Predictive Variables for Mortality After Acute Ischemic Stroke

Carter, Angela M.; Catto, Andrew J.; Mansfield, Michael W.; Bamford, John; Grant, Peter J.

doi:10.1161/strokeaha.106.474569

Cited by 137 publications

(133 citation statements)

References 29 publications

Supporting

Mentioning

117

Contrasting

Unclassified

Order By: Relevance

“…Also, the severity of impaired kidney function was associated with increased risk of early mortality (odd ratio= 1.7, 95% CI =1.4-2 , per 1mg/dl increase in serum creatinine). Similarly, Carter et al 33 . showed that serum creatinine level was a strong predictor of mortality in patients with ischemic stroke.…”

mentioning

confidence: 86%

Baseline Renal Dysfunction in Acute Ischemic Stroke Patients: Prevalence and Impact on Early Mortality.

Mahmoud.¹,

Badawy.²,

Shehta³

et al. 2017

IJAR

View full text Add to dashboard Cite

mentioning

confidence: 86%

Baseline Renal Dysfunction in Acute Ischemic Stroke Patients: Prevalence and Impact on Early Mortality.

Mahmoud.¹,

Badawy.²,

Shehta³

et al. 2017

IJAR

View full text Add to dashboard Cite

“…Based on publications identified by Miyasaka et al, 89 Carter et al 90 and Pocock et al, 91 people with AF, stroke or HF are assumed to be at increased risk of all-cause mortality versus the UK general population. Furthermore, people with AF and stroke and people with AF and HF are assumed to be at further risk of death as a result of the concomitant conditions.…”

Section: Mortalitymentioning

confidence: 99%

“…Case fatality as a result of stroke was calculated from data presented by Carter et al 90 Carter et al 90 report the number of people dying within 30 days of an acute stroke event (n = 32/545) and, of these, the number with concomitant AF (n = 14). Table 39 summarises the calculation of the probability of stroke case fatality in people with and without AF.…”

Section: Mortalitymentioning

confidence: 99%

Dual-chamber pacemakers for treating symptomatic bradycardia due to sick sinus syndrome without atrioventricular block: a systematic review and economic evaluation

Edwards¹,

Karner²,

Trevor³

et al. 2015

Health Technol Assess

View full text Add to dashboard Cite

BackgroundBradycardia [resting heart rate below 60 beats per minute (b.p.m.)] can be caused by conditions affecting the natural pacemakers of the heart, such as sick sinus syndrome (SSS) and atrioventricular (AV) blocks. People suffering from bradycardia may present with palpitations, exercise intolerance and fainting. The only effective treatment for patients suffering from symptomatic bradycardia is implantation of a permanent pacemaker.ObjectiveTo appraise the clinical effectiveness and cost-effectiveness of dual-chamber pacemakers compared with single-chamber atrial pacemakers for treating symptomatic bradycardia in people with SSS and no evidence of AV block.Data sourcesAll databases (MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, Health Technology Assessment database, NHS Economic Evaluations Database) were searched from inception to June 2014.MethodsA systematic review of the clinical and economic literature was carried out in accordance with the general principles published by the Centre for Reviews and Dissemination. Randomised controlled trials (RCTs) evaluating dual-chamber and single-chamber atrial pacemakers and economic evaluations were included. Pairwise meta-analysis was carried out. A de novo economic model was developed.ResultsOf 493 references, six RCTs were included in the review. The results were predominantly influenced by the largest trial DANPACE. Dual-chamber pacing was associated with a statistically significant reduction in reoperation [odds ratio (OR) 0.48, 95% confidence interval (CI) 0.36 to 0.63] compared with single-chamber atrial pacing. The difference is primarily because of the development of AV block requiring upgrade to a dual-chamber device. The risk of paroxysmal atrial fibrillation was also reduced with dual-chamber pacing compared with single-chamber atrial pacing (OR 0.75, 95% CI 0.59 to 0.96). No statistically significant difference was found between the pacing modes for mortality, heart failure, stroke, chronic atrial fibrillation or quality of life. However, the risk of developing heart failure may vary with age and device. The de novo economic model shows that dual-chamber pacemakers are more expensive and more effective than single-chamber atrial devices, resulting in a base-case incremental cost-effectiveness ratio (ICER) of £6506. The ICER remains below £20,000 in probabilistic sensitivity analysis, structural sensitivity analysis and most scenario analyses and one-way sensitivity analyses. The risk of heart failure may have an impact on the decision to use dual-chamber or single-chamber atrial pacemakers. Results from an analysis based on age (> 75 years or ≤ 75 years) and risk of heart failure indicate that dual-chamber pacemakers dominate single-chamber atrial pacemakers (i.e. are less expensive and more effective) in older patients, whereas dual-chamber pacemakers are dominated by (i.e. more expensive and less effective) single-chamber atrial pacemakers in younger patients. However, these results are based on a subgroup analysis and should be treated with caution.ConclusionsIn patients with SSS without evidence of impaired AV conduction, dual-chamber pacemakers appear to be cost-effective compared with single-chamber atrial pacemakers. The risk of developing a complete AV block and the lack of tools to identify patients at high risk of developing the condition argue for the implantation of a dual-chamber pacemaker programmed to minimise unnecessary ventricular pacing. However, considerations have to be made around the risk of developing heart failure, which may depend on age and device.Study registrationThis study is registered as PROSPERO CRD42013006708.FundingThe National Institute for Health Research Health Technology Assessment programme.

