Authorship equity guidelines in global health journals

Datos Bibliográficos

ID21881669
AutoresChris A Rees (0000-0001-6449-0377, Children's Healthcare of Atlanta, autor de correspondencia), Stephanie J Sirna (0009-0002-7675-2236, Cornell University), Hussein K Manji (0000-0003-4572-0338, Aga Khan Hospital Dar es Salaam), Rodrick Kisenge (0000-0002-3273-8136, Muhimbili University of Health and Allied Sciences), Karim Manji (0000-0002-7069-6408, Muhimbili University of Health and Allied Sciences), Karim P Manji (Muhimbili University of Health and Allied Sciences)
Año2022
Volumen7
Número10
Páginase010421
Fecha de publicación2022-10-01
Peer ReviewedSí
Open AccessSí
TipoARTICLE
RevistaBMJ Global Health (JOURNAL)
Identificadores de la revistaISSN: 2059-7908 • E-ISSN: 2059-7908
EditorialBMJ (PUBLISHER • GB)
DOI10.1136/bmjgh-2022-010421
PMID36220309
OpenAlexW4304202802
IdiomaEN
Citas recibidas9
Referencias citadas13

Background Thrombectomy for acute ischemic stroke treatment leads to improved outcomes, but many patients do not achieve a good outcome despite successful reperfusion. We determined predictors of poor outcome after successful thrombectomy (TICI 2b–3) with an emphasis on modifiable factors. Methods Patients from the randomized DEFUSE 3 trial who underwent thrombectomy with TICI 2b–3 revascularization were included. Primary outcome was a poor outcome at 90 days (modified Rankin Scale score 3–6). Results 70 patients were included. Poor outcome patients were older (73.5 vs 66.5 years; P=0.01), more likely to be female (68% vs 39%; P=0.02), had higher NIHSS scores (20 vs 13; P<0.001), and had poor cerebral perfusion collaterals (hypoperfusion intensity ratio) (median 0.45 vs 0.38; P=0.03). Following thrombectomy, poor outcome patients had larger 24 hour’ core infarctions (median 59.5 vs 29.9 mL; P=0.01), more core infarction growth (median 33.6 vs 13.4 mL; P<0.001), and more mild (65% vs 50%; P=0.02) and severe (18% vs 0%; P=0.01) reperfusion hemorrhage. In a logistic regression analysis, the presence of any reperfusion hemorrhage (OR 3.3 [95% CI, 1.67 to 5]; P=0.001), age (OR 1.1 [95% CI, 1.03 to 1.11], P=0.004), higher NIHSS (OR 1.25 [95% CI, 1.07 to 1.41], P=0.002), and time from imaging to femoral artery puncture (OR 5 [95% CI, 1.16 to 16.67], P=0.03) independently predicted poor outcomes. Conclusions In late time windows, both mild and severe reperfusion hemorrhage were associated with poor outcomes. Older age, higher NIHSS, and increased time from imaging to arterial puncture were also associated with poor outcomes despite successful revascularization. Trial registration https://clinicaltrials.gov/ct2/show/NCT02586415

Cardiology · Infarction · Ischemia · Ischemic stroke · Logistic regression · Modified Rankin Scale · Myocardial infarction · Perfusion · Perfusion scanning · Randomized controlled trial · Revascularization · Acute Ischemic Stroke Management · Cardiac, Anesthesia and Surgical Outcomes · Global Health and Surgery · Medicine · Internal Medicine · Surgery