Publications

Authors:

Battaglini, Denise; Kelly, Thu-Lan; Griffee, Matthew; Fanning, Jonathon; Premraj, Lavienraj; Whitman, Glenn; Porto, Diego Bastos; Arora, Rakesh; Thomson, David; Pelosi, Paolo; White, Nicole M; Bassi, Gianluigi Li; Suen, Jacky; Fraser, John F; Robba, Chiara; Cho, Sung-Min; Donadello, Katia

Title:

Stroke in critically ill patients with respiratory failure due to COVID-19: Disparities between low-middle and high-income countries

Year:

2024

Type of item:

Articolo in Rivista

Tipologia ANVUR:

Articolo su rivista

Language:

Inglese

Referee:

No

Name of journal:

HEART & LUNG

ISSN of journal:

0147-9563

N° Volume:

68

Page numbers:

131-144

Keyword:

COVID-19; Disability; Income countries; Neurological complications; Stroke

Short description of contents:

Purpose: 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 < 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 < 0.001)]. Patients with stroke were more likely to die than those without stroke [RR = 1.43 (95 %CI = 1.19-1.72), p < 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.

Product ID:

142166

Handle IRIS:

11562/1144333

Last Modified:

October 31, 2024

Bibliographic citation:

Battaglini, Denise; Kelly, Thu-Lan; Griffee, Matthew; Fanning, Jonathon; Premraj, Lavienraj; Whitman, Glenn; Porto, Diego Bastos; Arora, Rakesh; Thomson, David; Pelosi, Paolo; White, Nicole M; Bassi, Gianluigi Li; Suen, Jacky; Fraser, John F; Robba, Chiara; Cho, Sung-Min; Donadello, Katia, Stroke in critically ill patients with respiratory failure due to COVID-19: Disparities between low-middle and high-income countries «HEART & LUNG» , vol. 68 , 2024 , pp. 131-144

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