Spontánní intracerebrální hemoragie (SICH) jsou spojeny s řadou rizikových faktorů, které můžeme rozdělit na faktory ovlivnitelné a neovlivnitelné. Jejich nejvýznamnějším rizikovým faktorem je arteriální hypertenze. Péče o pacienty se SICH musí být komplexní a multidisciplinární. V akutní fázi se stává imperativem snaha o co nejrychlejší korekci arteriální hypertenze a zvrácení účinku antikoagulační terapie. Do budoucna lze recentně očekávat dosažení lepšího výsledného klinického stavu u vybraných pacientů se supratentoriální (především lobární) SICH operovaných do 24 h s využitím minimálně invazivní parafascikulární chirurgie.
Spontaneous intracerebral hemorrhages (SICH) are associated with a number of risk factors, which can be divided into controllable and uncontrollable factors. Their most important risk factor is arterial hypertension. The care for patients with SICH must be complex and multidisciplinary. In the acute phase, it becomes imperative to try to correct arterial hypertension and reverse the effect of anticoagulant therapy as quickly as possible. In the future, a better clinical outcome can recently be expected in selected patients with supratentorial (mainly lobar) SICH operated on within 24 h using minimally invasive parafascicular surgery.
- Klíčová slova
- spontánní intracerebrální hemoragie,
- MeSH
- antikoagulancia škodlivé účinky terapeutické užití MeSH
- cévní mozková příhoda diagnóza etiologie farmakoterapie klasifikace MeSH
- hypertenze diagnóza klasifikace komplikace MeSH
- intrakraniální krvácení * diagnóza farmakoterapie prevence a kontrola MeSH
- lidé MeSH
- management nemoci MeSH
- miniinvazivní chirurgické výkony klasifikace metody MeSH
- rizikové faktory MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- práce podpořená grantem MeSH
- přehledy MeSH
BACKGROUND: Dabigatran directly inhibits thrombin and is used in primary and secondary stroke prevention in individuals with nonvalvular atrial fibrillation. The prodrug dabigatran etexilate is absorbed by enteral P-glycoprotein (ABCB1) and then activated by hepatic and intestinal carboxylesterases (CES1) to produce active metabolites. Variations in dabigatran metabolism because of genetics may affect concentration levels and clinical outcomes. STUDY QUESTION: We conducted a study to assess how polymorphisms in the CES1 (rs2244613) and ABCB1 (rs4148738) genes affect the through plasma level (c min ) of dabigatran and its correlation to clinical outcomes. STUDY DESIGN: Retrospective multicentric study of consecutive patients on dabigatran therapy. Examination of CES1 rs2244613 and ABCB1 rs4148738 polymorphisms, c min 12 hours after administration, clinical follow-up (ischemic stroke, major or clinically relevant hemorrhage, myocardial infarction, other thromboembolism, and death). MEASURES AND OUTCOMES: A total of 432 patients received treatment for an average of 19.78 months (SD of 20.165). The sex distribution of the patients was 56.5% male, and the average age was 67.56 years (SD of 14.7). The ABCB1 variant genotype was present in 67.8% of patients, whereas 37.5% carried the CES1 polymorphism. RESULTS: Compared with wild-type patients, patients with the CES1 variant had significantly lower dabigatran plasma levels (with a mean difference of 16.986; 95% confidence interval, 5.794-28.178 ng/mL, P = 0.003). We also found a significant risk of major bleeding in patients carrying the ABCB1 rs4148738 allele (hazard ratio = 1.99, confidence interval 95% 1.10 to 3.59, P = 0.024). CONCLUSIONS: The CES1 variant genotype rs2244613 is closely linked with reduced c min of dabigatran. Carriers of the ABCB1 rs4148738 polymorphism exhibit a tendency toward higher plasma levels of dabigatran, which leads to a significantly increased risk of bleeding.
