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1. Impact of Hemoglobin Levels on Composite Cardiac Arrest or Stroke Outcome in Patients With Respiratory Failure Due to COVID-19

Author

Shi Nan Feng, BSPH, Thu-Lan Kelly, PhD, John F. Fraser, MD, PhD, Gianluigi Li Bassi, MD, PhD, Jacky Suen, PhD, Akram Zaaqoq, MD, MPH, Matthew J. Griffee, MD, Rakesh C. Arora, MD, Nicole White, PhD, Glenn Whitman, MD, Chiara Robba, MD, PhD, Denise Battaglini, MD, PhD, Sung-Min Cho, DO, MHS, on behalf of COVID-19 Critical Care Consortium (CCCC), Robert Bartlett, John F. Fraser, Gianluigi Li Bassi, Jacky Y. Suen, Heidi J. Dalton, John Laffey, Daniel Brodie, Eddy Fan, Antoni Torres, Davide Chiumello, Alyaa Elhazm, Carol Hodgson, Shingo Ichiba, Carlos Luna, Srinivas Murthy, Alistair Nichol, Pauline Yeung Ng, Mark Ogino, Aidan Burrell, Antonio Pesenti, Tala Al-Dabbous, Huda Alfoudri, Mohammed Shamsah, Subbarao Elapavaluru, Ashley Berg, Christina Horn, Yunis Mayasi, Stephan Schroll, Dan Meyer, Jorge Velazco, Ludmyla Ploskanych, Wanda Fikes, Rohini Bagewadi, Marvin Dao, Haley White, Alondra Berrios Laviena, Ashley Ehlers Maysoon, Shalabi-McGuire, Trent Witt, Lorenzo Grazioli, Luca Lorini, E. Wilson Grandin, Jose Nunez, Tiago Reyes, Diarmuid O’Briain, Stephanie Hunter, Mahesh Ramanan, Julia Affleck, Hemanth Hurkadli Veerendra, Sumeet Rai, Josie Russell-Brown, Mary Nourse, Mark Joseph, Brook Mitchell, Martha Tenzer, Ryuzo Abe, Hwa Jin Cho, In Seok Jeong, Nadeem Rahman, Vivek Kakar, Andres Oswaldo Razo Vazquez, Nicolas Brozzi, Omar Mehkri, Sudhir Krishnan Abhijit, Duggal Stuart Houltham, Jerónimo Graf, Roderigo Diaz, Roderigo Orrego, Camila Delgado, Joyce González, Maria Soledad Sanchez, Michael Piagnerelli, Josefa Valenzuela Sarrazin, A/Prof. Gustavo Zabert, Lucio Espinosa, Paulo Delgado, Victoria Delgado, Diego Fernando, Bautista Rincón, Angela Maria Marulanda Yanten, Melissa Bustamante Duque, Alyaa Elhazmi, Abdullah Al-Hudaib, Maria Callahan, M. Azhari Taufik, Elizabeth Yasmin Wardoyo, Margaretha Gunawan, Nurindah S Trisnaningrum, Vera Irawany, Muhammad Rayhan, Mauro Panigada, Alberto Zanella, Giacomo Grasselli, Sebastiano Colombo, Chiara Martinet, Gaetano Florio, Massimo Antonelli, Simone Carelli, Domenico L. Grieco, Motohiro Asaki, Kota Hoshino, Leonardo Salazar, Mary Alejandra Mendoza Monsalve, Bairbre McNicholas, David Cosgrave, Joseph McCaffrey, Allison Bone, Yusuff Hakeem, James Winearls, Mandy Tallott, David Thomson, Christel Arnold-Day, Jerome Cupido, Zainap Fanie, Malcom Miller, Lisa Seymore, Dawid van Straaten, Ali Ait Hssain, Jeffrey Aliudin, Al-Reem Alqahtani, Khoulod Mohamed, Ahmed Mohamed, Darwin Tan, Joy Villanueva, Ahmed Zaqout, Ethan Kurtzman, Arben Ademi, Ana Dobrita, Khadija El Aoudi, Juliet Segura, Gezy Giwangkancana, Shinichiro Ohshimo, Javier Osatnik, Anne Joosten, Minlan Yang, Ana Motos, Francisco Arancibia, Virginie Williams, Alexandre Noel, Nestor Luque, Marina Fantini, Ruth Noemi Jorge García, Enrique Chicote Alvarez, Anna Greti, Adrian Ceccato, Angel Sanchez, Ana Loza Vazquez, Ferran Roche-Campo, Diego Franch-Llasat, Divina Tuazon, Marcelo Amato, Luciana Cassimiro, Flavio Pola, Francis Ribeiro, Guilherme Fonseca, Heidi Dalton, Mehul Desai, Erik Osborn Hala Deeb, Antonio Arcadipane, Gennaro Martucci, Giovanna Panarello, Chiara Vitiello, Claudia Bianco, Giovanna Occhipinti, Matteo Rossetti, Raffaele Cuffaro, Sung-Min Cho, Glenn Whitman, Hiroaki Shimizu, Naoki Moriyama, Jae-Burm Kim, Nobuya Kitamura, Johannes Gebauer, Toshiki Yokoyama, Abdulrahman Al-Fares, Sarah Buabbas, Esam Alamad, Fatma Alawadhi, Kalthoum Alawadi, Hiro Tanaka, Satoru Hashimoto, Masaki Yamazaki, Tak-Hyuck Oh, Mark Epler, Cathleen Forney, Louise Kruse, Jared Feister, Joelle Williamson, Katherine Grobengieser, Eric Gnall, Sasha Golden, Mara Caroline, Timothy Shapiro, Colleen Karaj, Lisa Thome, Lynn Sher, Mark Vanderland, Mary Welch, Sherry McDermott, Matthew Brain, Sarah Mineall, Dai Kimura, Luca Brazzi, Gabriele Sales, Giorgia Montrucchio, Tawnya Ogston, Dave Nagpal, Karlee Fischer, Roberto Lorusso, Rajavardhan Rangappa, Sujin Rai, Argin Appu, Mariano Esperatti, Nora Angélica Fuentes, Maria Eugenia Gonzalez, Edmund G. Carton, Ayan Sen, Amanda Palacios, Deborah Rainey, Gordan Samoukoviv, Josie Campisi, Lucia Durham, Emily Neumann, Cassandra Seefeldt, Octavio Falcucci, Amanda Emmrich, Jennifer Guy, Carling Johns, Kelly Potzner, Catherine Zimmermann, Angelia Espinal, Nina Buchtele, Michael Schwameis, Andrea Korhnfehl, Roman Brock, Thomas Staudinger, Stephanie-Susanne, Stecher Michaela Barnikel, Sófia Antón, Alexandra Pawlikowski, Akram Zaaqoq, Lan Anh Galloway, Caitlin Merley, Marc Csete, Luisa Quesada, Isabela Saba, Daisuke Kasugai, Hiroaki Hiraiwa, Taku Tanaka, Eva Marwali, Yoel Purnama, Santi Rahayu Dewayanti, Ardiyan, Dafsah Arifa Juzar, Debby Siagian, Yih-Sharng Chen, Indrek Ratsep, Andra-Maris Post, Piret Sillaots, Anneli Krund, Merili-Helen Lehiste, Tanel Lepik, Frank Manetta, Effe Mihelis, Iam Claire Sarmiento, Mangala Narasimhan, Michael Varrone, Mamoru Komats, Julia Garcia-Diaz, Catherine Harmon, S. Veena Satyapriya, Amar Bhatt, Nahush A. Mokadam, Alberto Uribe, Alicia Gonzalez, Haixia Shi, Johnny McKeown, Joshua Pasek, Juan Fiorda, Marco Echeverria, Rita Moreno, Bishoy Zakhary, Marco Cavana, Alberto Cucino, Giuseppe Foti, Marco Giani, Benedetta Fumagalli, Valentina Castagna, Andrea Dell’Amore, Paolo Navalesi, Hoi-Ping Shum, Alain Vuysteke, Asad Usman, Andrew Acker, Benjamin Smood, Blake Mergler, Federico Sertic, Madhu Subramanian, Alexandra Sperry, Nicolas Rizer, Erlina Burhan, Menaldi Rasmin, Ernita Akmal, Faya Sitompul, Navy Lolong, Bhat Naivedh, Simon Erickson, Peter Barrett, David Dean, Julia Daugherty, Antonio Loforte, Irfan Khan, Mohammed Abraar Quraishi, Olivia DeSantis, Dominic So, Darshana Kandamby, Jose M. Mandei, Hans Natanael, Eka YudhaLantang, Anastasia Lantang, Surya Oto