scholarly journals Pre-Diabetes is a Predictor of Short-Term Poor Outcomes After Acute Ischemic Stroke Using iv Thrombolysis.: Pre-Diabetes Might Be an Alienated Area From Medical Attention Before Stroke Onset

2020 ◽  
Author(s):  
Byoung-Gwon Kim ◽  
Ga-Yeon Kim ◽  
Jae-Kwan Cha
Keyword(s):  
Ischemic Stroke ◽  
Glucose Metabolism ◽  
Functional Outcomes ◽  
Hospital Death ◽  
Long Term Outcomes ◽  
Short Term ◽  
Normal Glucose ◽  
Poor Outcomes ◽  
Hba1c Levels

Abstract Backgrounds: Pre-diabetes is an intermediate state between normal glucose metabolism and diabetes. Recent studies suggest that the presence of pre-diabetes is associated with poor outcomes after AIS. However, the results have been controversial. This study examines whether pre-diabetes influences the patients' short and long-term outcomes for AIS using IV thrombolysis. Methods: We enrolled 661 AIS patients with IV thrombolysis. Based on the 2010 ADA guidelines, patients were classified as pre-diabetes, with HbA1c levels of 5.7%–6.4%; diabetes, HbA1c levels more than 6.5%; and NGM (normal glucose metabolism), with HbA1c levels less than 5.7%. We investigated short-term outcomes, including early neurologic deterioration (END), in-hospital death, and poor functional outcomes (mRS>2) at 90days. As for long-term outcomes, poor functional outcomes were measured at 1 year. Results: Of the 661 AIS patients treated with IV thrombolysis, 197 patients (29.8%) were diagnosed with pre-diabetes, and 210 (31.8%) were diagnosed with diabetes. In a multivariate analysis, pre-diabetes was an independent predictor for END (OR=2.02; 95% CI 1.12-3.62; p=0.02) and in-hospital death (OR=3.12; 95% CI 1.06-9.09; p=0.04). In contrast, diabetes was a significant independent factor for poor long-term outcomes (OR=1.75; 95% CI 1.09-2.78; p=0.02) after correcting confounding factors. Conclusion: Unlike diabetes, pre-diabetes can be an important predictor of short-term outcomes after AIS. However, more detailed research is needed to specify the precise mechanisms by which pre-diabetes affects the prognosis of acute ischemic stroke.

scholarly journals Pre-diabetes is a predictor of short-term poor outcomes after acute ischemic stroke using IV thrombolysis

BMC Neurology ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Byoung-Gwon Kim ◽  
Ga Yeon Kim ◽  
Jae-Kwan Cha
Keyword(s):  
Ischemic Stroke ◽  
Glucose Metabolism ◽  
Functional Outcomes ◽  
Hospital Death ◽  
Long Term Outcomes ◽  
Short Term ◽  
Normal Glucose ◽  
Poor Outcomes ◽  
Hba1c Levels

Abstract Backgrounds Pre-diabetes is an intermediate state between normal glucose metabolism and diabetes. Recent studies suggest that the presence of pre-diabetes is associated with poor outcomes after AIS. However, the results have been controversial. This study examines whether pre-diabetes influences the patients’ short and long-term outcomes for AIS using IV thrombolysis. Methods We enrolled 661 AIS patients with IV thrombolysis. Based on the 2010 ADA guidelines, patients were classified as pre-diabetes, with HbA1c levels of 5.7–6.4%; diabetes, with HbA1c levels more than 6.5%; and NGM (normal glucose metabolism), with HbA1c levels less than 5.7%. We investigated short-term outcomes, including early neurologic deterioration (END), in-hospital death, and poor functional outcomes (mRS > 2) at 90 days. As for long-term outcomes, poor functional outcomes were measured at 1 year. Results Of the 661 AIS patients treated with IV thrombolysis, 197 patients (29.8%) were diagnosed with pre-diabetes, and 210 (31.8%) were diagnosed with diabetes. In a multivariate analysis, pre-diabetes was an independent predictor for END (OR = 2.02; 95% CI 1.12–3.62; p = 0.02) and in-hospital death (OR = 3.12; 95% CI 1.06–9.09; p = 0.04). On the other hand, diabetes was a significant independent factor for poor long-term outcomes (OR = 1.75; 95% CI 1.09–2.78; p = 0.02) after correcting confounding factors. Conclusions Unlike diabetes, pre-diabetes can be an important predictor of short-term outcomes after AIS. However, a more detailed research is needed to specify the precise mechanisms through which pre-diabetes affects the prognosis of acute ischemic stroke.