- MeSH
- antithrombiny * škodlivé účinky krev farmakokinetika aplikace a dávkování MeSH
- dabigatran * škodlivé účinky farmakokinetika krev aplikace a dávkování MeSH
- fibrilace síní farmakoterapie genetika komplikace krev MeSH
- ischemická cévní mozková příhoda * prevence a kontrola genetika krev MeSH
- jednonukleotidový polymorfismus MeSH
- karboxylesterhydrolasy * genetika krev MeSH
- krvácení * chemicky indukované krev MeSH
- lidé středního věku MeSH
- lidé MeSH
- P-glykoproteiny * genetika MeSH
- retrospektivní studie MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- multicentrická studie MeSH
BACKGROUND AND OBJECTIVES: COVID-19-related inflammation, endothelial dysfunction, and coagulopathy may increase the bleeding risk and lower the efficacy of revascularization treatments in patients with acute ischemic stroke (AIS). We aimed to evaluate the safety and outcomes of revascularization treatments in patients with AIS and COVID-19. METHODS: This was a retrospective multicenter cohort study of consecutive patients with AIS receiving intravenous thrombolysis (IVT) and/or endovascular treatment (EVT) between March 2020 and June 2021 tested for severe acute respiratory syndrome coronavirus 2 infection. With a doubly robust model combining propensity score weighting and multivariate regression, we studied the association of COVID-19 with intracranial bleeding complications and clinical outcomes. Subgroup analyses were performed according to treatment groups (IVT-only and EVT). RESULTS: Of a total of 15,128 included patients from 105 centers, 853 (5.6%) were diagnosed with COVID-19; of those, 5,848 (38.7%) patients received IVT-only and 9,280 (61.3%) EVT (with or without IVT). Patients with COVID-19 had a higher rate of symptomatic intracerebral hemorrhage (SICH) (adjusted OR 1.53; 95% CI 1.16-2.01), symptomatic subarachnoid hemorrhage (SSAH) (OR 1.80; 95% CI 1.20-2.69), SICH and/or SSAH combined (OR 1.56; 95% CI 1.23-1.99), 24-hour mortality (OR 2.47; 95% CI 1.58-3.86), and 3-month mortality (OR 1.88; 95% CI 1.52-2.33). Patients with COVID-19 also had an unfavorable shift in the distribution of the modified Rankin score at 3 months (OR 1.42; 95% CI 1.26-1.60). DISCUSSION: Patients with AIS and COVID-19 showed higher rates of intracranial bleeding complications and worse clinical outcomes after revascularization treatments than contemporaneous non-COVID-19 patients receiving treatment. Current available data do not allow direct conclusions to be drawn on the effectiveness of revascularization treatments in patients with COVID-19 or to establish different treatment recommendations in this subgroup of patients with ischemic stroke. Our findings can be taken into consideration for treatment decisions, patient monitoring, and establishing prognosis. TRIAL REGISTRATION INFORMATION: The study was registered under ClinicalTrials.gov identifier NCT04895462.
- MeSH
- cerebrální krvácení komplikace MeSH
- cévní mozková příhoda * epidemiologie terapie diagnóza MeSH
- COVID-19 * komplikace MeSH
- endovaskulární výkony * škodlivé účinky MeSH
- fibrinolytika terapeutické užití MeSH
- intrakraniální krvácení etiologie MeSH
- ischemická cévní mozková příhoda * epidemiologie chirurgie MeSH
- ischemie mozku * komplikace epidemiologie chirurgie MeSH
- kohortové studie MeSH
- lidé MeSH
- registrace MeSH
- trombolytická terapie škodlivé účinky MeSH
- výsledek terapie MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- multicentrická studie MeSH
- práce podpořená grantem MeSH
BACKGROUND: Acute ischemic stroke (AIS) due to anterior circulation tandem lesion (TL) remains a technical and clinical challenge for endovascular treatment (EVT). Conflicting results from observational studies and missing evidence from the randomized trials led us to report a recent real-world multicenter clinical experience and evaluate possible predictors of good outcome after EVT. METHODS: We analyzed all AIS patients with TL enrolled in the prospective national study METRICS (Mechanical Thrombectomy Quality Indicators Study in Czech Stroke Centers). A good 3-month clinical outcome was scored as 0-2 points in modified Rankin Scale (mRS), achieved recanalization using the Thrombolysis In Cerebral Infarction (TICI) scale and symptomatic intracerebral hemorrhage (sICH) according to the Safe Implementation of Thrombolysis in Stroke-Monitoring Study (SITS-MOST) criteria. RESULTS: Of 1178 patients enrolled in METRICS, 194 (19.2%) (59.8% males, mean age 68.7±11.5 years) were treated for TL. They did not differ in mRS 0-2 (48.7% vs 46.7%; p=0.616), mortality (17.3% vs 22.7%; p=0.103) and sICH (4.7% vs 5.1%; p=0.809) from those with single occlusion (SO). More TL patients with prior intravenous thrombolysis (IVT) reached TICI 3 (70.3% vs 50.8%; p=0.012) and mRS 0-2 (55.4% vs 34.4%; p=0.007) than those without IVT. No difference was found in the rate of sICH (6.2% vs 1.6%; p=0.276). Multivariate logistic regression analysis showed prior IVT as a predictor of mRS 0-2 after adjustment for potential confounders (OR 3.818, 95% CI 1.614 to 9.030, p=0.002). CONCLUSION: Patients with TL did not differ from those with SO in outcomes after EVT. TL patients with prior IVT had more complete recanalization and mRS 0-2 and IVT was found to be a predictor of good outcome after EVT.