Wijaya, Anna Jung, George Ng, Wing Yiu Ng, Shu Fang, Alexis Tabah, Megan Ratcliffe, Maree Duroux, Shingo Adachi, Shota Nakao, Pablo Blanco, Ana Prieto, Jesús Sánchez, Meghan Nicholson, Warwick Butt, Alyssa Serratore, Carmel Delzoppo, Pierre Janin, Elizabeth Yarad, Richard Totaro, Jennifer Coles, Bambang Pujo, Robert Balk, Andy Vissing, Esha Kapania, James Hays, Samuel Fox, Garrett Yantosh, Pavel Mishin, Saptadi Yuliarto, Kohar Hari Santoso, Susanthy Djajalaksana, Arie Zainul Fatoni, Masahiro Fukuda, Keibun Liu, Paolo Pelosi, Denise Battaglini, Juan Fernando Masa Jiménez, Diego Bastos, Sérgio Gaião, Desy Rusmawatiningtyas, Young-Jae Cho, Su Hwan Lee, Tatsuya Kawasaki, Laveena Munshi, Pranya Sakiyalak, Prompak Nitayavardhana, Tamara Seitz, Rakesh Arora, David Kent, Daniel Marino, Swapnil Parwar, Andrew Cheng, Jennene Miller, Shigeki Fujitani, Naoki Shimizu, Jai Madhok, Clark Owyang, Hergen Buscher, Claire Reynolds, Olavi Maasikas, Aleksan Beljantsev, Vladislav Mihnovits, Takako Akimoto, Mariko Aizawa, Kanako Horibe, Ryota Onodera, Meredith Young, Timothy George, Kiran Shekar, Niki McGuinness, Lacey Irvine, Brigid Flynn, Tomoyuki Endo, Kazuhiro Sugiyama, Keiki Shimizu, Kathleen Exconde, Leslie Lussier, Gösta Lotz, Maximilian Malfertheiner, Lars Maier, Esther Dreier, Neurinda Permata Kusumastuti, Colin McCloskey, Al-Awwab Dabaliz, Tarek B Elshazly, Josiah Smith, Konstanty S. Szuldrzynski, Piotr Bielański, Keith Wille, Ken Kuljit, S. Parhar, Kirsten M. Fiest, Cassidy Codan, Anmol Shahid, Mohamed Fayed, Timothy Evans, Rebekah Garcia, Ashley Gutierrez, Tae Song, Rebecca Rose, Suzanne Bennett, Denise Richardson, Giles Peek, Lovkesh Arora, Kristina Rappapport, Kristina Rudolph, Zita Sibenaller, Lori Stout, Alicia Walter, Daniel Herr, Nazli Vedadi, Shaun Thompson, Julie Hoffman, Xiaonan Ying, Ryan Kennedy, Muhammed Elhadi, Matthew Griffee, Anna Ciullo, Yuri Kida, Ricard Ferrer Roca, JordI Riera, Sofia Contreras, Cynthia Alegre, Christy Kay, Irene Fischer, Elizabeth Renner, Hayato Taniguci, John Fraser, Jacky Suen, Adrian Barnett, Nicole White, Kristen Gibbons, Simon Forsyth, Amanda Corley, India Pearse, Samuel Hinton, Gabriella Abbate, Halah Hassan, Silver Heinsar, Varun A Karnik, Katrina Ki, Hollier F. O’Neill, Nchafatso Obonyo, Leticia Pretti Pimenta, Janice D. Reid, Kei Sato, Aapeli Vuorinen, Karin S. Wildi, Emily S. Wilson, Stephanie Yerkovich, James Lee, Daniel Plotkin, Barbara Wanjiru Citarella, Laura Merson, Emma Hartley, Bastian Lubis, Takanari Ikeyama, Balu Bhaskar, Jae-Seung Jung, Shay McGuinness, Glenn Eastwood, Sandra Rossi Marta, Fabio Guarracino, Stacy Gerle, Emily Coxon, Bruno Claro, Daniel Loverde, Namrata Patil, Vieri Parrini, Angela McBride, Kathryn Negaard, Angela Ratsch, Ahmad Abdelaziz, Juan David Uribe, Adriano Peris, Mark Sanders, Dominic Emerson, Muhammad Kamal, Pedro Povoa, Roland Francis, Ali Cherif, Sunimol Joseph, Matteo Di Nardo, Micheal Heard, Kimberly Kyle, Ray A Blackwell, Patrick Biston, Hye Won Jeong, Reanna Smith, Yogi Prawira, Arturo Huerta Garcia, Nahikari Salterain, Bart Meyns, Marsha Moreno, Rajat Walia, Amit Mehta, Annette Schweda, Moh Supriatna, Cenk Kirakli, Melissa Williams, Kyung Hoon Kim, Alexandra Assad, Estefania Giraldo, Wojtek Karolak, Martin Balik, Elizabeth Pocock, Evan Gajkowski, Kanamoto Masafumi, Nicholas Barrett, Yoshihiro Takeyama, Sunghoon Park, Faizan Amin, Fina Meilyana Andriyani, Serhii Sudakevych, Magdalena Vera, Rodrigo Cornejo, Patrícia Schwarz, Ana Carolina Mardini, Thais de Paula, Ary Serpa Neto, Andrea Villoldo, Alexandre Siciliano Colafranceschi, Alejandro Ubeda Iglesias, Juan Granjean, Lívia Maria Garcia Melro, Giovana Fioravante Romualdo, Diego Gaia, Helmgton Souza, Filomena Galas, Rafael Máñez Mendiluce, Alejandra Sosa, Ignacio Martinez, Hiroshi Kurosawa, Juan Salgado, Beate Hugi-Mayr, Eric Charbonneau, Vitor Salvatore Barzilai, Veronica Monteiro, Rodrigo Ribeiro de Souza, Michael Harper, Hiroyuki Suzuki, Celina Adams, Jorge Brieva, George Nyale, Faisal Saleem Eltatar, Jihan Fatani, Husam Baeissa, Ayman AL Masri, Ahmed Rabie, Mok Yee Hui, Masahiro Yamane, Hanna Jung, Ayorinde Mojisola Margaret, Newell Nacpil, Katja Ruck, Rhonda Bakken, Claire Jara, Tim Felton, Lorenzo Berra, Bobby Shah, Arpan Chakraborty, Monika Cardona, Gerry Capatos, Bindu Akkanti, Abiodun Orija, Harsh Jain, Asami Ito, Brahim Housni, Sennen Low, Koji Iihara, Joselito Chavez, Kollengode Ramanathan, Gustavo Zabert, Krubin Naidoo, Ian Seppelt, Marlice VanDyk, Sarah MacDonald, Randy McGregor, Teka Siebenaler, Hannah Flynn, Kristi Lofton, Toshiyuki Aokage, Kazuaki Shigemitsu, Andrea Moscatelli, Giuseppe Fiorentino, Matthias Baumgaertel, Serge Eddy Mba, Jana Assy, Amelya Hutahaean, Holly Roush, Kay A Sichting, Francesco Alessandri, Debra Burns, Gavin Salt, Carl P. Garabedian, Jonathan Millar, Malcolm Sim, Adrian Mattke, Danny McAuley, Jawad Tadili, Tim Frenzel, Yaron Bar-Lavie, Aaron Blandino Ortiz, Jackie Stone, Antony Attokaran, Michael Farquharson, Brij Patel, Derek Gunning, Kenneth Baillie, Pia Watson, Kenji Tamai, Gede Ketut Sajinadiyasa, Dyah Kanyawati, Marcello Salgado, Assad Sassine, Bhirowo Yudo, Scott McCaul, Bongjin Lee, Sang Min Lee, Arnon Afek, Yoshiaki Iwashita, Bambang Pujo Semedi, Jack Metiva, Nicole Van Belle, Ignacio Martin-Loeches, Lenny Ivatt, Chia Yew Woon, Hyun Mi Kang, Timothy Smith, Erskine James, Nawar Al-Rawas, Yudai Iwasaki, Kenny Chan King-Chung, Vadim Gudzenko, Fabio Taccone, Fajar Perdhana, Yoan Lamarche, Joao Miguel Ribeiro, Nikola Bradic, Klaartje Van den Bossche, Oude Lansink, Gurmeet Singh, Gerdy Debeuckelaere, Henry T. Stelfox, Cassia Yi, Jennifer Elia, Thomas Tribble, Shyam Shankar, Raj Padmanabhan, Bill Hallinan, Luca Paoletti, Yolanda Leyva, Tatuma Fykuda, Jenelle Badulak, Jillian Koch, Amy Hackman, Lisa Janowaik, Deb Hernandez, Jennifer Osofsky, Katia Donadello, Aizah Lawang, Josh Fine, and Benjamin Davidson

