Journal article
Stroke in critically ill patients with respiratory failure due to COVID-19: Disparities between low-middle and high-income countries
Heart & lung, v 68, pp 131-144
01 Nov 2024
PMID: 38968643
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
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.
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Details
- Title
- Stroke in critically ill patients with respiratory failure due to COVID-19: Disparities between low-middle and high-income countries
- Creators
- Denise Battaglini - Ospedale Policlinico San MartinoThu-Lan Kelly - University of GenoaMatthew Griffee - University of UtahJonathon Fanning - Griffith UniversityLavienraj Premraj - Griffith UniversityGlenn Whitman - Johns Hopkins UniversityDiego Bastos Porto - Universidade Federal do CearáRakesh Arora - University of Cape TownDavid Thomson - University of Cape TownPaolo Pelosi - Prince Charles HospitalNicole M. White - Wesley Research InstituteGianluigi Li Bassi - Wesley Research InstituteJacky Suen - Wesley HospitalJohn F. Fraser - Wesley HospitalChiara Robba - Johns Hopkins UniversitySungmin Cho - Johns Hopkins UniversityCOVID 19 Critical Care Consortium Investigators
- Publication Details
- Heart & lung, v 68, pp 131-144
- Publisher
- Elsevier
- Number of pages
- 14
- Grant note
- BITRECS fellowship Queensland Health Health Research Board of Ireland - Advance Queensland fellowship program, Queensland Government, Australia Fisher & Paykel Healthcare Wesley Medical Research Prince Charles Hospital Foundation 100010434; LCF/PR/ GN18/50310006 / La Caixa" Foundation; La Caixa Foundation University of Queensland INV-034765 / Bill & Melinda Gates Foundation; Bill & Melinda Gates Foundation Grand Challenges Explorations Initiative; CGIAR 754550 / European Union; European Union (EU)
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- College of Medicine
- Web of Science ID
- WOS:001268895800001
- Scopus ID
- 2-s2.0-85197512084
- Other Identifier
- 991022202501904721
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- Collaboration types
- Domestic collaboration
- International collaboration
- Web of Science research areas
- Cardiac & Cardiovascular Systems
- Nursing
- Respiratory System