Abstract T MP103: Long-Term Outcomes of Elderly Patients with Intracerebral Hemorrhage and Atrial Fibrillation

Stroke ◽  
2014 ◽  
Vol 45 (suppl_1) ◽  
Author(s):  
Melissa Stamplecoski ◽  
Jiming Fang ◽  
Moira K Kapral ◽  
Frank L Silver
Keyword(s):  
Ischemic Stroke ◽  
Elderly Patients ◽  
Major Bleeding ◽  
Long Term Outcomes ◽  
Short Term ◽  
Term Survival ◽  
Factors Associated ◽  
Short Term Mortality ◽  
Long Term Mortality

Background: There has been limited investigation into the long-term outcomes of elderly patients with intracerebral hemorrhage (ICH) and atrial fibrillation (AF). Although ICH is associated with high short-term mortality, the long-term mortality of those patients with AF who survive a first ICH is unknown, as is the true incidence of recurrent ICH, ischemic stroke and major bleeding. The aims of this study were to examine the long-term outcomes of a cohort of patients with ICH and AF and to identify factors associated with long-term survival. Methods: We used the Ontario Stroke Registry (OSR) to identify a population-based cohort of patients ≥ 65 years of age with ICH and AF who were admitted to one of Ontario’s 150 acute care hospitals between 2002 and 2011. Linkage to health administrative databases was performed to assess mortality at 30 days, 1 year and 2 years as well as rates of recurrent ICH, ischemic stroke and major hemorrhage at 1 year. Prescription drug utilization in the year following hospital discharge was assessed through linkage to the Ontario Drug Benefits (ODB) database. Multivariable logistic regression was used to identify factors associated with long-term survival in these patients. Results: Of the 1,236 elderly patients diagnosed with ICH, 329 (26.6%) had AF. Of those patients discharged alive, 21.1% were prescribed warfarin in the year following discharge. Mortality was 42.6% at 30 days, 58.7% at 1 year and 66.9% at 2 years. The all-cause readmission rate at 1 year was 12.1%, 5.0% for ischemic stroke, 3.5% for recurrent ICH and 7.5% for major bleeding. Multivariable analysis showed that being prescribed an antihypertensive agent (HR 0.151, p<0.0001), a statin (HR 0.463, p=0.0102) or warfarin (HR 0.136, p=0.0056) after ICH was associated with a decreased risk of death at 1 year. Conclusions: In patients with ICH and AF, the incidence of recurrent ICH is lower than the incidence of ischemic stroke or major bleeding at 1 year. Although ICH is associated with high short-term mortality, the 2 year mortality rate for those patients who survive the first 30 days remains stable. Although ICH is often considered a relative contraindication for anticoagulation, this study demonstrates a reduction in long-term mortality in ICH patients treated with warfarin.

Abstract #238: Improved Short Term and Long Term Outcomes of Early Insulin Initiation in Type 2 Diabetes Over 10 Years

2017 ◽  
Vol 23 ◽  
pp. 50
Author(s):  
Jothydev Kesavadev ◽  
Shashank Joshi ◽  
Banshi Saboo ◽  
Hemant Thacker ◽  
Arun Shankar ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Insulin Initiation ◽  
Long Term Outcomes ◽  
Short Term

Effect of Thrombocytopenia on Short-term and Long-term Outcomes after Esophagectomy for Esophageal Cancer

