Aim: Although renal dysfunction has been identified as a novel risk factor affecting stroke prognosis, few have analyzed the association within large-scale population-based setting, using wide-range estimated glomerular filtration rate (eGFR) category. We aimed to determine the association of admission eGFR with acute stroke outcomes using data from a registry established in Shiga Prefecture, Japan.Methods: Following exclusion of patients younger than 18 years, with missing serum creatinine data, and with onset more than 7 days prior to admission, 2,813 acute stroke patients registered in the Shiga Stroke Registry year 2011 were included in the final analysis. The Japanese Society of Nephrology equation was used to estimate GFR. Multivariable logistic regression was performed to analyze the association of eGFR with all-cause in-hospital death (modified Rankin Scale [mRS] 6), and atdischarge death/disability (mRS 2–6). Separate analyses were conducted within stroke subtypes.Results: Compared to eGFR 60–89 mL/min/1.73 m2, adjusted odds ratios (ORs) and 95% confidence interval [95% CI] for in-hospital death (in the order of eGFR < 45, 45–59, and ≥ 90 mL/min/1.73 m2) were 1.54 [1.04–2.27], 1.07 [0.72–1.58], and 1.04 [0.67–1.59]. Likewise, adjusted ORs [95% CI] for at-discharge death/disability were 1.54 [1.02–2.32], 0.97 [0.73–1.31], and 1.48 [1.06–2.05]. Similar pattern was further evident in the eGFR < 45 mL/min/1.73 m2 group for both outcomes within acute ischemic stroke patients.Conclusions: Our study has ascertained that in acute stroke, particularly ischemic stroke, low eGFR was significantly associated with in-hospital death and at-discharge death/disability. Additionally, high eGFR was found to be associated with at-discharge death/disability.
Background: Though extensively studied in other Asian countries, office and home blood pressure (BP)-based hypertension determination and phenotypes in rural population are still scarcely investigated in Indonesia. We aim to elaborate this in an East Indonesia rural area, by implementing two available BP thresholds. Material and methods: The Ternate Sehat Indonesia (TENSI) pilot study obtained demographic, anthropometric, biochemistry, office and home BP data from 146 residents aged ≥ 18 years old living in Ternate Island from July-August 2022. Hypertension and its phenotypes were defined in accordance with the 2019 Indonesian Society of Hypertension (InaSH) and the 2017 American College of Cardiology/American Heart Association (ACC/AHA) BP guidelines. Office and home BP differences were analyzed within each participant's characteristics. Results: Mean mm Hg ± SD office and home (i) systolic BP were 121.8 ± 17.9 and 117.8 ± 14.8 mm Hg (p < 0.001), (ii) diastolic BP were 77.9 ± 12.1 and 74.7 ± 8.9 mm Hg (p < 0.001). Hypertension was evident in 26% (InaSH) and 34.2% (ACC/AHA) participants. Moreover, 17.4% (InaSH) and 24.8% (ACC/AHA) of those self-reported to not having hypertension were found to be hypertensives. The proportion of sustained, white-coat, and masked hypertension were 7.5%, 9.6%, 8.9% (InaSH), and 8.2%, 21.2%, 4.8% (ACC/AHA). Compared to office BP, home BP significantly differed throughout more characteristics. Conclusions: Our study has ascertained the actual hypertension status and phenotypes within a rural East Indonesia environment. The revelation of stronger home BP ability to detect BP differences may promote its application within the population in the future.
Pendahuluan: Waktu tunggu menuju operasi pengangkatan tumor intrakranial elektif di Indonesia masih belum diketahui, terlebih lagi hubungannya dengan luaran fungsional pascaoperasi. Tujuan: Mengukur waktu tunggu menuju operasi pengangkatan tumor intrakranial elektif dan menganalisis hubungannya dengan luaran fungsional buruk, yang didefinisikan skor Skala Performa Karnofsky (KPS) 3 bulan pascaoperasi <70. Metode: Studi retrospektif berbasis rekam medis ini dilaksanakan pada pasien tumor intrakranial yang menjalani operasi pengangkatan tumor elektif pada tahun 2016. Analisis regresi logistik multivariabel dipergunakan untuk mencari adanya hubungan bermakna antara waktu tunggu menuju operasi pengangkatan tumor intrakranial elektif dengan luaran fungsional buruk, sambil mempertimbangkan usia, jenis kelamin, skor KPS praoperasi, volume tumor pra- dan pascaoperasi, persentase pengangkatan tumor, patologi. dan grading tumor. Hasil: Data diperoleh dari 191 pasien, dengan distribusi histopatologi sebagai berikut: 49% meningioma, 22% adenoma hipofisis, 9% astrositoma, 3% tumor metastatik tumors, 3% limfoma sistem saraf pusat primer, 2% oligodendroglioma, 2% kraniofaringioma, dan 10% lain-lain. Median (min-maks) waktu tunggu secara umum adalah 35 (0-529) hari. Tampak hubungan bermakna antara waktu tunggu menuju operasi pengangkatan tumor intrakranial elektif dengan luaran fungsional buruk pascaoperasi pada analisis univariabel (RO 1,004), tetapi tidak pada analisis multivariabel. Nilai kolinearitas volume tumor pra-operasi, pascaoperasi dan persentase pengangkatan tumor dengan waktu tunggu masing-masing adalah sebesar 5,92; 5,69; dan 3,2. Diskusi: Tidak ada hubungan bermakna antara waktu tunggu menuju operasi pengangkatan tumor elektif dengan luaran fungsional buruk pascaoperasi. Terdapat kolinearitas kuat antara waktu tunggu dengan volume tumor pra- dan pascaoperasi serta persentase pengangkatan tumor. Kata Kunci: luaran fungsional, operasi pengangkatan tumor, tumor intrakranial, waktu tunggu
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