Subjects
Medical emergencies. Critical care. Intensive care. First aid, RC86-88.9
Abstract

OBJECTIVES:. Anemia has been associated with an increased risk of both cardiac arrest and stroke, frequent complications of COVID-19. The effect of hemoglobin level at ICU admission on a composite outcome of cardiac arrest or stroke in an international cohort of COVID-19 patients was investigated. DESIGN:. Retrospective analysis of prospectively collected database. SETTING:. A registry of COVID-19 patients admitted to ICUs at over 370 international sites was reviewed for patients diagnosed with cardiac arrest or stroke up to 30 days after ICU admission. Anemia was defined as: normal (hemoglobin ≥ 12.0 g/dL for women, ≥ 13.5 g/dL for men), mild (hemoglobin 10.0–11.9 g/dL for women, 10.0–13.4 g/dL for men), moderate (hemoglobin ≥ 8.0 and < 10.0 g/dL for women and men), and severe (hemoglobin < 8.0 g/dL for women and men). PATIENTS:. Patients older than 18 years with acute COVID-19 infection in the ICU. INTERVENTIONS:. None. MEASUREMENTS AND MAIN RESULTS:. Of 6926 patients (median age = 59 yr, male = 65%), 760 patients (11.0%) experienced stroke (2.0%) and/or cardiac arrest (9.4%). Cardiac arrest or stroke was more common in patients with low hemoglobin, occurring in 12.8% of patients with normal hemoglobin, 13.3% of patients with mild anemia, and 16.7% of patients with moderate/severe anemia. Time to stroke or cardiac arrest by anemia status was analyzed using Cox proportional hazards regression with death as a competing risk. Covariates selected through clinical knowledge were age, sex, comorbidities (diabetes, hypertension, obesity, and cardiac or neurologic conditions), pandemic era, country income, mechanical ventilation, and extracorporeal membrane oxygenation. Moderate/severe anemia was associated with a higher risk of cardiac arrest or stroke (hazard ratio, 1.32; 95% CI, 1.05–1.67). CONCLUSIONS:. In an international registry of ICU patients with COVID-19, moderate/severe anemia was associated with increased hazard of cardiac arrest or stroke.

Published
2024
Full Text
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2. Assessment of 28-Day In-Hospital Mortality in Mechanically Ventilated Patients With Coronavirus Disease 2019: An International Cohort Study

