Association between Seizures and Outcomes among Intracerebral Hemorrhage Patients: The China National Stroke Registry

Li, Zixiao; Zhao, Xingquan; Wang, Yilong; Wang, Chunxue; Liu, Liping; Shao, Xiaoqiu; Wang, Wenjuan; Pan, Yuesong; Wang, Chunjuan; Ji, Ruijun; Zhang, Changqing; Jing, Jing; Wang, Yongjun

doi:10.1016/j.jstrokecerebrovasdis.2014.09.021

Cited by 17 publications

(21 citation statements)

References 42 publications

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“…Although we did not find a significant association between ITU admission, presence of diabetes mellitus, TACS, and pneumonia with post-stroke UTI rates, other studies have indicated they play a role (13, 31, 35, 41–43). The reason for differences in findings may be due to a difference in study design, sample population or how UTI has been diagnosed (i.e., our study did not provide a pre-specified definition).…”

Section: Discussioncontrasting

confidence: 99%

Hospital-Level Variations in Rates of Inpatient Urinary Tract Infections in Stroke

et al. 2019

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Background and purpose: Urinary tract infection (UTI) is one of the most common complications following stroke and has prognostic significance. UTI rates have been shown to vary between hospitals, but it is unclear whether this is due to case-mix differences or heterogeneities in care among hospitals. Methods: A prospective multi-center cohort study of acute stroke patients admitted to eight National Health Service (NHS) acute hospital trusts within the Anglia Stroke & Heart Clinical Network between 2009 and 2011 was conducted. We modeled the association between hospital (as a fixed-effect) and inpatient UTI using a multivariable logistic regression model, adjusting for established patient-level risk factors. We graphically and descriptively analyzed heterogeneities in hospital-level characteristics. Results: We included 2,241 stroke admissions in our analysis; 171 (7.6%) acquired UTI as an inpatient. UTI rates varied significantly between the eight hospitals, ranging from 3 to 11%. The hospital that had the lowest odds of UTI [odds ratio (OR) = 0.50 (95% confidence interval (CI) 0.22–.11)] in adjusted analysis, had the highest number of junior doctors and occupational therapists per five beds of all hospitals. The hospital with the highest adjusted UTI rate [OR=2.69 (1.56–4.64)] was tertiary, the largest and had the highest volume of stroke patients, lowest number of stroke unit beds per 100 admissions, and the highest number of hospital beds per CT scanner. Conclusions: There is hospital-level variation in post-stroke UTI. Our results suggest the potential influence of service characteristics independently of patient-level factors which may be amenable to be addressed to improve the ultimate stroke outcome.

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Section: Discussioncontrasting

confidence: 99%

Hospital-Level Variations in Rates of Inpatient Urinary Tract Infections in Stroke

et al. 2019

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“…A third reader reviewed the measurements and decided between the 2 when the disagreements were greater than 10%. In-hospital complications were prospectively recorded according to standardised definitions [15, 16]. Medical resource utilization records during hospitalization were also collected, including the admission department, the length of stay in hospital, and supporting interventions [16].…”

Section: Methodsmentioning

confidence: 99%

Risk Factors and Clinical Impact of Delayed Cerebral Ischemia after Aneurysmal Subarachnoid Hemorrhage: Analysis from the China National Stroke Registry