2018 ◽  
Vol 69 (6) ◽  
pp. 327-334
Author(s):  
Takashi Matsumoto ◽  
Naoya Yoshida ◽  
Yoshifumi Baba ◽  
Yohei Nagai ◽  
Hideo Baba
Keyword(s):  
Esophageal Cancer ◽  
Long Term Outcomes ◽  
Short Term

Short-term and long-term outcomes in living donors for liver transplantation: Cohort study

2020 ◽  
Vol 84 ◽  
pp. 147-153
Author(s):  
Kosei Takagi ◽  
Yuzo Umeda ◽  
Ryuichi Yoshida ◽  
Nobuyuki Watanabe ◽  
Takashi Kuise ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Cohort Study ◽  
Living Donors ◽  
Long Term Outcomes ◽  
Short Term

Cerebral Microbleeds Load and Long-Term Outcomes in Minor Ischemic Stroke

2021 ◽  
Vol 30 (9) ◽  
pp. 105973
Author(s):  
Kenichi Sakuta ◽  
Hiroshi Yaguchi ◽  
Ryoji Nakada ◽  
Takeo Sato ◽  
Tomomichi Kitagawa ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Cerebral Microbleeds ◽  
Long Term Outcomes ◽  
Minor Ischemic Stroke

scholarly journals Robotic and laparoscopic liver surgery for colorectal liver metastases: an experience from a German Academic Center

2020 ◽  
Vol 18 (1) ◽  
Author(s):  
Mirhasan Rahimli ◽  
Aristotelis Perrakis ◽  
Vera Schellerer ◽  
Andrew Gumbs ◽  
Eric Lorenz ◽  
...  
Keyword(s):  
Abdominal Surgery ◽  
Minimally Invasive ◽  
Liver Surgery ◽  
Colorectal Liver Metastases ◽  
Survival Rates ◽  
Long Term Outcomes ◽  
Short Term ◽  
Minimally Invasive Liver Surgery ◽  
Previous Abdominal Surgery

Abstract Background Minimally invasive liver surgery (MILS) in the treatment of colorectal liver metastases (CRLM) is increasing in incidence. The aim of this work was to present our experience by reporting short-term and long-term outcomes after MILS for CRLM with comparative analysis of laparoscopic (LLS) and robotic liver surgery (RLS). Methods Twenty-five patients with CRLM, who underwent MILS between May 2012 and March 2020, were selected from our retrospective registry of minimally invasive liver surgery (MD-MILS). Thirteen of these patients underwent LLS and 12 RLS. Short-term and long-term outcomes of both groups were analyzed. Results Operating time was significantly longer in the RLS vs. the LLS group (342.0 vs. 200.0 min; p = 0.004). There was no significant difference between the laparoscopic vs. the robotic group regarding length of postoperative stay (8.8 days), measured blood loss (430.4 ml), intraoperative blood transfusion, overall morbidity (20.0%), and liver surgery related morbidity (4%). The mean BMI was 27.3 (range from 19.2 to 44.8) kg/m2. The 30-day mortality was 0%. R0 resection was achieved in all patients (100.0%) in RLS vs. 10 patients (76.9%) in LLS. Major resections were carried out in 32.0% of the cases, and 84.0% of the patients showed intra-abdominal adhesions due to previous abdominal surgery. In 24.0% of cases, the tumor was bilobar, the maximum number of tumors removed was 9, and the largest tumor was 8.5 cm in diameter. The 1-, 3- and 5-year overall survival rates were 84, 56.9, and 48.7%, respectively. The 1- and 3-year overall recurrence-free survival rates were 49.6 and 36.2%, respectively, without significant differences between RLS vs. LLS. Conclusion Minimally invasive liver surgery for CRLM is safe and feasible. Minimally invasive resection of multiple lesions and large tumors is also possible. RLS may help to achieve higher rates of R0 resections. High BMI, previous abdominal surgery, and bilobar tumors are not a barrier for MILS. Laparoscopic and robotic liver resections for CRLM provide similar long-term results which are comparable to open techniques.

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