Author

Gianluigi Li Bassi, MD, PhD, Jacky Y. Suen, BSc, PhD, Nicole White, PhD, Heidi J. Dalton, MD, MCCM, Jonathon Fanning, BSc, MBBS, PhD, FANZCA, FCICM, Amanda Corley, RN, Sally Shrapnel, MBBS, BMedSc, MSc, PhD, FRACGP, Samuel Hinton, PhD, Simon Forsyth, PhD, Rex Parsons, BSc, MMedStats, John G. Laffey, MD, Eddy Fan, MD, PhD, Robert Bartlett, MD, Daniel Brodie, MD, Aidan Burrell, MD, PhD, Davide Chiumello, MD, Alyaa Elhazmi, MD, Giacomo Grasselli, MD, Carol Hodgson, PT, PhD, Shingo Ichiba, MD, Carlos Luna, MD, Eva Marwali, MD, Laura Merson, Bsc, Srinivas Murthy, MD, Alistair Nichol, MD, PhD, Mauro Panigada, MD, Paolo Pelosi, MD, FERS, Antoni Torres, MD, PhD, FERS, Pauline Yeung Ng, MD, Mark Ogino, MD, John F. Fraser, MBChB, PhD, FRCP(Glas), FFARCSI, FRCA, FCICM, on behalf of the COVID-19 Critical Care Consortium, Tala Al-Dabbous, Huda Alfoudri, Mohammed Shamsah, Subbarao Elapavaluru, Ashley Berg, Christina Horn, Stephan Schroll, Jorge Velazco, Ludmyla Ploskanych, Wanda Fikes, Dan Meyer, Ashley Ehlers, Maysoon Shalabi-McGuire, Trent Witt, Lorenzo Grazioli, Luca Lorini, E. Wilson Grandin, Jose Nunez, Tiago Reyes, Diarmuid O’Briain, Stephanie Hunter, Mahesh Ramanan, Julia Affleck, Hemanth Hurkadli Veerendra, Sumeet Rai, Josie Russell-Brown, Mary Nourse, Mark Joseph, Brook Mitchell, Martha Tenzer, Carilion Clinic, Ryuzo Abe, Hwa Jin Cho, In Seok Jeong, Nicolas Brozzi, Omar Mehkri, Sudhir Krishnan, Abhijit Duggal, Stuart Houltham, Jerónimo Graf, Roderigo Diaz, Camila Delgado, Joyce González, Maria Soledad Sanchez, Diego Fernando Bautista Rincón, Angela Maria Marulanda Yanten, Melissa Bustamante Duque, Daniel Brodie, Desy Rusmawatiningtyas, Maria Callahan, M. Azhari Taufik, Elizabeth Yasmin Wardoyo, Margaretha Gunawan, Nurindah S Trisnaningrum, Vera Irawany, Muhammad Rayhan, Mauro Panigada, Antonia Pesenti, Alberto Zanella, Michela Leone, Giacomo Grasselli, Silvia Coppola, Sebastiano Colombo, Massimo Antonelli, Simone Carelli, Domenico L. Grieco, Motohiro Asaki, Kota Hoshino, Leonardo Salazar, Laura Duarte, John Laffey, Bairbre McNicholas, David Cosgrave, Joseph McCaffrey, Allison Bone, Yusuff Hakeem, James Winearls, Mandy Tallott, David Thomson, Christel Arnold-Day, Jerome Cupido, Zainap Fanie, Malcom Miller, Lisa Seymore, Dawid van Straaten, Ali Ait Hssain, Jeffrey Aliudin, Al-Reem Alqahtani, Khoulod Mohamed, Ahmed Mohamed, Darwin Tan, Joy Villanueva, Ahmed Zaqout, Ethan Kurtzman, Arben Ademi, Ana Dobrita, Khadija El Aoudi, Juliet Segura, Gezy Giwangkancana, Shinichiro Ohshimo, Koji Hoshino, Saito Hitoshi, Javier Osatnik, Anne Joosten, Antoni Torres, Minlan Yang, Ana Motos, Carlos Luna, Francisco Arancibia, Virginie Williams, Alexandre Noel, Nestor Luque, Trieu Huynh Trung, Sophie Yacoub, Marina Fantini, Ruth Noemi Jorge García, Enrique Chicote Alvarez, Anna Greti, Adrian Ceccato, Angel Sanchez, Ana Loza Vazquez, Ferran Roche-Campo, Diego Franch-Llasat, Divina Tuazon, Marcelo Amato, Luciana Cassimiro, Flavio Pola, Francis Ribeiro, Guilherme Fonseca, Heidi Dalton, Mehul Desai, Erik Osborn, Hala Deeb, Antonio Arcadipane, Gennaro Martucci, Giovanna Panarello, Chiara Vitiello, Claudia Bianco, Giovanna Occhipinti, Matteo Rossetti, Raffaele Cuffaro, Sung-Min Cho Johns, Hiroaki Shimizu, Naoki Moriyama, Jae-Burm Kim, Nobuya Kitamura, Alyaa Elhazmi, Abdullah Al-Hudaib, Johannes Gebauer, Toshiki Yokoyama, Abdulrahman Al-Fares, Sarah Buabbas, Esam Alamad, Fatma Alawadhi, Kalthoum Alawadi, Hiro Tanaka, Satoru Hashimoto, Masaki Yamazaki, Tak-Hyuck Oh, Mark Epler, Cathleen Forney, Louise Kruse, Jared Feister, Joelle Williamson, Katherine Grobengieser, Eric Gnall, Sasha Golden, Mara Caroline, Timothy Shapiro, Colleen Karaj, Lisa Thome, Lynn Sher, Mark Vanderland, Mary Welch, Sherry McDermott, Matthew Brain, Sarah Mineall, Dai Kimura, Luca Brazzi, Gabriele Sales, Tawnya Ogston, Dave Nagpal, Karlee Fischer, Roberto Lorusso, Mariano Esperatti, Edmund G. Carton, Ayan Sen, Amanda Palacios, Deborah Rainey, Gordan Samoukoviv, Josie Campisi, Emily Neumann, Cassandra Seefeldt, Lucia Durham, Octavio Falcucci, Amanda Emmrich, Jennifer Guy, Carling Johns, Nina Buchtele, Michael Schwameis, Stephanie-Susanne Stecher, Delila Singh, Michaela Barnikel, Lukas Arenz, Akram Zaaqoq, Lan Anh Galloway, Caitlin Merley, Marc Csete, Luisa Quesada, Isabela Saba, Daisuke Kasugai, Hiroaki Hiraiwa, Taku Tanaka, Eva Marwali, Yoel Purnama, Santi Rahayu Dewayanti, Ardiyan, Dafsah Arifa Juzar, Debby Siagian, Kita Jakarta, Yih-Sharng Chen, Mark Ogino, Indrek Ratsep, Getter Oigus, Kristo Erikson, Andra-Maris Post, Lauri Enneveer, Piret Sillaots, Frank Manetta, Effe Mihelis, Iam Claire Sarmiento, Mangala Narasimhan, Michael Varrone, Mamoru Komats, S. Veena Satyapriya, Amar Bhatt, Nahush A. Mokadam, Alberto Uribe, Alicia Gonzalez, Haixia Shi, Johnny McKeown, Joshua Pasek, Juan Fiorda, Marco Echeverria, Rita Moreno, Bishoy Zakhary, Marco Cavana, Alberto Cucino, Giuseppe Foti, Marco Giani, Vincenzo Russotto, Davide Chiumello, Valentina Castagna, Andrea Dell’Amore, Paolo Navalesi, Hoi-Ping Shum, Alain Vuysteke, Asad Usman, Andrew Acker, Benjamin Smood, Blake Mergler, Federico Sertic, Madhu Subramanian, Alexandra Sperry, Nicolas Rizer, Erlina Burhan, Menaldi Rasmin, Ernita Akmal, Faya Sitompul, Navy Lolong, Bhat Naivedh, Simon Erickson, Peter Barrett, David Dean, Julia Daugherty, Antonio Loforte, Irfan Khan, Mohammed Abraar Quraishi, Olivia DeSantis, Dominic So, Darshana Kandamby, Jose M. Mandei, Hans Natanael, Eka YudhaLantang, Anastasia Lantang, Surya Oto Wijaya, Anna Jung, George Ng, Wing Yiu Ng, Pauline Yeung Ng, Alexis Tabah, Megan Ratcliffe, Maree Duroux, Shingo Adachi, Shota Nakao, Pablo Blanco, Ana Prieto, Jesús Sánchez, Meghan Nicholson, Warwick Butt, Alyssa Serratore, Carmel Delzoppo, Pierre Janin, Elizabeth Yarad, Richard Totaro, Jennifer Coles, Bambang Pujo, Robert Balk, Andy Vissing, Esha Kapania, James Hays, Samuel Fox, Garrett Yantosh, Pavel Mishin, Saptadi Yuliarto, Kohar Hari Santoso, Susanthy Djajalaksana, Arie Zainul Fatoni, Masahiro Fukuda, Keibun Liu, Paolo Pelosi, Denise Battaglini, Diego Bastos, Sérgio Gaião, Jessica Buchner, Young-Jae Cho, Su Hwan Lee, Pranya Sakiyalak, Prompak Nitayavardhana, Tamara Seitz, Rakesh Arora, David Kent, Swapnil Parwar, Andrew Cheng, Jennene Miller, Shigeki Fujitani, Naoki Shimizu, Jai Madhok, Clark Owyang, Hergen Buscher, Claire Reynolds, Olavi Maasikas, Aleksan Beljantsev, Vladislav Mihnovits, Takako Akimoto, Mariko Aizawa, Kanako Horibe, Ryota Onodera, Carol Hodgson, Aidan Burrell, Meredith Young, Kiran Shekar, Niki McGuinness, Lacey Irvine, Brigid Flynn, Kazuhiro Sugiyama, Keiki Shimizu, Eddy Fan, Kathleen Exconde, Shingo Ichiba, Leslie Lussier, Gösta Lotz, Lars Maier, Esther Dreier, Neurinda Permata Kusumastuti, Colin McCloskey, Al-Awwab Dabaliz, Tarek B Elshazly, Josiah Smith, Konstanty S. Szuldrzynski, Piotr Bielański, Keith Wille, Srinivas Murthy, Ken Kuljit S. Parhar, Kirsten M. Fiest, Cassidy Codan, Anmol Shahid, Mohamed Fayed, Timothy Evans, Rebekah Garcia, Ashley Gutierrez, Tae Song, Rebecca Rose, Suzanne Bennett, Denise Richardson, Lovkesh Arora, Kristina Rappapport, Kristina Rudolph, Zita Sibenaller, Lori Stout, Alicia Walter, Daniel Herr, Nazli Vedadi, Robert Bartlett, Antonio Pesenti, Shaun Thompson, Lace Sindt, Sean Rajnic, Cale Ewald, Julie Hoffman, Matthew Griffee, Anna Ciullo, Yuri Kida, Ricard Ferrer Roca, JordI Riera, Sofia Contreras, Cynthia Alegre, Christy Kay, Irene Fischer, Elizabeth Renner, Hayato Taniguci, John Fraser, Gianluigi Li Bassi, Jacky Suen, Adrian Barnett, Nicole White, Kristen Gibbons, Simon Forsyth, Amanda Corley, India Pearse, Samuel Hinton, Gabriella Abbate, Halah Hassan, Silver Heinsar, Varun A Karnik, Katrina Ki, Hollier F. O’Neill, Nchafatso Obonyo, Janice D. Reid, Kei Sato, Aapeli Vuorinen, Karin S. Wildi, Emily S. Wood, Stephanie Yerkovich, James Lee, Daniel Plotkin, Laura Merson, Emma Hartley, Bastian Lubis, Takanari Ikeyama, Balu Bhaskar, Jae-Seung Jung, Shay McGuinness, Glenn Eastwood, Sandra Rossi Marta, Fabio Guarracino, Stacy Gerle, Emily Coxon, Bruno Claro, Gonzo Gonzalez-Stawinski, Daniel Loverde, Namrata Patil, Vieri Parrini, Angela McBride, Kathryn Negaard, Angela Ratsch, Ahmad Abdelaziz, Juan David Uribe, Adriano Peris, Mark Sanders, Dominic Emerson, Muhammad Kamal, Pedro Povoa, Roland Francis, Ali Cherif, Sunimol Joseph, Matteo Di Nardo, Micheal Heard, Kimberly Kyle, Ray A Blackwell, Michael Piagnerelli, Patrick Biston, Hye Won Jeong, Reanna Smith, Yogi Prawira, Giorgia Montrucchio, Nadeem Rahman, Vivek Kakar, Josefa Valenzuela Sarrazin, Arturo Huerta Garcia, Nahikari Salterain, Bart Meyns, Marsha Moreno, Rajat Walia, Amit Mehta, Annette Schweda, Moh Supriatna, Bhirowo Yudo, Cenk Kirakli, Melissa Williams, Kyung Hoon Kim, Alexandra Assad, Estefania Giraldo, Wojtek Karolak, Martin Balik, Elizabeth Pocock, Evan Gajkowski, Kanamoto Masafumi, Nicholas Barrett, Yoshihiro Takeyama, Sunghoon Park, Faizan Amin, Fina Meilyana Andriyani, Serhii Sudakevych, Magdalena Vera, Rodrigo Cornejo, Patrícia Schwarz, Ana Carolina Mardini, Ary Serpa Neto, Andrea Villoldo, Alexandre Siciliano Colafranceschi, Alejandro Ubeda, Juan Granjean, Lívia Maria Garcia Melro, Giovana Fioravante Romualdo, Diego Gaia, Helmgton Souza, Filomena Galas, Rafael Máñez Mendiluce, Alejandra Sosa, Ignacio Martinez, Hiroshi Kurosawa, Juan Salgado, Beate Hugi-Mayr, Eric Charbonneau, Vitor Salvatore Barzilai, Veronica Monteiro, Rodrigo Ribeiro de Souza, Michael Harper, Hiroyuki Suzuki, Celina Adams, Jorge Brieva, George Nyale, Faisal Saleem Eltatar, Jihan Fatani, Husam Baeissa, Ayman AL Masri, Ahmed Rabie, Mok Yee Hui, Masahiro Yamane, Hanna Jung, Ayorinde Mojisola, Margaret, Newell Nacpil, Katja Ruck, Rhonda Bakken, Claire Jara, Tim Felton, Lorenzo Berra, Bobby Shah, Arpan Chakraborty, Monika Cardona, Gerry Capatos, Bindu Akkanti, Abiodun Orija, Harsh Jain, Asami Ito, Brahim Housni, Sennen Low, Koji Iihara, Joselito Chavez, Kollengode Ramanathan, Gustavo Zabert, Krubin Naidoo, Ian Seppelt, Marlice VanDyk, Sarah MacDonald, Randy McGregor, Teka Siebenaler, Hannah Flynn, Julia Garcia-Diaz, Catherine Harmon, Kristi Lofton, Toshiyuki Aokage, Kazuaki Shigemitsu, Andrea Moscatelli, Giuseppe Fiorentino, Matthias Baumgaertel, Serge Eddy Mba, Jana Assy, Amelya Hutahaean, Holly Roush, Kay A Sichting, Francesco Alessandri, Debra Burns, Gavin Salt, Carl P. Garabedian, Jonathan Millar, Malcolm Sim, Adrian Mattke, Danny McAuley, Jawad Tadili, Tim Frenzel, Yaron Bar-Lavie, Aaron Blandino Ortiz, Jackie Stone, Antony Attokaran, Michael Farquharson, Brij Patel, Derek Gunning, Kenneth Baillie, Pia Watson, Kenji Tamai, Gede Ketut Sajinadiyasa, Dyah Kanyawati, Marcello Salgado, Assad Sassine, Scott McCaul, Bongjin Lee, Sang Min Lee, Arnon Afek, Yoshiaki Iwashita, Laveena Munshi, Bambang Pujo Semedi, Neurinda Permata, Kusumastuti, Jack Metiva, Nicole Van Belle, Daniel Marino, Ignacio Martin-Loeches, Lenny Ivatt, Chia Yew Woon, Hyun Mi Kang, Timothy Smith, Erskine James, Nawar Al-Rawas, Tomoyuki Endo, Yudai Iwasaki, Kenny Chan King-Chung, Vadim Gudzenko, Fabio Taccone, Fajar Perdhana, Yoan Lamarche, Joao Miguel Ribeiro, Nikola Bradic, Klaartje Van den Bossche, Oude Lansink, Gurmeet Singh, Gerdy Debeuckelaere, Henry T. Stelfox, Cassia Yi, Jennifer Elia, Shu Fang, Thomas Tribble, Shyam Shankar, Raj Padmanabhan, Bill Hallinan, Luca Paoletti, Yolanda Leyva, Tatuma Fykuda, Jenelle Badulak, Jillian Koch, Amy Hackman, Lisa Janowaik, Deb Hernandez, Jennifer Osofsky, Katia Donadello, Aizah Lawang, Josh Fine, Benjamin Davidson, and Andres Oswaldo Razo Vazquez