- MeSH
- benchmarking MeSH
- cerebrální krvácení etiologie MeSH
- cévní mozková příhoda * diagnostické zobrazování chirurgie MeSH
- endovaskulární výkony * metody MeSH
- fibrinolytika MeSH
- ischemická cévní mozková příhoda * diagnostické zobrazování chirurgie MeSH
- ischemie mozku * diagnostické zobrazování terapie etiologie MeSH
- lidé středního věku MeSH
- lidé MeSH
- prospektivní studie MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- trombektomie škodlivé účinky MeSH
- trombolytická terapie metody MeSH
- výsledek terapie MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- multicentrická studie MeSH
PURPOSE: To investigate the safety and efficacy of baseline antiplatelet treatment in patients with acute ischemic stroke (AIS) undergoing mechanical thrombectomy (MT). MATERIALS AND METHODS: Baseline use of antiplatelet medication before MT for (AIS) may provide benefit on reperfusion and clinical outcome but could also carry an increased risk of intracranial hemorrhage (ICH). All consecutive patients with AIS and treated with MT with and without intravenous thrombolysis (IVT) between January 2012 and December 2019 in all centers performing MT nationwide were reviewed. Data were prospectively collected in national registries (eg, SITS-TBY and RES-Q). Primary outcome was functional independence (modified Rankin Scale 0-2) at 3 months; secondary outcome was ICH. RESULTS: Of the 4,351 patients who underwent MT, 1,750 (40%) and 666 (15%) were excluded owing to missing data from the functional independence and ICH outcome cohorts, respectively. In the functional independence cohort (n = 2,601), 771 (30%) patients received antiplatelets before MT. Favorable outcome did not differ in any antiplatelet, aspirin, and clopidogrel groups when compared with that in the no-antiplatelet group: odds ratio (OR), 1.00 (95% CI, 0.84-1.20); OR, 1.05 (95% CI, 0.86-1.27); and OR, 0.88 (95% CI, 0.55-1.41), respectively. In the ICH cohort (n = 3,685), 1095 (30%) patients received antiplatelets before MT. The rates of ICH did not increase in any treatment options (any antiplatelet, aspirin, clopidogrel, and dual antiplatelet groups) when compared with those in the no-antiplatelet group: OR, 1.03 (95% CI, 0.87-1.21); OR, 0.99 (95% CI, 0.83-1.18); OR, 1.10 (95% CI, 0.82-1.47); and OR, 1.43 (95% CI, 0.87-2.33), respectively. CONCLUSIONS: Antiplatelet monotherapy before MT did not improve functional independence or increase the risk of ICH.
