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BACKGROUND: Abnormal electrolytes were closely related to the prognosis of various diseases, the prognostic role of electrolytes in stroke has not been investigated well. We aimed to investigate the association between electrolytes and clinical outcomes in patients with acute ischemic stroke (AIS) or transient ischemic attack (TIA). METHODS: Data were recruited from the China National Stroke Registry III study. Patients were classified into three groups according to tertiles and the normal range of each electrolyte. Multivariable logistic and Cox proportional hazards regressions were adopted to explore the associations of electrolytes with poor functional outcomes [modified Rankin Scale (mRS) 3–6/2–6] and all-cause death at 3 months and 1 year. RESULTS: A total of 10,299 eligible patients were enrolled. After adjusted for confounding factors, the first tertile electrolytes were associated with increased risk of poor functional outcome (mRS score 3–6) at 1 year, the adjusted odds ratios (95% confidence intervals) were 1.33 (1.14–1.55) for potassium, 1.41 (1.20–1.60) for sodium, 1.27 (1.08–1.48) for chloride, compared with the second tertile. Similar results were found when poor functional outcome was defined as mRS score 2–6 and all-cause death. However, almost no significant association was present of calcium with these outcomes. All results were consistent when each electrolyte was classified into three groups according to the normal range and the outcomes timepoint was set at 3 months. CONCLUSIONS: Lower levels of potassium, sodium, chloride but not calcium were associated with higher risk of poor functional outcomes and death in patients with AIS or TIA.

BACKGROUND: Lowering low-density lipoprotein cholesterol (LDL-C) is crucial for secondary stroke prevention in stroke patients with preexisting cardiovascular diseases (CVD) or cerebrovascular diseases (CeVD). However, data on attainment of guideline-recommended LDL-C levels are lacking. METHODS: We analyzed data from the Chinese Stroke Center Alliance (CSCA) program for patients with ischemic stroke and transient ischemic attack (TIA) hospitalized between August 2015 and July 2019. Participants were classified into different disease groups according to preexisting CeVD (stroke/TIA) or CVD [coronary heart disease (CHD) or myocardial infarction (MI)]. RESULTS: Of 858,509 patients presenting with an acute stroke/TIA, 251,176 (29.3%) had a preexisting CeVD, 44,158 (5.1%) had preexisting CVD, 33,070 (3.9%) had concomitant preexisting CeVD and CVD, and 530,105 (61.7%) had no documented history of CeVD/CVD. Overall, only 397,596 (46.3%) met the target for LDL-C

Background Mild stroke accounts for more than a half of all stroke patients, and short-term outcomes after treatment with intravenous (IV) recombinant tissue plasminogen activator (rtPA) have not been fully investigated in this group. Methods Our study investigated short-term outcomes and predictors for a favorable functional outcome at discharge in mild stroke patients with IV rtPA. 6,752 mild stroke patients in the China Stroke Center Alliance with a clinical diagnosis of acute ischemic stroke, within 4.5 hours from symptom onset, with a baseline National Institutes of Health Stroke Scale score ≤5 and received rt-PA treatment were included in this retrospective analysis. Univariable and multivariable analyses were performed to identify factors independently associated with a favorable functional outcome. Results Only 18.5% had an unfavorable functional outcome at discharge, 91.1% were discharged home, 89.9% could ambulate independently, 95.9% had a length of stay of 3 days or longer and 1.9% had sICH. A multivariable Logistic regression model identified that age >80 years [adjusted odds ratio (aOR): 1.57 (1.1-2.25)], diabetes mellitus [aOR: 1.35 (1.16-1.58)], 3-4.5 h time window [aOR: 1.43 (1.26-1.63)] and NIHSS score [3 vs. 0, aOR: 1.49 (1.05-2.11); 4 vs. 0, aOR: 2.36 (1.68-3.33); 5 vs. 0, aOR: 2.51 (1.77-3.56)] were independent risk factors for mRS >2 with hospital region, hospital level and hypertension as covariates. Conclusions Our findings suggest that tPA is safe and effective in mild stroke patients with age ≤80 within the 3 hour time window and in those without diabetes mellitus, further studies are needed to confirm the findings.