Subjects
Medical emergencies. Critical care. Intensive care. First aid, RC86-88.9
Abstract

IMPORTANCE:. Factors associated with mortality in coronavirus disease 2019 patients on invasive mechanical ventilation are still not fully elucidated. OBJECTIVES:. To identify patient-level parameters, readily available at the bedside, associated with the risk of in-hospital mortality within 28 days from commencement of invasive mechanical ventilation or coronavirus disease 2019. DESIGN, SETTING, AND PARTICIPANTS:. Prospective observational cohort study by the global Coronavirus Disease 2019 Critical Care Consortium. Patients with laboratory-confirmed coronavirus disease 2019 requiring invasive mechanical ventilation from February 2, 2020, to May 15, 2021. MAIN OUTCOMES AND MEASURES:. Patient characteristics and clinical data were assessed upon ICU admission, the commencement of invasive mechanical ventilation and for 28 days thereafter. We primarily aimed to identify time-independent and time-dependent risk factors for 28-day invasive mechanical ventilation mortality. RESULTS:. One-thousand five-hundred eighty-seven patients were included in the survival analysis; 588 patients died in hospital within 28 days of commencing invasive mechanical ventilation (37%). Cox-regression analysis identified associations between the hazard of 28-day invasive mechanical ventilation mortality with age (hazard ratio, 1.26 per 10-yr increase in age; 95% CI, 1.16–1.37; p < 0.001), positive end-expiratory pressure upon commencement of invasive mechanical ventilation (hazard ratio, 0.81 per 5 cm H2O increase; 95% CI, 0.67–0.97; p = 0.02). Time-dependent parameters associated with 28-day invasive mechanical ventilation mortality were serum creatinine (hazard ratio, 1.28 per doubling; 95% CI, 1.15–1.41; p < 0.001), lactate (hazard ratio, 1.22 per doubling; 95% CI, 1.11–1.34; p < 0.001), Paco2 (hazard ratio, 1.63 per doubling; 95% CI, 1.19–2.25; p < 0.001), pH (hazard ratio, 0.89 per 0.1 increase; 95% CI, 0.8–14; p = 0.041), Pao2/Fio2 (hazard ratio, 0.58 per doubling; 95% CI, 0.52–0.66; p < 0.001), and mean arterial pressure (hazard ratio, 0.92 per 10 mm Hg increase; 95% CI, 0.88–0.97; p = 0.003). CONCLUSIONS AND RELEVANCE:. This international study suggests that in patients with coronavirus disease 2019 on invasive mechanical ventilation, older age and clinically relevant variables monitored at baseline or sequentially during the course of invasive mechanical ventilation are associated with 28-day invasive mechanical ventilation mortality hazard. Further investigation is warranted to validate any causative roles these parameters might play in influencing clinical outcomes.

Published
2021
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3. Integrated genomic and epigenomic analysis of breast cancer brain metastasis.

Author

Bodour Salhia, Jeff Kiefer, Julianna T D Ross, Raghu Metapally, Rae Anne Martinez, Kyle N Johnson, Danielle M DiPerna, Kimberly M Paquette, Sungwon Jung, Sara Nasser, Garrick Wallstrom, Waibhav Tembe, Angela Baker, John Carpten, Jim Resau, Timothy Ryken, Zita Sibenaller, Emanuel F Petricoin, Lance A Liotta, Ramesh K Ramanathan, Michael E Berens, and Nhan L Tran

Subjects
Medicine, Science
Abstract

The brain is a common site of metastatic disease in patients with breast cancer, which has few therapeutic options and dismal outcomes. The purpose of our study was to identify common and rare events that underlie breast cancer brain metastasis. We performed deep genomic profiling, which integrated gene copy number, gene expression and DNA methylation datasets on a collection of breast brain metastases. We identified frequent large chromosomal gains in 1q, 5p, 8q, 11q, and 20q and frequent broad-level deletions involving 8p, 17p, 21p and Xq. Frequently amplified and overexpressed genes included ATAD2, BRAF, DERL1, DNMTRB and NEK2A. The ATM, CRYAB and HSPB2 genes were commonly deleted and underexpressed. Knowledge mining revealed enrichment in cell cycle and G2/M transition pathways, which contained AURKA, AURKB and FOXM1. Using the PAM50 breast cancer intrinsic classifier, Luminal B, Her2+/ER negative, and basal-like tumors were identified as the most commonly represented breast cancer subtypes in our brain metastasis cohort. While overall methylation levels were increased in breast cancer brain metastasis, basal-like brain metastases were associated with significantly lower levels of methylation. Integrating DNA methylation data with gene expression revealed defects in cell migration and adhesion due to hypermethylation and downregulation of PENK, EDN3, and ITGAM. Hypomethylation and upregulation of KRT8 likely affects adhesion and permeability. Genomic and epigenomic profiling of breast brain metastasis has provided insight into the somatic events underlying this disease, which have potential in forming the basis of future therapeutic strategies.