show abstract

“…8) In patients with acute ischemic stroke, a condition resembling acute coronary syndrome, a low serum albumin level was observed in several patients and has been shown to be an independent predictor of mortality in acute ischemic stroke. 10) The aim of the present report was to determine the association between low serum albumin levels measured immediately upon hospital admission and in-hospital adverse outcomes in patients with acute coronary syndrome. Furthermore, we combined this association with other variables to assess the value of albumin in predicting adverse outcomes.…”

mentioning

confidence: 96%

Low Serum Albumin Levels and In-Hospital Adverse Outcomes in Acute Coronary Syndrome

2010

View full text Add to dashboard Cite

SummaryEpidemiological studies have demonstrated an association between low serum albumin levels and coronary heart disease and mortality. Nevertheless, the impact of a low serum albumin level during acute coronary syndrome has not yet been established. The aim of the present study was to investigate whether low serum albumin levels are associated with adverse outcomes in acute coronary syndrome. We enrolled 82 consecutive patients with acute coronary syndrome from whom venous blood for serum albumin measurement was drawn immediately upon hospital admission. Thirty-five patients had a low albumin level (hypoalbuminemia) and 47 had a normal albumin level (normoalbuminemia). In-hospital adverse outcomes (death, acute heart failure, cardiogenic shock, and reinfarction) were recorded during hospitalization in the intensive coronary care unit. The results of our study showed that the incidence of in-hospital adverse outcomes was 43%, with death occurring in 8 patients (10%). In-hospital adverse outcomes occurred more frequently in patients presenting with hypoalbuminemia, whereas mortality did not differ significantly. Univariate analysis showed that hypoalbuminemia was associated with a 2.8-fold greater risk of developing adverse outcomes. This risk was greater in the subgroup of NSTEACS (5.4-fold increased risk), but not in those with STEMI. Adjustment with other covariates revealed that hypoalbuminemia did not predict independently in-hospital adverse outcomes. It interacted with other predictors, especially Killip class II-IV, which was consistently an independent predictor of in-hospital adverse outcomes. (Int Heart J 2010; 51: 221-226)

show abstract

Predictive Variables for Mortality After Acute Ischemic Stroke

Cited by 137 publications

References 29 publications

Baseline Renal Dysfunction in Acute Ischemic Stroke Patients: Prevalence and Impact on Early Mortality.

Baseline Renal Dysfunction in Acute Ischemic Stroke Patients: Prevalence and Impact on Early Mortality.

Dual-chamber pacemakers for treating symptomatic bradycardia due to sick sinus syndrome without atrioventricular block: a systematic review and economic evaluation

Low Serum Albumin Levels and In-Hospital Adverse Outcomes in Acute Coronary Syndrome

Contact Info

Product

Resources

About