BACKGROUND: It is unknown about the influence of prestroke antiplatelet use on early outcomes in patients with and without the indication. We aimed to evaluate the in-hospital prognosis of first-ever noncardiogenic ischemic stroke patients with and without indications of antiplatelet use for primary prevention. METHODS: This was a retrospective, observational study based on a prospective hospital-based registry (Chinese Stroke Center Alliance). Using the data with 436,660 first-ever noncardiogenic acute ischemic strokes recorded from Aug 1, 2015, to July 31, 2019, from 1,453 hospitals in China, we examined the associations between the indication for prestroke antiplatelet use and in-hospital clinical outcomes. RESULTS: Among 436,660 first-ever noncardiogenic ischemic stroke patients, 42,409 patients (9.7%) had a documented previous vascular indication and 394,251 (90.3%) did not. Compared to those without, patients with the indication were associated with increased prevalence of in-hospital morbid conditions, including stroke severity (OR 2.71; 95% CI: 2.62–2.81; P14 days (OR 1.16; 95% CI: 1.13–1.19; P

Clinical prediction models, also known as “prognostic models”, “risk scores”, or “prediction rules”, have received increasing attention in recent years (1,2). Clinical prediction models appear to be the next rising star in personalized medicine, just as systematic reviews and meta-analyses were in the era of evidence-based medicine.

BACKGROUND: The past decade has witnessed a rapid increase in the number of contributors per article, which has made explicitly defining the roles of each contributor even more challenging. The Contributor Roles Taxonomy (CRediT) was developed to explicitly define author roles, but there is a lack of empirical data on how CRediT is used in clinical trials. This study aimed to provide empirical data on the use of CRediT in randomized controlled trials (RCTs) and discuss some limitations of CRediT. A new taxonomy (CRediT-RCT) is proposed to explicitly define the author roles in RCTs. METHODS: The electronic database of PubMed was searched from July 2017 to October 2019 to identify component trials with a randomized controlled design. Publications from the Public Library of Science (PLoS) were included because they embed the CRediT roles within the authors’ metadata rather than solely as a separate paragraph of text. RESULTS: A total of 446 articles involving 4,185 authors were included in the study. Most authors participated in the study’s conceptualization (44.9%) and investigation (48.8%), but only a fraction of the authors participated in software management (7.4%). Many CRediT roles were correlated with each other: the strongest correlation was the one between funding acquisition and conceptualization (correlation metric =0.39), followed by the one between conceptualization and methodology (0.37). The authors who acquired funding (OR: 2.06; 95% CI: 1.54–2.76; P

Background: Despite a few studies have demonstrated sex differences in stroke care and outcomes, limited research has explored insurance-related disparities in outcomes, particularly among women stroke patients. The aim was to determine whether rural-urban health insurance status affect the stroke treatment, process of care, and 1-year clinical outcomes for inpatient ischemic stroke in women. Methods: Women patients with acute ischemic stroke (AIS) covered by New Rural Cooperative Medical Scheme (NRCMS) and urban resident/employee-based basic medical insurance scheme (URBMI/UEBMI) were abstracted from the China National Stroke Registry II (CNSR II). Shared frailty model in the Cox model or generalized estimating equation with consideration of the hospital’s cluster effect were used to assess the associations between rural-urban insurance status and quality of care during hospitalization and 1-year stroke outcomes including all-cause death, 1-year recurrence, and 1-year disability. Results: A total of 5,707 women patients enrolled from 219 hospitals in CNSR II were analyzed. Compared with 2,880 women patients covered by URBMI/UEBMI, 2,827 women patients covered by NRCMS were younger (65.7 versus 68.9 years), less likely to have vascular risk factors, awareness and treatment of hypertension and dyslipidemia prior to stroke. Women covered by NRCMS were more likely to receive early antithrombotics, discharge antithrombotics, lipid-lowering drugs, but less likely to receive antihypertensive medication than those covered by URBMI/UEBMI. One-year all-cause mortality and stroke recurrence were both significantly higher in women patients with NRCMS than those with URBMI/UEBMI [adjusted hazard ratio (95% confidence interval): 1.40 (1.06–1.84) and 1.38 (1.04–1.83), separately]. Conclusions: AIS women patients with rural-urban insurance status demonstrated remarkable differences in age, stroke risk factors, awareness and treatment, the process of care, and 1-year stroke recurrence and mortality. Healthcare policymakers need to focus their attention on these disparities and take proper steps to improve primary healthcare service in rural areas.

Demographic tables are widely used to report baseline characteristics in medical research. However, the traditional copy-paste production method is time-consuming and frequently generates typing errors. Current available statistical tools are still far away from ideal, because they are difficult to understand and they lack flexibility. A user-friendly, dynamic, and flexible tool is needed for researchers to automate the creation of demographic tables. In this paper, we introduce a SAS macro, %ggBaseline, that automatically analyzing and reporting baseline characteristics with the final production of publication-quality demographic tables. The macro provides optional parameters that allow for the full customization of desired demographic tables. Since %ggBaseline allows for the quick creation of reproducible and fully customizable tables, it can be beneficial to academics, clinical trials and medical research studies by making the presentation and formatting of results faster and more efficient.