Published
2014
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4. Comprehensive analysis of MGMT promoter methylation: correlation with MGMT expression and clinical response in GBM.

Author

Nameeta Shah, Biaoyang Lin, Zita Sibenaller, Timothy Ryken, Hwahyung Lee, Jae-Geun Yoon, Steven Rostad, and Greg Foltz

Subjects
Medicine, Science
Abstract

O⁶-methylguanine DNA-methyltransferase (MGMT) promoter methylation has been identified as a potential prognostic marker for glioblastoma patients. The relationship between the exact site of promoter methylation and its effect on gene silencing, and the patient's subsequent response to therapy, is still being defined. The aim of this study was to comprehensively characterize cytosine-guanine (CpG) dinucleotide methylation across the entire MGMT promoter and to correlate individual CpG site methylation patterns to mRNA expression, protein expression, and progression-free survival. To best identify the specific MGMT promoter region most predictive of gene silencing and response to therapy, we determined the methylation status of all 97 CpG sites in the MGMT promoter in tumor samples from 70 GBM patients using quantitative bisulfite sequencing. We next identified the CpG site specific and regional methylation patterns most predictive of gene silencing and improved progression-free survival. Using this data, we propose a new classification scheme utilizing methylation data from across the entire promoter and show that an analysis based on this approach, which we call 3R classification, is predictive of progression-free survival (HR = 5.23, 95% CI [2.089-13.097], p

Published
2011
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9. Supplementary Tables 1-2, Figures 1-3 from Mutational Inactivation of PTPRD in Glioblastoma Multiforme and Malignant Melanoma

Author

Todd Waldman, Yardena Samuels, Hai Yan, Darell Bigner, Walter Jean, Habtom Ressom, Steven A. Rosenberg, Timothy Ryken, Zita Sibenaller, Julia C. Cronin, Jung-Sik Kim, and David A. Solomon

Abstract

Supplementary Tables 1-2, Figures 1-3 from Mutational Inactivation of PTPRD in Glioblastoma Multiforme and Malignant Melanoma

Published
2023
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13. Pain, Analgesic Use, and Patient Satisfaction With Spinal Versus General Anesthesia for Hip Fracture Surgery : A Randomized Clinical Trial

Author

Mark D, Neuman, Rui, Feng, Susan S, Ellenberg, Frederick, Sieber, Daniel I, Sessler, Jay, Magaziner, Nabil, Elkassabany, Eric S, Schwenk, Derek, Dillane, Edward R, Marcantonio, Diane, Menio, Sabry, Ayad, Manal, Hassan, Trevor, Stone, Steven, Papp, Derek, Donegan, Mitchell, Marshall, J Douglas, Jaffe, Charles, Luke, Balram, Sharma, Syed, Azim, Robert, Hymes, Ki-Jinn, Chin, Richard, Sheppard, Barry, Perlman, Joshua, Sappenfield, Ellen, Hauck, Mark A, Hoeft, Ann, Tierney, Lakisha J, Gaskins, Annamarie D, Horan, Trina, Brown, James, Dattilo, Jeffrey L, Carson, Thomas, Looke, Sandra, Bent, Ariana, Franco-Mora, Pamela, Hedrick, Matthew, Newbern, Rafik, Tadros, Karen, Pealer, Kamen, Vlassakov, Carolyn, Buckley, Lauren, Gavin, Svetlana, Gorbatov, James, Gosnell, Talora, Steen, Avery, Vafai, Jose, Zeballos, Jennifer, Hruslinski, Louis, Cardenas, Ashley, Berry, John, Getchell, Nicholas, Quercetti, Gauasan, Bajracharya, Damien, Billow, Michael, Bloomfield, Evis, Cuko, Mehrun K, Elyaderani, Robert, Hampton, Hooman, Honar, Dilara, Khoshknabi, Daniel, Kim, David, Krahe, Michael M, Lew, Conjeevram B, Maheshwer, Azfar, Niazi, Partha, Saha, Ahmed, Salih, Robert J, de Swart, Andrew, Volio, Kelly, Bolkus, Matthew, DeAngelis, Gregory, Dodson, Jeffrey, Gerritsen, Brian, McEniry, Ludmil, Mitrev, M Kwesi, Kwofie, Anne, Belliveau, Flynn, Bonazza, Vera, Lloyd, Izabela, Panek, Jared, Dabiri, Chris, Chavez, Jason, Craig, Todd, Davidson, Chad, Dietrichs, Cheryl, Fleetwood, Mike, Foley, Chris, Getto, Susie, Hailes, Sarah, Hermes, Andy, Hooper, Greg, Koener, Kate, Kohls, Leslie, Law, Adam, Lipp, Allison, Losey, William, Nelson, Mario, Nieto, Pam, Rogers, Steve, Rutman, Garrett, Scales, Barbara, Sebastian, Tom, Stanciu, Gregg, Lobel, Michelle, Giampiccolo, Dara, Herman, Margit, Kaufman, Bryan, Murphy, Clara, Pau, Thomas, Puzio, Marlene, Veselsky, Kelly, Apostle, Dory, Boyer, Brenda Chen, Fan, Susan, Lee, Mike, Lemke, Richard, Merchant, Farhad, Moola, Kyrsten, Payne, Bertrand, Perey, Darius, Viskontas, Mark, Poler, Patricia, D'Antonio, Greg, O'Neill, Amer, Abdullah, Jamie, Fish-Fuhrmann, Mark, Giska, Christina, Fidkowski, Stuart Trent, Guthrie, William, Hakeos, Lillian, Hayes, Joseph, Hoegler, Katherine, Nowak, Jeffery, Beck, Jaslynn, Cuff, Greg, Gaski, Sharon, Haaser, Michael, Holzman, A Stephen, Malekzadeh, Lolita, Ramsey, Jeff, Schulman, Cary, Schwartzbach, Tangwan, Azefor, Arman, Davani, Mahmood, Jaberi, Courtney, Masear, Syed Basit, Haider, Carolyn, Chungu, Ali, Ebrahimi, Karim, Fikry, Andrew, Marcantonio, Anitha, Shelvan, David, Sanders, Collin, Clarke, Abdel, Lawendy, Gary, Schwartz, Mohit, Garg, Joseph, Kim, Juan, Caruci, Ekow, Commeh, Randy, Cuevas, Germaine, Cuff, Lola, Franco, David, Furgiuele, Matthew, Giuca, Melissa, Allman, Omid, Barzideh, James, Cossaro, Armando, D'Arduini, Anita, Farhi, Jason, Gould, John, Kafel, Anuj, Patel, Abraham, Peller, Hadas, Reshef, Mohammed, Safur, Fiore, Toscano, Tiffany, Tedore, Michael, Akerman, Eric, Brumberger, Sunday, Clark, Rachel, Friedlander, Anita, Jegarl, Joseph, Lane, John P, Lyden, Nili, Mehta, Matthew T, Murrell, Nathan, Painter, William, Ricci, Kaitlyn, Sbrollini, Rahul, Sharma, Peter A D, Steel, Michele, Steinkamp, Roniel, Weinberg, David Stephenson, Wellman, Antoun, Nader, Paul, Fitzgerald, Michaela, Ritz, Greg, Bryson, Alexandra, Craig, Cassandra, Farhat, Braden, Gammon, Wade, Gofton, Nicole, Harris, Karl, Lalonde, Allan, Liew, Bradley, Meulenkamp, Kendra, Sonnenburg, Eugene, Wai, Geoffrey, Wilkin, Karen, Troxell, Mary Ellen, Alderfer, Jason, Brannen, Christopher, Cupitt, Stacy, Gerhart, Renee, McLin, Julie, Sheidy, Katherine, Yurick, Fei, Chen, Karen, Dragert, Geza, Kiss, Halina, Malveaux, Deborah, McCloskey, Scott, Mellender, Sagar S, Mungekar, Helaine, Noveck, Carlos, Sagebien, Luat, Biby, Gail, McKelvy, Anna, Richards, Ramon, Abola, Brittney, Ayala, Darcy, Halper, Ana, Mavarez, Sabeen, Rizwan, Stephen, Choi, Imad, Awad, Brendan, Flynn, Patrick, Henry, Richard, Jenkinson, Lilia, Kaustov, Elizabeth, Lappin, Paul, McHardy, Amara, Singh, Joanne, Donnelly, Meera, Gonzalez, Christopher, Haydel, Jon, Livelsberger, Theresa, Pazionis, Bridget, Slattery, Maritza, Vazquez-Trejo, Jaime, Baratta, Michael, Cirullo, Brittany, Deiling, Laura, Deschamps, Michael, Glick, Daniel, Katz, James, Krieg, Jennifer, Lessin, Jeffrey, Mojica, Marc, Torjman, Rongyu, Jin, Mary Jane, Salpeter, Mark, Powell, Jeffrey, Simmons, Prentiss, Lawson, Promil, Kukreja, Shanna, Graves, Adam, Sturdivant, Ayesha, Bryant, Sandra Joyce, Crump, Michelle, Verrier, James, Green, Matthew, Menon, Richard, Applegate, Ana, Arias, Natasha, Pineiro, Jeffrey, Uppington, Phillip, Wolinsky, Amy, Gunnett, Jennifer, Hagen, Sara, Harris, Kevin, Hollen, Brian, Holloway, Mary Beth, Horodyski, Trevor, Pogue, Ramachandran, Ramani, Cameron, Smith, Anna, Woods, Matthew, Warrick, Kelly, Flynn, Paul, Mongan, Yatish, Ranganath, Sean, Fernholz, Esperanza, Ingersoll-Weng, Anil, Marian, Melinda, Seering, Zita, Sibenaller, Lori, Stout, Allison, Wagner, Alicia, Walter, Cynthia, Wong, Denise, Orwig, Maithri, Goud, Chris, Helker, Lydia, Mezenghie, Brittany, Montgomery, Peter, Preston, J Sanford, Schwartz, Ramona, Weber, Lee A, Fleisher, Samir, Mehta, Alisa J, Stephens-Shields, Cassandra, Dinh, Jacques E, Chelly, Shiv, Goel, Wende, Goncz, Touichi, Kawabe, Sharad, Khetarpal, Amy, Monroe, Vladislav, Shick, Max, Breidenstein, Timothy, Dominick, Alexander, Friend, Donald, Mathews, Richard, Lennertz, Robert, Sanders, Helen, Akere, Tyler, Balweg, Amber, Bo, Christopher, Doro, David, Goodspeed, Gerald, Lang, Maggie, Parker, Amy, Rettammel, Mary, Roth, Marissa, White, Paul, Whiting, Brian F S, Allen, Tracie, Baker, Debra, Craven, Matt, McEvoy, Teresa, Turnbo, Stephen, Kates, Melanie, Morgan, Teresa, Willoughby, Wade, Weigel, David, Auyong, Ellie, Fox, Tina, Welsh, Bruce, Cusson, Sean, Dobson, Christopher, Edwards, Lynette, Harris, Daryl, Henshaw, Kathleen, Johnson, Glen, McKinney, Scott, Miller, Jon, Reynolds, B Scott, Segal, Jimmy, Turner, David, VanEenenaam, Robert, Weller, Jineli, Lei, Miriam, Treggiari, Shamsuddin, Akhtar, Marcelle, Blessing, Chanel, Johnson, Michael, Kampp, Kimberly, Kunze, Mary, O'Connor, Jinlei, Li, Duminda N, Wijeysundera, Sachin, Kheterpal, Reneé H, Moore, Alexander K, Smith, Laura L, Tosi, Lee, Fleisher, Christine, Langlois, Samuel, Oduwole, and Thomas, Rose

