Evidence map›Paper›PMID 37054775›Full record

ArticleChest2023

National Trends, Risk Factors, and Outcomes of Acute In-Hospital Stroke Following Lung Transplantation in the United States: Analysis of the United Network for Organ Sharing Registry.

Benjamin L Shou, Christopher Wilcox, Isabella S Florissi, Aravind Krishnan, Bo Soo Kim, Steven P Keller, Glenn J R Whitman, Ken Uchino, Errol L Bush, Sung-Min Cho

Open access · greenAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Chest, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 pooled it
1.0field-weighted citation impact, top 26% 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

2 citing papers in PubMed, 1 synthesis or guideline pooled it, 3 citations in OpenAlex.

  1. Pooled it
  2. Observational
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

10 authors at 3 institutions in 1 country.

Benjamin L ShouDivision of Cardiac Surgery, Johns Hopkins School of Medicine, Baltimore, MD.
Christopher WilcoxDivision of Neurosciences Critical Care, Johns Hopkins School of Medicine, Baltimore, MD.
Isabella S FlorissiDivision of Cardiac Surgery, Johns Hopkins School of Medicine, Baltimore, MD.
Aravind KrishnanDepartment of Cardiothoracic Surgery, Stanford University, Stanford, CA.
Bo Soo KimDivision of Pulmonary and Critical Care Medicine, Johns Hopkins School of Medicine, Baltimore, MD.
Steven P KellerDivision of Pulmonary and Critical Care Medicine, Johns Hopkins School of Medicine, Baltimore, MD.
Glenn J R WhitmanDivision of Cardiac Surgery, Johns Hopkins School of Medicine, Baltimore, MD.
Ken UchinoCerebrovascular Center, Neurological Institute, Cleveland Clinic, Cleveland, OH.
Errol L BushDivision of General Thoracic Surgery, Johns Hopkins School of Medicine, Baltimore, MD.
Sung-Min ChoDivision of Cardiac Surgery, Johns Hopkins School of Medicine, Baltimore, MD; Division of Neurosciences Critical Care, Johns Hopkins School of Medicine, Baltimore, MD. Electronic address: csungmi1@jhmi.edu.
Johns Hopkins University · USCleveland Clinic · USStanford University · US

Funding

Functional restoration of ventriculo-arterial coupling in cardiogenic shock via dual mechanical supportK08HL143342 · NHLBI · JOHNS HOPKINS UNIVERSITY · PI KELLER, STEVEN PAUL · 2018 to 2023
$853k
CLots and Oxygen in Va-ExtracorpoReal membrane oxygenation (CLOVER) studyK23HL157610 · NHLBI · JOHNS HOPKINS UNIVERSITY · PI Sung-Min Cho · 2022 to 2026
$797k
NHLBI NIH HHS K08 HL143342NHLBI NIH HHS K23 HL157610NHLBI NIH HHS L30 HL165486
6 · The paper itself

Abstract

backgroundLung transplantation (LTx) is the definitive treatment for end-stage lung failure. However, there have been no large, long-term studies on the impact of acute in-hospital stroke in this population. RESEARCH QUESTION: What are the trends, risk factors, and outcomes of acute stroke in patients undergoing LTx in the United States? STUDY DESIGN AND

methodsWe identified adult first-time isolated LTx recipients from the United Network for Organ Sharing database, which comprehensively captures every transplant in the United States, between May 2005 and December 2020. Stroke was defined as occurring at any time after LTx but prior to discharge. Multivariable logistic regression with stepwise feature elimination was used to identify risk factors for stroke. Freedom from death in patients with a stroke vs those without a stroke was evaluated with Kaplan-Meier analysis. Cox proportional hazards analysis was used to identify predictors of death at 24 months.

resultsOf 28,564 patients (median age, 60 years; 60% male), 653 (2.3%) experienced an acute in-hospital stroke after LTx. Median follow-up was 1.2 (stroke) and 3.0 (non-stroke) years. Annual incidence of stroke increased (1.5% in 2005 to 2.4% in 2020; P for trend = .007), as did lung allocation score and utilization of post-LTx extracorporeal membrane oxygenation (P = .01 and P < .001, respectively). Compared with those without stroke, patients with stroke had lower survival at 1 month (84% vs 98%), 12 months (61% vs 88%), and 24 months (52% vs 80%) (log-rank test, P < .001 for all). In Cox analysis, acute stroke conferred a high hazard of mortality (hazard ratio, 3.01; 95% CI, 2.67-3.41). Post-LTx extracorporeal membrane oxygenation was the strongest risk factor for stroke (adjusted OR, 2.98; 95% CI, 2.19-4.06).

interpretationAcute in-hospital stroke post-LTx has been increasing over time and is associated with markedly worse short- and long-term survival. As increasingly sicker patients undergo LTx as well as experience stroke, further research on stroke characteristics, prevention, and management strategies is warranted.

Indexed as

Lung TransplantationRegistriesStrokeAgedFemaleHumansIncidenceMaleMiddle AgedPostoperative ComplicationsRetrospective StudiesRisk FactorsUnited Stateslung transplantstrokeUNOS

Identifiers

PMID37054775
PMCPMC10567928
OpenAlexW4364382612

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.