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3 "retrospective studies"
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Original Articles
Anesthesiology
Anesthesiological management in endovascular mechanical thrombectomy: a propensity score-matched retrospective analysis in Italy
Antonio Romanelli, Aniello Iovino, Antonella Langone, Rosa Napoletano, Giulia Frauenfelder, Flora Minichino, Liliana D’Ambrosio, Miriam Caterino, Raffaele Tortora, Renato Gammaldi, Paolo Barone, Renato Saponiero, Daniele Giuseppe Romano
Acute Crit Care. 2025;40(2):252-263.   Published online April 11, 2025
DOI: https://doi.org/10.4266/acc.003000
  • 2,728 View
  • 67 Download
  • 1 Web of Science
  • 1 Crossref
AbstractAbstract PDF
Background
Endovascular mechanical thrombectomy (EMT) can be performed with general anesthesia (GA) or using non-GA techniques. Several meta-analyses on the topic have reported discordant main outcomes. The aim of this retrospective single-center study was to analyze the relationship between clinical outcomes and anesthesiological management (GA vs. non-GA) in patients who underwent EMT for acute anterior ischemic stroke (AIS).
Methods
We performed a propensity score-matched (PSM) analysis of patients who underwent EMT for acute AIS from January 2018 to December 2021. For PSM, we chose covariates influencing clinical decisions about anesthesiological management. Comparisons between groups were performed with the chi-square test for categorical variables and Student t-test or the Mann-Whitney U-test for continuous variables as appropriate. The relationships between anesthesiological management and clinical outcomes were analyzed using logistic regression, and results are reported as odds ratios with 95% confidence intervals. A two-sided P-value <0.05 was considered statistically significant.
Results
From 194 observations (78 in the GA group, 116 in the non-GA group), after PSM, we obtained 70 data pairs. Both anesthesiological approaches resulted in similar rates of in-hospital mortality, 90-day functional independence, full recanalization, procedural complications, and intracerebral hemorrhage (ICH). Performing EMT with GA was unrelated to the in-hospital and 90-day death rates, 90-day functional independence, full recanalization rate, procedural complications, and ICH (P>0.05).
Conclusions
Anesthesiological management did not influence clinical outcomes of EMT for acute AIS. Physiological stability during EMT may impact outcomes more significantly than anesthesiological management. Further studies on this topic are needed.

Citations

Citations to this article as recorded by  
  • Impact of anesthesia methods on functional outcomes in patients with acute ischemic stroke undergoing mechanical thrombectomy: insights from the ENCHANTED2/MT trial
    Hao Wang, Hongye Xu, Xiongfeng Wu, Xiaoxi Zhang, Rundong Chen, Lei Zhang, Xiaofei Ye, Yongwei Zhang, Pengfei Yang, Shengdong Chen, Xin You, Jianmin Liu
    Frontiers in Neurology.2026;[Epub]     CrossRef
Neurosurgery
Acute Cholecystitis as a Cause of Fever in Aneurysmal Subarachnoid Hemorrhage
Na Rae Yang, Kyung Sook Hong, Eui Kyo Seo
Korean J Crit Care Med. 2017;32(2):190-196.   Published online May 31, 2017
DOI: https://doi.org/10.4266/kjccm.2016.00857
  • 8,659 View
  • 91 Download
  • 3 Web of Science
  • 4 Crossref
AbstractAbstract PDF
Background
Fever is a very common complication that has been related to poor outcomes after aneurysmal subarachnoid hemorrhage (aSAH). The incidence of acalculous cholecystitis is reportedly 0.5%–5% in critically ill patients, and cerebrovascular disease is a risk factor for acute cholecystitis (AC). However, abdominal evaluations are not typically performed for febrile patients who have recently undergone aSAH surgeries. In this study, we discuss our experiences with febrile aSAH patients who were eventually diagnosed with AC.
Methods
We retrospectively reviewed 192 consecutive patients who underwent aSAH from January 2009 to December 2012. We evaluated their characteristics, vital signs, laboratory findings, radiologic images, and pathological data from hospitalization. We defined fever as a body temperature of >38.3°C, according to the Society of Critical Care Medicine guidelines. We categorized the causes of fever and compared them between patients with and without AC.
Results
Of the 192 enrolled patients, two had a history of cholecystectomy, and eight (4.2%) were eventually diagnosed with AC. Among them, six patients had undergone laparoscopic cholecystectomy. In their pathological findings, two patients showed findings consistent with coexistent chronic cholecystitis, and two showed necrotic changes to the gall bladder. Patients with AC tended to have higher white blood cell counts, aspartame aminotransferase levels, and C-reactive protein levels than patients with fevers from other causes. Predictors of AC in the aSAH group were diabetes mellitus (odds ratio [OR], 8.758; P = 0.033) and the initial consecutive fasting time (OR, 1.325; P = 0.024).
Conclusions
AC may cause fever in patients with aSAH. When patients with aSAH have a fever, diabetes mellitus and a long fasting time, AC should be suspected. A high degree of suspicion and a thorough abdominal examination of febrile aSAH patients allow for prompt diagnosis and treatment of this condition. Additionally, physicians should attempt to decrease the fasting time in aSAH patients.