Subjects
Male, Analgesics, Canada, Pain, Postoperative, Hip Fractures, Pain, General Medicine, Anesthesia, General, Anesthesia, Spinal, Patient Satisfaction, Internal Medicine, Humans, Female, Aged
Abstract

The REGAIN (Regional versus General Anesthesia for Promoting Independence after Hip Fracture) trial found similar ambulation and survival at 60 days with spinal versus general anesthesia for hip fracture surgery. Trial outcomes evaluating pain, prescription analgesic use, and patient satisfaction have not yet been reported.To compare pain, analgesic use, and satisfaction after hip fracture surgery with spinal versus general anesthesia.Preplanned secondary analysis of a pragmatic randomized trial. (ClinicalTrials.gov: NCT02507505).46 U.S. and Canadian hospitals.Patients aged 50 years or older undergoing hip fracture surgery.Spinal or general anesthesia.Pain on postoperative days 1 through 3; 60-, 180-, and 365-day pain and prescription analgesic use; and satisfaction with care.A total of 1600 patients were enrolled. The average age was 78 years, and 77% were women. A total of 73.5% (1050 of 1428) of patients reported severe pain during the first 24 hours after surgery. Worst pain over the first 24 hours after surgery was greater with spinal anesthesia (rated from 0 [no pain] to 10 [worst pain imaginable]; mean difference, 0.40 [95% CI, 0.12 to 0.68]). Pain did not differ across groups at other time points. Prescription analgesic use at 60 days occurred in 25% (141 of 563) and 18.8% (108 of 574) of patients assigned to spinal and general anesthesia, respectively (relative risk, 1.33 [CI, 1.06 to 1.65]). Satisfaction was similar across groups.Missing outcome data and multiple outcomes assessed.Severe pain is common after hip fracture. Spinal anesthesia was associated with more pain in the first 24 hours after surgery and more prescription analgesic use at 60 days compared with general anesthesia.Patient-Centered Outcomes Research Institute