- MeSH
- Aspirin škodlivé účinky MeSH
- cévní mozková příhoda * diagnostické zobrazování terapie MeSH
- intrakraniální krvácení chemicky indukované MeSH
- ischemická cévní mozková příhoda * diagnostické zobrazování terapie MeSH
- ischemie mozku * diagnostické zobrazování terapie MeSH
- klopidogrel škodlivé účinky MeSH
- lidé MeSH
- mechanická trombolýza * škodlivé účinky MeSH
- trombektomie škodlivé účinky MeSH
- trombolytická terapie škodlivé účinky MeSH
- výsledek terapie MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
Cíl: Mechanická trombektomie (MT) symptomatického uzávěru mozkové tepny u pacientů s akutní ischemickou cévní mozkovou příhodou (iCMP) se stala standardní léčbou. Cílem studie METRICS (MechanicalThrombectomy Quality Indicators Study in Czech Stroke Centers) bylo ověřit, zda centra v České republice provádějící endovaskulámí léčbu iCMP plní indikátory kvality navržené multioborovým konsenzem, a tak v mezinárodním kontextu ověřit kvalitu péče napříč naší republikou. Metodika: Národní prospektivní observační studie METRICS probíhala v České republice v roce 2019. Studie se zúčastnilo 12 z 15 center provádějících mechanickou trombektomii. Všechna technická a klinická data byla sbírána prospektivně a následně byla srovnána s doporučenými hodnotamijednotlivých parametrů multioborového konsenzu. Výsledky: V práci jsou analyzována data z 12 center, ve kterých bylo mechanickou trombektomii ošetřeno celkem 1178 pacientů (50,3% mužů) s mediánem věku 72 roky (18-98 let). Intravenóznitrombolýzou (IVT) bylo před MT léčeno 827 nemocných (70,2%) a 445 (37,8%) bylo sekundárně transponováno k MT z jiného centra. Získaná data z národní prospektivní observační studie METRICS byla hodnocena pro jednotlivá centra. Shoda výsledků péče s doporučeními navrženými multioborovým konsenzem byla velmi vysoká. Pět center splnilo parametry všech doporučení. Ostatní centra nesplnila pouze ojedinělá kritéria a ve většině případů jen hraničně. Závěr: Výsledky studie METRICS ukazují, že lze splnit doporučované hodnoty parametrů uvedených v mezinárodním multioborovém konsenzu i v podmínkách běžné klinické praxe napříč Českou republikou.
Aim: Mechanical thrombectomy (MT) of symptomatic occlusion of cerebral artery has become a standard treatment in acute ischemic stroke (IS) patients. The aim of the presented study was to evaluate if centers performing endovascular treatment of acute ischemic stroke meet the recommendations established by the international multi-society consensus. Methods: The national prospective observational multicenter study METRICS (Mechanical Thrombectomy Quality Indicators Study in Czech Stroke Centers) was conducted in Czech Republic in year 2019. Twelve of 15 centers performing mechanicaltrombectomy were participating on study. Alltechnicaland clinical data were collected prospectively and achieved results were subsequently compared with the recommendations established by international multi-society consensus. Results: In 12 centers 1178 (86%) patients (50.3% males, median of age 72 years, range 18-98 years) by MT were treated in 2019 and the collected data of these patients were analyzed. IV thrombolysis prior MT was performed in 827 (70.2%) patients and 445 (37.8%) patients were transferred secondarily for MT from primary stroke centers to dedicated comprehensive centers. Achieved data from the study METRICS were subsequently evaluated for individual participating centers. The concordance of results with the recommendations of multi-society consensus was very high. Five centers met parameters of all recommendations. Remaining centers did not meet sporadic criteria only and most parameters had borderline values. Conclusion: The results of METRICS study showed that it is possible meet the recommended values of parameters stated in the international multi-society consensus even in a real world practice across the Czech Republic.
- Klíčová slova
- studie METRICS,
- MeSH
- ischemická cévní mozková příhoda * terapie MeSH
- lidé MeSH
- mechanická trombolýza metody MeSH
- prospektivní studie MeSH
- ukazatele kvality zdravotní péče MeSH
- Check Tag
- lidé MeSH
INTRODUCTION: Patent foramen ovale (PFO) is a risk factor of decompression sickness (DCS). However, data on risk stratification of divers with a PFO are sparse. This study sought to evaluate the risk of neurological DCS (DCSneuro), based on the presence and grade of a right-to-left shunt (RLS). METHODS: A total of 640 divers were screened for a RLS using TCD between 1/2006 and 4/2017. RLS was graded as low, medium, or high grade with two subgroups - after a Valsalva maneuver or at rest. Divers were questioned about their DCS history. Survival analysis techniques were used to assess risk factors for unprovoked DCS. RESULTS: A RLS was found in 258 divers (40.3 %). 44 (17.1 %) divers with a RLS experienced DCSneuro compared to 5 (1.3 %) divers without a RLS (p <0.001). The proportion of DCSneuro increased from 4.6 % in the low-grade RLS subgroup to 57.1 % in the subgroup with high-grade RLS at rest. The hazard ratio for DCSneuro and RLS was11.806 (p <0.001). CONCLUSIONS: Divers with a RLS had a higher risk of DCSneuro and the risk increased with RLS grade. We suggest that TCD is an appropriate method for RLS screening and risk stratification in divers (Tab. 4, Fig. 2, Ref. 29).
