In-Hospital Mortality in Acute Ischemic Stroke Treated With Hemicraniectomy in US Hospitals

Alshekhlee, Amer; Horn, Christopher; Jung, Richard; Alawi, Aws; Cruz‐Flores, Salvador

doi:10.1016/j.jstrokecerebrovasdis.2009.11.019

Cited by 30 publications

(15 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Alshekhlee et al came to a completely different conclusion, that the prevalence is the same over a similar time period. [36] While the same database was analyzed over a slightly different time period, their analysis only identified 252 patients undergoing DC (whereas our study identified 3121 patients) for ischemic stroke. These small numbers, in combination with only 502,231 patients identified as having an acute ischemic stroke, raises the possibility that the investigators did not perform a valid, accurate weighted analysis to determine true nationwide estimates.…”

Section: Discussionmentioning

confidence: 99%

Craniectomy for Malignant Cerebral Infarction: Prevalence and Outcomes in US Hospitals

et al. 2011

View full text Add to dashboard Cite

ObjectRandomized trials have demonstrated the efficacy of craniectomy for the treatment of malignant cerebral edema following ischemic stroke. We sought to determine the prevalence and outcomes related to this by using a national database.MethodsPatient discharges with ischemic stroke as the primary diagnosis undergoing craniectomy were queried from the US Nationwide Inpatient Sample from 1999 to 2008. A subpopulation of patients was identified that underwent thrombolysis. Two primary end points were examined: in-hospital mortality and discharge to home/routine care. To facilitate interpretations, adjusted prevalence was calculated from the overall prevalence and two age-specific logistic regression models. The predictive margin was then generated using a multivariate logistic regression model to estimate the probability of in-hospital mortality after adjustment for admission type, admission source, length of stay, total hospital charges, chronic comorbidities, and medical complications.ResultsAfter excluding 71,996 patients with the diagnosis of intracranial hemorrhage and posterior intracranial circulation occlusion, we identified 4,248,955 adult hospitalizations with ischemic stroke as a primary diagnosis. The estimated rates of hospitalizations in craniectomy per 10,000 hospitalizations with ischemic stroke increased from 3.9 in 1999–2000 to 14.46 in 2007–2008 (p for linear trend<0.001). Patients 60+ years of age had in-hospital mortality of 44% while the 18–59 year old group was found to be 24%(p = 0.14). Outcomes were comparable if recombinant tissue plasminogen activator had been administered.ConclusionsCraniectomy is being increasingly performed for malignant cerebral edema following large territory cerebral ischemia. We suspect that the increase in the annual incidence of DC for malignant cerebral edema is directly related to the expanding collection of evidence in randomized trials that the operation is efficacious when performed in the correct patient population. In hospital mortality is high for all patients undergoing this procedure.

show abstract

Section: Discussionmentioning

confidence: 99%

Craniectomy for Malignant Cerebral Infarction: Prevalence and Outcomes in US Hospitals

et al. 2011

View full text Add to dashboard Cite

show abstract

“…Variables collected include demographics, prior medical history, and Elixhauser comorbidities as defined by the Agency for Healthcare Research and Quality and using ICD codes and clinical classification software (CCS) codes as defined in the NIS database. The CCS codes have been used to define groups of medical conditions in prior studies …”

Section: Methodsmentioning

confidence: 99%

Safety of catheter ablation for atrial fibrillation in the octogenarian population

Romero

Ogunbayo²,

Elayi³

et al. 2019

Cardiovasc electrophysiol

View full text Add to dashboard Cite

Introduction Catheter ablation (CA) has been shown to be an effective treatment for atrial fibrillation (AF). The complication rates and outcomes among octogenarians remain poorly studied. We aimed to compare trends, morbidity, and mortality associated with CA for AF among octogenarians versus those less than 80 years old. Methods Using weighted sampling from the National Inpatient Sample database, we identified patients with a primary diagnosis of AF and a primary procedure of CA (2004‐2013). Our primary outcome was mortality. Secondary outcomes included incidence of major and minor complications. Results Among 86,119 patients who underwent CA for AF, 3,482 were 80 years old or older. Complications were significantly more frequent in octogenarians; [16.2% (564 of 3,482) versus 9.8% (8,092 of 82,637), P < 0.001]. Of note, there was no significant difference for the composite of major complications; [3.6% (124 of 3482) in octogenarians versus 2.8% (2286 of 82637), P = 0.20]. The total mortality rate was not significant in a multivariate regression analysis (odds ratio [OR], 0.96; 95% confidence interval [CI], 0.35‐2.64; P = .94). The presence of chronic renal failure (OR, 4.19; 95% CI, 2.75‐6.36; P < 0.001), anemia (OR, 1.75; 95% CI, 1.03‐2.97; P = .04), and chronic pulmonary disease (OR, 1.75; 95% CI, 1.11‐2.62; P = .015) were predictors of major complications in octogenarians. Conclusion Catheter ablation for AF in octogenarians does not confer a higher mortality risk than in those less than 80 years old. The procedure is associated with a higher rate of overall complications but there was no difference in terms of major complications or death. The presence of anemia, CKD or pulmonary disease were predictors of major complications in octogenarians.

show abstract

“…Each of these complications was associated with an increased rate of mortality and were significantly higher compared with patients with a similar comorbidity index. 24 …”

Section: Complications Associated With Hemicraniectomymentioning

confidence: 99%

Hemicraniectomy in Malignant Middle Cerebral Artery Infarction

Staykov

Gupta²

2011

Stroke

View full text Add to dashboard Cite

In-Hospital Mortality in Acute Ischemic Stroke Treated With Hemicraniectomy in US Hospitals

Cited by 30 publications

References 25 publications

Craniectomy for Malignant Cerebral Infarction: Prevalence and Outcomes in US Hospitals

Craniectomy for Malignant Cerebral Infarction: Prevalence and Outcomes in US Hospitals

Safety of catheter ablation for atrial fibrillation in the octogenarian population

Hemicraniectomy in Malignant Middle Cerebral Artery Infarction

Contact Info

Product

Resources

About