Published
2022

14. Engaging patients as partners in a multicentre trial of spinal versus general anaesthesia for older adults

Author

Jennifer Hruslinski, Diane A. Menio, Robert A. Hymes, J. Douglas Jaffe, Christine Langlois, Lolita Ramsey, Lakisha J. Gaskins, Mark D. Neuman, Thomas Looke, Sandra Bent, Ariana Franco-Mora, Pamela Hedrick, Matthew Newbern, Rafik Tadros, Karen Pealer, Edward Marcantonio, Kamen Vlassakov, Carolyn Buckley, Svetlana Gorbatov, James Gosnell, Talora Steen, Avery Vafai, Jose Zeballos, Louis Cardenas, Ashley Berry, John Getchell, Nicholas Quercetti, Daniel I. Sessler, Sabry Ayad, Manal Hassan, Assad Ali, Gauasan Bajracharya, Damien Billow, Michael Bloomfield, Kavita Elliott, Robert Hampton, Linda He, Hooman Honar, Dilara Khoshknabi, Daniel Kim, Paul Minko, Adam Morris, Azfar Niazi, Tara Nutcharoen, Jeffrey Roberts, Partha Saha, Ahmed Salih, Alexis Skolaris, Taylor Stang, Victor Strimbu, Jesse Templeton, Andrew Volio, Jiayi Wang, Kelly Bolkus, Matthew DeAngelis, Gregory Dodson, Jeffrey Gerritsen, Brian McEniry, Ludmil Mitrev, Kwesi Kwofie, Flynn Bonazza, Vera Lloyd, Izabela Panek, Jared Dabiri, Chris Chavez, Jason Craig, Todd Davidson, Chad Dietrichs, Cheryl Fleetwood, Mike Foley, Chris Getto, Susie Hailes, Sarah Hermes, Andy Hooper, Greg Koener, Kate Kohls, Leslie Law, Adam Lipp, Allison Losey, William Nelson, Mario Nieto, Pam Rogers, Steve Rutman, Garrett Scales, Barbara Sebastian, Tom Stanciu, Gregg Lobel, Michelle Giampiccolo, Dara Herman, Margit Kaufman, Bryan Murphy, Clara Pau, Thomas Puzio, Marlene Veselsky, Trevor Stone, Kelly Apostle, Dory Boyer, Brenda Chen Fan, Susan Lee, Mike Lemke, Richard Merchant, Farhad Moola, Kyrsten Payne, Bertrand Perey, Darius Viskontas, Mark Poler, Patricia D'Antonio, Richard Sheppard, Amer Abdullah, Jamie Fish-Fuhrmann, Mark Giska, Christina Fidkowski, Trent Guthrie, William Hakeos, Lillian Hayes, Joseph Hoegler, Katherine Nowak, Robert Hymes, Jeffery Beck, Jaslynn Cuff, Greg Gaski, Sharon Haaser, Michael Holzman, A. Stephen Malekzadeh, Jeff Schulman, Cary Schwartzbach, Frederick Sieber, Tangwan Azefor, Charles Brown, Arman Davani, Mahmood Jaberi, Courtney Masear, Balram Sharma, Syed Basit Haider, Carolyn Chungu, Ali Ebrahimi, Karim Fikry, Kerri Gannon, Andrew Marcantonio, Meredith Pace, David Sanders, Collin Clarke, Abdel Lawendy, Gary Schwartz, Mohit Garg, Joseph Kim, Mitchell Marshall, Juan Caurci, Ekow Commeh, Randy Cuevas, Germaine Cuff, Lola Franco, David Furguiele, Matthew Giuca, Melissa Allman, Omid Barzideh, James Cossaro, Armando D'Arduini, Anita Farhi, Jason Gould, John Kafel, Anuj Patel, Abraham Peller, Hadas Reshef, Mohammed Safur, Fiore Toscano, Tiffany Tedore, Michael Akerman, Eric Brumberger, Sunday Clark, Rachel Friedlander, Anita Jegarl, Joseph Lane, John P. Lyden, Nili Mehta, Matthew T. Murrell, Nathan Painter, William Ricci, Kaitlyn Sbrollini, Rahul Sharma, Peter A.D. Steel, Michele Steinkamp, Roniel Weinberg, David Stephenson Wellman, Antoun Nader, Paul Fitzgerald, Michaela Ritz, Steven Papp, Greg Bryson, Alexandra Craig, Cassandra Farhat, Braden Gammon, Wade Gofton, Nicole Harris, Karl Lalonde, Allan Liew, Bradley Meulenkamp, Kendra Sonnenburg, Eugene Wai, Geoffrey Wilkin, Derek Donegan, Cassandra Dinh, Nabil Elkassabany, Annamarie Horan, Samir Mehta, Karen Troxell, Mary Ellen Alderfer, Jason Brannen, Christopher Cupitt, Stacy Gerhart, Renee McLin, Julie Sheidy, Katherine Yurick, Jeffrey Carson, Fei Chen, Karen Dragert, Geza Kiss, Halina Malveaux, Deborah McCloskey, Scott Mellender, Sagar S. Mungekar, Helaine Noveck, Carlos Sagebien, Barry Perlman, Luat Biby, Gail McKelvy, Anna Richards, Syed Azim, Ramon Abola, Brittney Ayala, Darcy Halper, Ana Mavarez, Stephen Choi, Imad Awad, Brendan Flynn, Patrick Henry, Richard Jenkinson, Lilia Kaustov, Elizabeth Lappin, Paul McHardy, Amara Singh, Ellen Hauck, Joanne Donnelly, Meera Gonzalez, Christopher Haydel, Jon Livelsberger, Theresa Pazionis, Bridget Slattery, Maritza Vazquez-Trejo, Eric Schwenk, Jaime Baratta, Brittany Deiling, Laura Deschamps, Michael Glick, Daniel Katz, James Krieg, Jennifer Lessin, Marc Torjman, Ki Jinn Chin, Rongyu Jin, Mary Jane Salpeter, Mark Powell, Jeffrey Simmons, Prentiss Lawson, Promil Kukreja, Shanna Graves, Adam Sturdivant, Ayesha Bryant, Sandra Joyce Crump, Derek Dillane, Michael Taylor, Michelle Verrier, Richard Applegate, Ana Arias, Natasha Pineiro, Jeffrey Uppington, Phillip Wolinsky, Joshua Sappenfield, Amy Gunnett, Jennifer Hagen, Sara Harris, Kevin Hollen, Brian Holloway, Mary Beth Horodyski, Trevor Pogue, Ramachandran Ramani, Cameron Smith, Anna Woods, Matthew Warrick, Kelly Flynn, Paul Mongan, Yatish Ranganath, Sean Fernholz, Esperanza Ingersoll-Weng, Anil Marian, Melinda Seering, Zita Sibenaller, Lori Stout, Allison Wagner, Alicia Walter, Cynthia Wong, Jay Magaziner, Denise Orwig, Trina Brown, Jim Dattilo, Susan Ellenberg, Rui Feng, Lee Fleisher, Lakisha Gaskins, Maithri Goud, Chris Helker, Lydia Mezenghie, Brittany Montgomery, Peter Preston, Alisa Stephens, J. Sanford Schwartz, Ann Tierney, Ramona Weber, Jacques Chelly, Shiv Goel, Wende Goncz, Touichi Kawabe, Sharad Khetarpal, Kevin King, Frank Kunkel, Charles Luke, Amy Monroe, Vladislav Shick, Anthony Silipo, Caroline Stehle, Katherine Szabo, Sudhakar Yennam, Mark Hoeft, Max Breidenstein, Timothy Dominick, Alexander Friend, Donald Mathews, Richard Lennertz, Helen Akere, Tyler Balweg, Amber Bo, Christopher Doro, David Goodspeed, Gerald Lang, Maggie Parker, Amy Rettammel, Mary Roth, Robert Sanders, Marissa White, Paul Whiting, Brian Allen, Tracie Baker, Debra Craven, Matt McEvoy, Teresa Turnbo, Stephen Kates, Melanie Morgan, Teresa Willoughby, Wade Weigel, David Auyong, Ellie Fox, Tina Welsh, Bruce Cusson, Sean Dobson, Christopher Edwards, Lynette Harris, Daryl Henshaw, Kathleen Johnson, Glen McKinney, Scott Miller, Jon Reynolds, Jimmy Turner, David VanEenenaam, Robert Weller, Shamsuddin Akhtar, Marcelle Blessing, Chanel Johnson, Michael Kampp, Kimberly Kunze, Jinlei Li, Mary O'Connor, and Miriam Treggiari

Subjects
medicine.medical_specialty, Canada, Research Subjects, Patient engagement, Hip fracture surgery, Patient Advocacy, Anesthesia, General, Patient advocacy, Anesthesia, Spinal, 03 medical and health sciences, 0302 clinical medicine, Nursing, 030202 anesthesiology, Fracture Fixation, Medicine, Humans, General anaesthesia, Cooperative Behavior, Geriatrics, Hip fracture, business.industry, Hip Fractures, Lived experience, Age Factors, Research process, medicine.disease, United States, Anesthesiology and Pain Medicine, Research Design, Patient Participation, business, Decision Making, Shared
Abstract

Summary Engaging patients—defined broadly as individuals with lived experience of a given condition, family members, caregivers, and the organisations that represent them—as partners in research is a priority for policymakers, funders, and the public. Nonetheless, formal efforts to engage patients are absent from most studies, and models to support meaningful patient engagement in clinical anaesthesia research have not been previously described. Here, we review our experience in developing and implementing a multifaceted patient engagement strategy within the Regional Versus General Anesthesia for Promoting Independence After Hip Fracture (REGAIN) surgery trial, an ongoing randomised trial comparing spinal vs general anaesthesia for hip fracture surgery in 1600 older adults across 45 hospitals in the USA and Canada. This strategy engaged patients and their representatives at both the level of overall trial oversight and at the level of individual recruiting sites. Activities spanned a continuum ranging from events designed to elicit patients' input on key decisions to longitudinal collaborations that empowered patients to actively participate in decision-making related to trial design and management. Engagement activities were highly acceptable to participants and led to concrete changes in the design and conduct of the REGAIN trial. The REGAIN experience offers a model for future efforts to engage patients as partners in clinical anaesthesia research, and highlights potential opportunities for investigators to increase the relevance of anaesthesia studies by incorporating patient voices and perspectives into the research process.

Published
2020

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