- MeSH
- dekompresní nemoc * epidemiologie etiologie klasifikace patofyziologie MeSH
- dospělí MeSH
- foramen ovale apertum komplikace MeSH
- lidé MeSH
- plošný screening metody MeSH
- potápění * škodlivé účinky MeSH
- rizikové faktory MeSH
- statistika jako téma MeSH
- syndrom přetrvávajícího fetálního oběhu diagnóza epidemiologie komplikace MeSH
- ultrasonografie dopplerovská transkraniální MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- Publikační typ
- klinická studie MeSH
- práce podpořená grantem MeSH
OBJECTIVES: This paper sought to evaluate the occurrence of decompression sickness (DCS) after the application of a patent foramen ovale (PFO) screening and risk stratification strategy. BACKGROUND: PFO is associated with an increased risk of DCS. Recently, transcatheter closure was reported to reduce DCS occurrence in divers with a high-grade shunt. However, to date, there are no data regarding the effectiveness of any PFO screening and risk stratification strategy for divers. METHODS: A total of 829 consecutive divers (age 35.4 ± 10.0 years, 81.5% men) were screened for PFO by means of transcranial color-coded sonography in the DIVE-PFO (Decompression Illness Prevention in Divers with a Patent Foramen Ovale) registry. Divers with a high-grade PFO were offered either catheter-based PFO closure (the closure group) or advised conservative diving (high grades). Divers with a low-grade shunt were advised conservative diving (low grades), whereas those with no PFO continued unrestricted diving (controls). A telephone follow-up was performed. To study the effect of the screening and risk stratification strategy, DCS occurrence before enrollment and during the follow-up was compared. RESULTS: Follow-up was available for 748 (90%) divers. Seven hundred and 2 divers continued diving and were included in the analysis (mean follow-up 6.5 ± 3.5 years). The DCS incidence decreased significantly in all groups, except the controls. During follow-up, there were no DCS events in the closure group; DCS incidence was similar to the controls in the low-grade group (HR: 3.965; 95% CI: 0.558-28.18; P = 0.169) but remained higher in the high-grade group (HR: 26.170; 95% CI: 5.797-118.160; P < 0.0001). CONCLUSIONS: The screening and risk stratification strategy using transcranial color-coded sonography was associated with a decrease in DCS occurrence in divers with PFO. Catheter-based PFO closure was associated with a DCS occurrence similar to the controls; the conservative strategy had a similar effect in the low-grade group, but in the high-grade group the DCS incidence remained higher than in all other groups.
