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Introduction Mechanical thrombectomy (MT) can improve outcomes following ischaemic stroke. Patient selection for MT is predominantly based on physiological and imaging parameters. We assessed whether people living with pre-stroke frailty had differing outcomes following MT. Methods We included consecutive patients undergoing MT at a UK comprehensive stroke centre. We calculated a cumulative deficits frailty index to identify pre-stroke frailty in those patients presenting directly to the centre. Frailty was defined as an index score ≥ 0.24. We assessed univariable and multivariable association between pre-stroke frailty and stroke outcomes. Our primary outcomes were modified Rankin Scale (mRS) and mortality at 90 days. Results Of 175 patients who underwent MT (2014–2018), we identified frailty in 49 (28%). Frail and non-frail patients had similar rates of thrombolysis administration, successful recanalization and onset to recanalization times. Those with pre-stroke frailty had higher 24 hour National Institutes of Health Stroke Scale (12(IQR: 8–17) versus 3(IQR: 2–13); P = 0.001); were less likely to be independent (mRS 0–2: 18% versus 61%; P Conclusion Pre-stroke frailty is prevalent in real-world patients eligible for MT and is an important predictor of poor outcomes. Routine assessment of pre-stroke frailty could help decision-making around patient selection for MT.

Supplemental material, sj-pdf-1-taw-10.1177_20420986211016645 for Anticholinergic burden measures and older people’s falls risk: a systematic prognostic review by Carrie Stewart, Martin Taylor-Rowan, Roy L. Soiza, Terence J. Quinn, Yoon K. Loke and Phyo Kyaw Myint in Therapeutic Advances in Drug Safety

Supplemental Material, sj-pdf-3-eso-10.1177_23969873211042192 for European Stroke Organisation and European Academy of Neurology joint guidelines on post-stroke cognitive impairment by Terence J Quinn, Edo Richard, Yvonne Teuschl, Thomas Gattringer, Melanie Hafdi, John T O’Brien, Niamh Merriman, Celine Gillebert, Hanne Huyglier, Ana Verdelho, Reinhold Schmidt, Emma Ghaziani, Hysse Forchammer, Sarah T Pendlebury, Rose Bruffaerts, Milija Mijajlovic, Bogna A Drozdowska, Emily Ball and Hugh S Markus in European Stroke Journal

Supplemental Material, sj-pdf-1-eso-10.1177_23969873211042192 for European Stroke Organisation and European Academy of Neurology joint guidelines on post-stroke cognitive impairment by Terence J Quinn, Edo Richard, Yvonne Teuschl, Thomas Gattringer, Melanie Hafdi, John T O’Brien, Niamh Merriman, Celine Gillebert, Hanne Huyglier, Ana Verdelho, Reinhold Schmidt, Emma Ghaziani, Hysse Forchammer, Sarah T Pendlebury, Rose Bruffaerts, Milija Mijajlovic, Bogna A Drozdowska, Emily Ball and Hugh S Markus in European Stroke Journal

Supplemental Material, sj-pdf-2-eso-10.1177_23969873211042192 for European Stroke Organisation and European Academy of Neurology joint guidelines on post-stroke cognitive impairment by Terence J Quinn, Edo Richard, Yvonne Teuschl, Thomas Gattringer, Melanie Hafdi, John T O’Brien, Niamh Merriman, Celine Gillebert, Hanne Huyglier, Ana Verdelho, Reinhold Schmidt, Emma Ghaziani, Hysse Forchammer, Sarah T Pendlebury, Rose Bruffaerts, Milija Mijajlovic, Bogna A Drozdowska, Emily Ball and Hugh S Markus in European Stroke Journal

Supplemental material, sj-pdf-2-eso-10.1177_2396987321997045 for Prognostic rules for predicting cognitive syndromes following stroke: A systematic review by Bogna A Drozdowska, Kris McGill, Michael McKay, Roisin Bartlam, Peter Langhorne and Terence J Quinn in European Stroke Journal

Supplemental material, sj-pdf-1-taw-10.1177_2042098620985690 for Routine use of immunosuppressants is associated with mortality in hospitalised patients with COVID-19 by Phyo K. Myint, Ben Carter, Fenella Barlow-Pay, Roxanna Short, Alice G. Einarsson, Eilidh Bruce, Kathryn McCarthy, Alessia Verduri, Jemima Collins, James Hesford, Frances Rickard, Emma Mitchell, Mark Holloway, Aine McGovern, Arturo Vilches-Moraga, Philip Braude, Lyndsay Pearce, Michael Stechman, Angeline Price, Terence J. Quinn, Enrico Clini, Susan Moug and Jonathan Hewitt in Therapeutic Advances in Drug Safety

Background In response to the COVID-19 pandemic, many countries mandated staying at home to reduce transmission. This study examined the association between living arrangements (house occupancy numbers) and outcomes in COVID-19. Methods Study population was drawn from the COPE study, a multicentre cohort study. House occupancy was defined as: living alone; living with one other person; living with multiple other people; or living in a nursing/residential home. Outcomes were time from admission to mortality and discharge (Cox regression), and Day 28 mortality (logistic regression) analyses were adjusted for key comorbidities and covariates including admission: age, sex, smoking, heart failure, admission C-reactive protein (CRP), chronic obstructive pulmonary disease, estimated glomerular filtration rate, frailty and others. Results A total of 1584 patients were included from 13 hospitals across UK and Italy: 676 (42.7%) were female, 907 (57.3%) were male, median age was 74 years (range: 19–101). At 28 days, 502 (31.7%) had died. Median admission CRP was 67, 82, 79.5 and 83 mg/l for those living alone, with someone else, in a house of multiple occupancy and in a nursing/residential home, respectively. Compared to living alone, living with anyone was associated with increased mortality: within a couple [adjusted hazard ratios (aHR) = 1.39, 95% confidence intervals (CI) 1.09–1.77, P = 0.007]; living in a house of multiple occupancy (aHR = 1.67, 95% CI 1.17–2.38, P = 0.005); and living in a residential home (aHR = 1.36, 95% CI 1.03–1.80, P = 0.031). Conclusion For patients hospitalized with COVID-19, those living with one or more people had an increased association with mortality, they also exhibited higher CRP indicating increased disease severity suggesting they delayed seeking care.

