion via MT were included. SBPr was calculated using the formula 100×([admission SBP−mean SBP]/admission SBP). Poor outcome was defined as a modified Rankin Scale (mRS) score of 3–6 at 90 days. Safety endpoints included symptomatic intracerebral hemorrhage, mortality, and requirement for hemicraniectomy during admission. A generalized mixed linear model was used to study the association between SBPr and outcomes.ResultsA total of 1361 patients were included in the final analysis. SBPr as a continuous variable was inversely associated with poor outcome (OR=0.97; 95% CI 0.95 to 0.98; p<0.001) but not with the safety outcomes. Subanalysis based on reperfusion status showed that SBPr was associated with lower odds of poor outcome only in patients with complete reperfusion (modified Thrombolysis in Cerebral Infarction (mTICI 3)) but not in patients with incomplete reperfusion (mTICI 2b). When SBPr was divided into categories (<1%, 1%–10%, 11%–20%, >20%), the rate of poor outcome was highest in the first group.ConclusionSBPr in the first 24 hours after successful reperfusion was inversely associated with poor outcome. No association between SBPr and safety outcome was found.

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Association between hydroxocobalamin administration and acute kidney injury after smoke inhalation: a multicenter retrospective study

Critical Care ◽

10.1186/s13054-019-2706-0 ◽

2019 ◽

Vol 23 (1) ◽

Cited By ~ 1

Author(s):

François Dépret ◽

Clément Hoffmann ◽

Laura Daoud ◽

Camille Thieffry ◽

Laure Monplaisir ◽

...

Keyword(s):

Acute Kidney Injury ◽

Retrospective Study ◽

Confidence Interval ◽

Odds Ratio ◽

Adjusted Odds Ratio ◽

Kidney Injury ◽

Smoke Inhalation ◽

Logistic Regression Models ◽

Increased Risk ◽

The Impact

Abstract Background The use of hydroxocobalamin has long been advocated for treating suspected cyanide poisoning after smoke inhalation. Intravenous hydroxocobalamin has however been shown to cause oxalate nephropathy in a single-center study. The impact of hydroxocobalamin on the risk of acute kidney injury (AKI) and survival after smoke inhalation in a multicenter setting remains unexplored. Methods We conducted a multicenter retrospective study in 21 intensive care units (ICUs) in France. We included patients admitted to an ICU for smoke inhalation between January 2011 and December 2017. We excluded patients discharged at home alive within 24 h of admission. We assessed the risk of AKI (primary endpoint), severe AKI, major adverse kidney (MAKE) events, and survival (secondary endpoints) after administration of hydroxocobalamin using logistic regression models. Results Among 854 patients screened, 739 patients were included. Three hundred six and 386 (55.2%) patients received hydroxocobalamin. Mortality in ICU was 32.9% (n = 243). Two hundred eighty-eight (39%) patients developed AKI, including 186 (25.2%) who developed severe AKI during the first week. Patients who received hydroxocobalamin were more severe and had higher mortality (38.1% vs 27.2%, p = 0.0022). The adjusted odds ratio (95% confidence interval) of AKI after intravenous hydroxocobalamin was 1.597 (1.055, 2.419) and 1.772 (1.137, 2.762) for severe AKI; intravenous hydroxocobalamin was not associated with survival or MAKE with an adjusted odds ratio (95% confidence interval) of 1.114 (0.691, 1.797) and 0.784 (0.456, 1.349) respectively. Conclusion Hydroxocobalamin was associated with an increased risk of AKI and severe AKI but was not associated with survival after smoke inhalation. Trial registration ClinicalTrials.gov, NCT03558646

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