- MeSH
- dekompresní nemoc * diagnostické zobrazování epidemiologie etiologie MeSH
- dospělí MeSH
- foramen ovale apertum * komplikace diagnostické zobrazování epidemiologie MeSH
- hodnocení rizik MeSH
- lidé středního věku MeSH
- lidé MeSH
- prediktivní hodnota testů MeSH
- registrace MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
INTRODUCTION: During the COVID-19 pandemic, studies reported less number of hospitalizations for acute stroke and reduction in the use of recanalization treatments. This study analyzes nationwide data on stroke admissions and management in the Czech Republic during the first wave of the COVID-19 pandemic. METHODS: We compared the early COVID-19 pandemic (March-May 2020) with the pre-pandemic period (January-February 2020 and March-May 2019): (a) the National Register of Reimbursed Health Services provided volume of all admissions for subarachnoid hemorrhage (SAH), intracerebral hemorrhage (ICH), and ischemic stroke (IS), and volume of recanalization treatments (intravenous thrombolysis [IVT] and mechanical thrombectomy [MT]); (b) Registry of Stroke Care Quality provided door-to-needle time (DNT), onset-to-door time (ODT), and stroke severity at admission (National Institutes of Health Stroke Scale, NIHSS) for IS. RESULTS: During the pandemic (March-May 2020), the peak number of COVID-19 patients treated in Czech hospitals was 39 per million. In March-May 2020 versus March-May 2019, hospital admissions decreased as follows: stroke overall by 14% (p < 0.001), IS by 14% (p < 0.001), SAH by 15% (p = 0.07), and ICH by 7% (p = 0.17). The mean age was 74 years versus 74 years (p = 0.33), and 52% versus 51% were men (p = 0.34). The volumes of IVT and MT decreased by 14% (p = 0.001) and 19% (p = 0.01), respectively. The proportions of all IS patients receiving IVT or MT remained unchanged, with, respectively, 17% versus 17% receiving IVT (p = 0.86) and 5% versus 5% receiving MT (p = 0.48). DNT and ODT were 24 versus 25 min (p = 0.58) and 168 versus 156 min (p = 0.23), respectively. NIHSS at admission did not differ (6 vs. 6; p = 0.54). CONCLUSION: Even with a low burden of COVID-19 during the first wave and no change in organization and logistics of stroke services, stroke admissions and volume of recanalization treatments decreased. Public health communication campaigns should encourage people to seek emergency medical care for stroke symptoms during the COVID-19 pandemic.
- MeSH
- cévní mozková příhoda * terapie MeSH
- COVID-19 * epidemiologie terapie MeSH
- lidé MeSH
- pandemie * MeSH
- senioři MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
BACKGROUND AND PURPOSE: Recent studies suggested an increased incidence of cerebral venous thrombosis (CVT) during the coronavirus disease 2019 (COVID-19) pandemic. We evaluated the volume of CVT hospitalization and in-hospital mortality during the 1st year of the COVID-19 pandemic compared to the preceding year. METHODS: We conducted a cross-sectional retrospective study of 171 stroke centers from 49 countries. We recorded COVID-19 admission volumes, CVT hospitalization, and CVT in-hospital mortality from January 1, 2019, to May 31, 2021. CVT diagnoses were identified by International Classification of Disease-10 (ICD-10) codes or stroke databases. We additionally sought to compare the same metrics in the first 5 months of 2021 compared to the corresponding months in 2019 and 2020 (ClinicalTrials.gov Identifier: NCT04934020). RESULTS: There were 2,313 CVT admissions across the 1-year pre-pandemic (2019) and pandemic year (2020); no differences in CVT volume or CVT mortality were observed. During the first 5 months of 2021, there was an increase in CVT volumes compared to 2019 (27.5%; 95% confidence interval [CI], 24.2 to 32.0; P<0.0001) and 2020 (41.4%; 95% CI, 37.0 to 46.0; P<0.0001). A COVID-19 diagnosis was present in 7.6% (132/1,738) of CVT hospitalizations. CVT was present in 0.04% (103/292,080) of COVID-19 hospitalizations. During the first pandemic year, CVT mortality was higher in patients who were COVID positive compared to COVID negative patients (8/53 [15.0%] vs. 41/910 [4.5%], P=0.004). There was an increase in CVT mortality during the first 5 months of pandemic years 2020 and 2021 compared to the first 5 months of the pre-pandemic year 2019 (2019 vs. 2020: 2.26% vs. 4.74%, P=0.05; 2019 vs. 2021: 2.26% vs. 4.99%, P=0.03). In the first 5 months of 2021, there were 26 cases of vaccine-induced immune thrombotic thrombocytopenia (VITT), resulting in six deaths. CONCLUSIONS: During the 1st year of the COVID-19 pandemic, CVT hospitalization volume and CVT in-hospital mortality did not change compared to the prior year. COVID-19 diagnosis was associated with higher CVT in-hospital mortality. During the first 5 months of 2021, there was an increase in CVT hospitalization volume and increase in CVT-related mortality, partially attributable to VITT.
- Publikační typ
- časopisecké články MeSH