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Electromechanical dissociation of atria after cardioversion- Clinical case and management considerations.
Get PDFThe Importance of Serial 12-Lead ECGs in the Prehospital Setting: A Case of Transient ST Elevation Myocardial Infarction (TSTEMI)
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Gene Expression Analysis of Atypical Fibroxanthoma Patients Reveals New Insights into the Tumor Microenvironment
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Characteristics of patients with multi-system inflammatory syndrome in children (MIS-C) by disease severity: the experience of a medium-sized children’s hospital
Get PDFDefining Optimal Location for Adductor Canal Regional Anesthetic Placement in the Pediatric Patient for Knee Arthroscopy
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Stroke in critically ill patients with respiratory failure due to COVID-19: Disparities between low-middle and high-income countries.
No full textPURPOSE: We aimed to compare the incidence of stroke in low-and middle-income countries (LMICs) versus high-income countries (HICs) in critically ill patients with COVID-19 and its impact on in-hospital mortality.
METHODS: International observational study conducted in 43 countries. Stroke and mortality incidence rates and rate ratios (IRR) were calculated per admitted days using Poisson regression. Inverse probability weighting (IPW) was used to address the HICs vs. LMICs imbalance for confounders.
RESULTS: 23,738 patients [20,511(86.4 %) HICs vs. 3,227(13.6 %) LMICs] were included. The incidence stroke/1000 admitted-days was 35.7 (95 %CI = 28.4-44.9) LMICs and 17.6 (95 %CI = 15.8-19.7) HICs; ischemic 9.47 (95 %CI = 6.57-13.7) LMICs, 1.97 (95 %CI = 1.53, 2.55) HICs; hemorrhagic, 7.18 (95 %CI = 4.73-10.9) LMICs, and 2.52 (95 %CI = 2.00-3.16) HICs; unspecified stroke type 11.6 (95 %CI = 7.75-17.3) LMICs, 8.99 (95 %CI = 7.70-10.5) HICs. In regression with IPW, LMICs vs. HICs had IRR = 1.78 (95 %CI = 1.31-2.42, p \u3c 0.001). Patients from LMICs were more likely to die than those from HICs [43.6% vs 29.2 %; Relative Risk (RR) = 2.59 (95 %CI = 2.29-2.93), p \u3c 0.001)]. Patients with stroke were more likely to die than those without stroke [RR = 1.43 (95 %CI = 1.19-1.72), p \u3c 0.001)].
CONCLUSIONS: Stroke incidence was low in HICs and LMICs although the stroke risk was higher in LMICs. Both LMIC status and stroke increased the risk of death. Improving early diagnosis of stroke and redistribution of healthcare resources should be a priority.
TRIAL REGISTRATION: ACTRN12620000421932 registered on 30/03/2020