Evidence map›Paper›PMID 33403579›Full record

ArticleNeurocritical care2021

Sustained Low-Efficiency Dialysis is Associated with Worsening Cerebral Edema and Outcomes in Intracerebral Hemorrhage.

Alireza Shirazian, Andres F Peralta-Cuervo, Maria P Aguilera-Pena, Louis Cannizzaro, Vi Tran, Doan Nguyen, Ifeanyi Iwuchukwu

Abstract readMulticenter Study
PubMed Publisher
In one paragraph

Article in Neurocritical care, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 2 pooled it
0.8field-weighted citation impact, top 27% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 2 syntheses or guidelines pooled it, 8 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Review
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 3 institutions in 1 country.

Alireza ShirazianTulane University School of Medicine, 1430 Tulane Ave, New Orleans, LA, 70112, USA. ashirazian@tulane.edu.ORCID http://orcid.org/0000-0002-6029-6822
Andres F Peralta-CuervoOchsner Clinical School, Jefferson, LA, USA.
Maria P Aguilera-PenaOchsner Clinical School, Jefferson, LA, USA.
Louis CannizzaroOchsner Clinic Foundation, Jefferson, LA, USA.
Vi TranUniversity of South Alabama School of Medicine, Mobile, AL, USA.
Doan NguyenInstitute for Translational Research, Ochsner Medical Center, Jefferson, LA, USA.
Ifeanyi IwuchukwuOchsner Clinical School, The University of Queensland, Jefferson, LA, USA.
Ochsner Medical Center · USTulane University · USUniversity of South Alabama · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

BACKGROUND/

objectivesWe postulated that renal replacement therapy (RRT) in ICH patients with advanced chronic kidney disease (CKD) is associated with increased frequency and size of perihematomal edema (PHE) expansion and worse patient outcomes.

methodsThe Get With the Guidelines-Stroke Registry was queried for all patients admitted with ICH (N = 1089). Secondary causes, brainstem ICH, and initial HV < 7 cc were excluded. We identified patients with advanced CKD with and without RRT following admission for ICH. ABC/2 formula was used to measure hematoma volume (HV) and PHE. Patient outcomes were 30-day mortality, 90-day modified Rankin Scale score, and discharge disposition. We used propensity scores and optimal matching to adjust for multiple covariates.

resultsAt 48 h post-ICH, PHE expansion was a significant predictor of poor patient outcomes in our cohort. Patients with CKD who received sustained low-efficacy dialysis (SLED) treatment had larger 48 h PHE growth compared to both untreated CKD group (average treatment effect (ATE), 11.5; 95% CI, 4.9-18.1; p < 0.01) and all untreated patients (ATE, 7.43; 95% CI, 4.7-10.2; p < 0.01). Moreover, patients with RRT had significantly worse functional and mortality outcomes.

conclusionsSLED treatment in ICH patients with CKD was associated with significant increase in rate and frequency of PHE expansion. Absolute increase in PHE during 48-h post-ICH was associated with increased mortality and worse functional outcomes. Further prospective and multicenter evaluation is needed to differentiate the effects of RRT on hematoma dynamics and patient outcomes from those attributed to CKD.

Indexed as

Brain EdemaHybrid Renal Replacement TherapyCerebral HemorrhageHematomaHumansTreatment OutcomeCerebral edemaChronic kidney diseaseHematoma expansionIntracerebral hemorrhageOutcomesPerihematomal edemaRenal replacement therapy

Identifiers

PMID33403579
OpenAlexW3119530087

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.