et al. 2018

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Background: Delayed cerebral ischemia (DCI) after aneurysmal subarachnoid hemorrhage (aSAH) is a significant cause of morbidity and mortality. While it is important to detect early signs of DCI, patients with high risk of DCI are difficult to identify, and the potential risk factors are uncertain. This study aimed to identify independent risk factors of DCI and clarify their clinical impact on outcome and the disease course. Methods: For this nationwide, multicenter, prospective clinical study involving consecutive patients with aSAH recruited from the China National Stroke Registry, demographic, clinical, radiological, and laboratorial data during hospitalisation, in-hospital complications, functional outcomes, and mortality at 3, 6, and 12 months were recorded. Using univariate and multivariate logistic regression to determine risk factors associated with the development of DCI, the contribution of DCI to short- and long-term outcomes was evaluated. Results: Of all 504 patients with aSAH, 155 developed DCI. Multivariate analysis revealed that being female, a history of diabetes mellitus, a Hunt and Hess grade of 4–5, and a World Federation of Neurosurgical Societies grade of IV–V were independent risk factors of DCI. DCI was associated with high in-hospital complications, and with a high utilization rate of supporting interventions. DCI also contributed to poorer functional outcome and higher mortality at discharge and after 3, 6, and 12 months. Conclusions: Female sex, a history of diabetes mellitus, and poor clinical grade are independent early risk factors for the development of DCI and can contribute to a better identification of patients at a high risk for DCI. DCI was associated with severe clinical course, poor outcome, and mortality both in the short- and long-term in patients with aSAH in China.

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“…ICH was defined according to World Health Organization criteria (13), and dICH was located at the following regions: putamen, caudate nucleus, internal capsule, thalamus, and brain stem. Cortical hemorrhage, deep intracerebral hemorrhage, intraventricular hemorrhage, prestroke modified Ranking Scale >2, lack of data for hematoma volume, and hemorrhage resulting from trauma, underlying tumor, aneurysm, or arteriovenous malformation were excluded (15).…”

Section: Methodsmentioning

confidence: 99%

Risk Profile of Ischemic Stroke Caused by Small-Artery Occlusion vs. Deep Intracerebral Hemorrhage

Chen

et al. 2019

Front. Neurol.

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Background: Small-artery occlusion (SAO) subtype accounts for a quarter of the cases of ischemic stroke and is mainly caused by pathological changes in cerebral small vessels, which also involve in deep intracerebral hemorrhage (dICH). However, the factors that drive some cases to SAO and others to dICH remained incompletely defined.Material and Methods: This study is a cross-sectional study from the China National Stroke Registry that included consecutive patients with ischemic stroke or intracerebral hemorrhage between August 2007 and September 2008. We compared the risk profile between the two subgroups using multivariable logistic regression.Results: A total of 1,135 patients with SAO stroke and 1,125 dICH patients were included for analyses. Generally, patients with SAO stroke were more likely to be male (odds ratio = 0.74, confidence interval = 0.58–0.94) and have diabetes (0.30, 0.22–0.40), higher atherogenic lipid profiles, higher body mass index (0.96, 0.94–0.99), higher waist/height ratio (0.12, 0.03–0.48), higher platelet count (0.84, 0.77–0.91), and higher proportion of abnormal estimated glomerular filtration rate (<90, ml/min/1.73 m2) (0.77, 0.62–0.95). Conversely, patients with dICH were more likely to have higher blood pressure parameters, inflammation levels (white blood cell count: 1.61, 1.48–1.76; high sensitivity C-reactive protein: 2.07, 1.36–3.16), and high-density lipoprotein-c (1.57, 1.25–1.98).Conclusions: The risk profile between SAO stroke and dICH were different. Furthermore, despite of traditional indexes, waist/height ratio, platelet count, inflammation levels, lipid profile, and estimated glomerular filtration rate also play important roles in driving arteriolosclerosis into opposite ends.

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Association between Seizures and Outcomes among Intracerebral Hemorrhage Patients: The China National Stroke Registry

Cited by 17 publications

References 42 publications

Hospital-Level Variations in Rates of Inpatient Urinary Tract Infections in Stroke

Hospital-Level Variations in Rates of Inpatient Urinary Tract Infections in Stroke

Risk Factors and Clinical Impact of Delayed Cerebral Ischemia after Aneurysmal Subarachnoid Hemorrhage: Analysis from the China National Stroke Registry

Risk Profile of Ischemic Stroke Caused by Small-Artery Occlusion vs. Deep Intracerebral Hemorrhage

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