Supplemental material, sj-pdf-1-wso-10.1177_17474930211045836 for Predicting post-stroke cognitive impairment using acute CT neuroimaging: A systematic review and meta-analysis by Emily L Ball, Rachel Sutherland, Charlotte Squires, Gillian E Mead, Dorota Religa, Erik Lundström, Joshua Cheyne, Joanna M Wardlaw, Terence J Quinn and Susan D Shenkin in International Journal of Stroke

Additional file 1: Supplementary text S1. Description of Study team. Supplementary text S2. Categories of research design assessed in the project. Supplementary text S3. Data dictionary for ‘included studies’ master sheet. Figure S1-S4 Traffic light visual summary of risk of bias (ROB). S1a) Traffic light summary of ROB for RCTs at individual study level. S1b) Traffic light summary of ROB for RCTs as aggregate scores. S2a) Traffic light summary of ROB for observational studies at individual study level. S2b) Traffic light summary of ROB for observational studies at aggregate level. S3a) Traffic light summary of ROB for test accuracy studies at individual study level. S3b) Traffic light summary of ROB for test accuracy studies at aggregate level. S4a) Traffic light summary of ROB for systematic reviews at individual study level. S4a) Traffic light summary of ROB for systematic reviews at aggregate level. Figure S5. Reporting guideline adherence (CONSORT) for RCTs. Figure S6. Reporting guideline adherence (STROBE) for observational studies. Figure S7 Reporting guideline adherence (STARD) for test accuracy studies. Figure S8 Reporting guideline adherence (PRISMA) for systematic review. Figure S9 Modified star plot describing overall and individual item level reporting adherence for STROBE (observational) reporting. Figure S10 Modified star plot describing overall and individual item level reporting adherence for CONSORT (RCT) reporting.

Supplemental material, sj-pdf-1-eso-10.1177_2396987321997045 for Prognostic rules for predicting cognitive syndromes following stroke: A systematic review by Bogna A Drozdowska, Kris McGill, Michael McKay, Roisin Bartlam, Peter Langhorne and Terence J Quinn in European Stroke Journal

Supplemental Material, sj-pdf-4-eso-10.1177_23969873211042192 for European Stroke Organisation and European Academy of Neurology joint guidelines on post-stroke cognitive impairment by Terence J Quinn, Edo Richard, Yvonne Teuschl, Thomas Gattringer, Melanie Hafdi, John T O’Brien, Niamh Merriman, Celine Gillebert, Hanne Huyglier, Ana Verdelho, Reinhold Schmidt, Emma Ghaziani, Hysse Forchammer, Sarah T Pendlebury, Rose Bruffaerts, Milija Mijajlovic, Bogna A Drozdowska, Emily Ball and Hugh S Markus in European Stroke Journal

Additional file 1:. List of morbidities. Table S1. Associations between categories of MVPA and incident dementia (all-cause, Alzheimer���s disease, and vascular dementia). Figure S1. Device-measured PA and its association with indecent dementia (all-cause, Alzheimer���s disease, and vascular dementia) using min/week. Figure S2. Device-measured PA and its association with indecent dementia (all-cause, Alzheimer���s disease, and vascular dementia) using a 2-year landmark. Figure S3. Cumulative hazard plot of Alzheimer���s disease incidence by categories of MVPA and follow-up time. Figure S4. Cumulative hazard plot of Alzheimer���s disease incidence by categories of MVPA and age. Figure S5. Cumulative hazard plot of vascular dementia incidence by categories of MVPA and follow-up time. Figure S6. Cumulative hazard plot of vascular dementia incidence by categories of MVPA and age.

Importance: Previous trials on the effect of levothyroxine on depressive symptom scores in patients with subclinical hypothyroidism were limited by small sample sizes (N = 57 to 94) and potential biases.Objective: To assess the effect of levothyroxine on the development of depressive symptoms in older adults with subclinical hypothyroidism in the largest trial on this subject and to update a previous meta-analysis including the results from this study.Design, setting, and participants: This predefined ancillary study analyzed data from participants in the Thyroid Hormone Replacement for Untreated Older Adults with Subclinical Hypothyroidism (TRUST) trial, a double-blind, randomized, placebo-controlled, parallel-group clinical trial conducted from April 2013 to October 31, 2016. The TRUST trial included adults aged 65 years or older diagnosed with subclinical hypothyroidism, defined as the presence of persistently elevated thyroid-stimulating hormone (TSH) levels (4.6-19.9 mIU/L) with free thyroxine (T4) within the reference range. Participants were identified from clinical and general practitioner laboratory databases and recruited from the community in Switzerland, the Netherlands, Ireland, and the UK. This ancillary study included a subgroup of 472 participants from the Netherlands and Switzerland; after exclusions, a total of 427 participants (211 randomized to levothyroxine and 216 to placebo) were analyzed. This analysis was conducted from December 1, 2019, to September 1, 2020.