Citations

Citations to this article as recorded by  
  • Role of serum magnesium in post-aneurysmal subarachnoid hemorrhagic hydrocephalus
    Moinay Kim, Hyunchul Jung, Seung Bin Kim, Jun Ha Hwang, Hanwool Jeon, Yeongu Chung, Youngbo Shim, Jae Hyun Kim, Joonho Byun, Aiden Cousins, Wonhyoung Park, Jung Cheol Park, Jae Sung Ahn, Seungjoo Lee
    Acute and Critical Care.2025; 40(4): 582.     CrossRef
  • Rare or Overlooked Cases of Acute Acalculous Cholecystitis in Young Patients with Central Nervous System Lesion
    Seong-Hun Kim, Min-Gyu Lim, Jun-Sang Han, Chang-Hwan Ahn, Tae-Du Jung
    Healthcare.2023; 11(10): 1378.     CrossRef
  • Acute cholecystitis as a rare and overlooked complication in stroke patients
    Myung Chul Yoo, Seung Don Yoo, Jinmann Chon, Young Rok Han, Seung Ah Lee
    Medicine.2019; 98(9): e14492.     CrossRef
  • Acute Acalculous Cholecystitis in Neurological Patients; Clinical Review, Risk Factors, and Possible Mechanism
    See Won Um, Hak Cheol Ko, Seung Hwan Lee, Hee Sup Shin, Jun Seok Koh
    Journal of Neurointensive Care.2019; 2(2): 77.     CrossRef
Cardiology/Pediatric
Effectiveness of Bradycardia as a Single Parameter in the Pediatric Acute Response System
Yu Hyeon Choi, Hyeon Seung Lee, Bong Jin Lee, Dong In Suh, June Dong Park
Korean J Crit Care Med. 2014;29(4):297-303.   Published online November 30, 2014
DOI: https://doi.org/10.4266/kjccm.2014.29.4.297
  • 7,757 View
  • 57 Download
  • 4 Crossref
AbstractAbstract PDF
BACKGROUND
Various tools for the acute response system (ARS) predict and prevent acute deterioration in pediatric patients. However, detailed criteria have not been clarified. Thus we evaluated the effectiveness of bradycardia as a single parameter in pediatric ARS.
METHODS
This retrospective study included patients who had visited a tertiary care children's hospital from January 2012 to June 2013, in whom ARS was activated because of bradycardia. Patient's medical records were reviewed for clinical characteristics, cardiologic evaluations, and reversible causes that affect heart rate.
RESULTS
Of 271 cases, 261 (96%) had ARS activation by bradycardia alone with favorable outcomes. Evaluations and interventions were performed in 165 (64.5%) and 13 cases (6.6%) respectively. All patients in whom ARS was activated owing to bradycardia and another criteria underwent evaluation, unlike those with bradycardia alone (100.0% vs. 63.2%, p = 0.016). Electrocardiograms were evaluated in 233 (86%) cases: arrhythmias were due to borderline QT prolongation and atrioventricular block (1st and 2nd-degree) in 25 cases (9.2%). Bradycardia-related causes were reversible in 202 patients (74.5%). Specific causes were different in departments at admission. Patients admitted to the hemato-oncology department required ARS activation during the night (69.3%, p = 0.03), those to the endocrinology department required ARS activation because of medication (72.4%, p < 0.001), and those to the gastroenterology department had low body mass indexes (32%, p = 0.01).
CONCLUSIONS
Using bradycardia alone in pediatric ARS is not useful, because of its low specificity and poor predictive ability for deterioration. However, bradycardia can be applied to ARS concurrently with other parameters.

Citations

Citations to this article as recorded by  
  • Impact of an independent pediatric rapid response team on pediatric patient safety
    Jin Hwan Lyu, Soo Keun Lee, Min Joo Kang, Sumin Lee, Mireu Park, Soo Yeon Kim, Kyung Won Kim, Jong Deok Kim
    Archives of Pediatric Critical Care.2024; 2(2): 91.     CrossRef
  • Effect of Diurnal Variation of Heart Rate and Respiratory Rate on Activation of Rapid Response System and Clinical Outcome in Hospitalized Children
    Lia Kim, Kyoung Sung Yun, June Dong Park, Bongjin Lee
    Children.2023; 10(1): 167.     CrossRef
  • Eleven years of experience in operating a pediatric rapid response system at a children’s hospital in South Korea
    Yong Hyuk Jeon, Bongjin Lee, You Sun Kim, Won Jin Jang, June Dong Park
    Acute and Critical Care.2023; 38(4): 498.     CrossRef
  • Pediatric triage modifications based on vital signs: a nationwide study
    Bongjin Lee, June Dong Park, Young Ho Kwak, Do Kyun Kim
    Clinical and Experimental Emergency Medicine.2022; 9(3): 224.     CrossRef
ACC : Acute and Critical Care
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