Impact of Perioperative Oral Care on the Length of Hospital Stay in Cardiovascular Surgery Patients.

BackgroundBleeding in early pregnancy is a common emergency department (ED) presentation. Although variability in approaches has been demonstrated, research is relatively uncommon on practices and outcomes. This study investigated the influence of clinical pattern of care, utility, and contribution of pelvic examination aimed at diagnosing and managing bleeding in early pregnancy at three Canadian EDs.MethodsAfter obtaining informed consent, data were collected from adult women who were pregnant and from treating ED physicians using a structured questionnaire. We defined the change in management based on the initial clinical plan at the time of the initial physician assessment in the ED and any subsequent changes made after the pelvic examination was performed. Patient telephone follow-up was supplemented by linking with provincial administrative data for births. Univariable and multivariable binary logistic regression analyses were performed to identify factors associated with a change in patient management following pelvic examination in the ED.ResultsOverall, 200 women were enrolled. The mean age was 31 years, patients had been bleeding for a median of 1 day and stayed in the ED for a median of 5 h. Of these, 166 (83.0%) received a pelvic examination, including speculum examination and/or bimanual palpation. Pregnancy outcome data were available for 192 pregnancies; 107 (56%) experienced a miscarriage. Factors significantly associated with a change in management after pelvic examination in the univariate logistic regression analysis were brown/dark-red bleeding per vaginam (physician determined), tachycardia, right lower quadrant tenderness, and bimanual palpation. In the multivariate logistic regression analysis, brown/dark-red bleeding per vaginam was independently associated with a reduced likelihood of a change in management after pelvic examination (aOR = 0.37; 95% CI: 0.14–0.98).ConclusionAmong women presenting to the ED with bleeding in early pregnancy prior to 20 weeks gestation, only brown/dark-red vaginal bleeding, potentially indicative of bleeding resolution, significantly independently influenced the baseline odds of a change in management after pelvic examination. Until the debate on the utility of pelvic examination in the ED for this presentation is resolved, physician preferences and shared decision making with patients should guide practice regarding speculum examination/bimanual palpation for the management of bleeding in early pregnancy.

Identify correlations between lymph node characteristics and extranodal extension (ENE). Retrospective chart review. Tertiary care center. Patients who underwent neck dissection for oral cavity squamous cell carcinoma from 2004 to 2018 were included, with a starting sample of 496. The primary outcome was ENE in at least 1 lymph node. Additional variables included number of dissected nodes, positive nodes by level, positive lymph node ratio (LNR), and diameter of metastatic deposit and ENE focus. Univariate and multivariate binary logistic regression analyses were performed to determine correlations between included variables and ENE. Of the 496 patients, 233 had nodal metastasis (47.0%). 13,814 nodes were removed, with 714 (5.2%) containing metastasis. Of the positive nodes, 28.0% had ENE, 47.2% did not have ENE, and 24.8% were unknown. The mean ENE diameter was 5.1 mm (SD, 9.9). On univariate logistic regression analysis, ipsilateral neck LNR per 0.1 unit increase (odds ratio [OR] 1.16, 95% confidence interval [CI] 1.02-1.32, P = .02), metastatic deposit size per 1 mm increase (OR 1.06, CI 1.04-1.08, P < .0001), and clinical T- (P = .02) and N-class (P = .0003) significantly correlated with ENE. On multivariate logistic regression analysis, size of metastatic deposit (OR 1.06, CI 1.03-1.08, P < .0001) remained significantly correlated with ENE. Controlling for confounding variables, size of metastatic deposit was an independent predictor of ENE, suggesting that as the metastatic deposit size increases, the odds of extension through the capsule also increases. This may be due to capsule thinning as the deposit grows or could represent the invasive nature of aggressive disease.

ObjectiveThe determination of clinico-surgical predictors of carotid body tumour (CBT) metastasizing and/or recurrence.MethodsPatients with CBT but without a history of its previous treatment who had received inpatient medical aid at a tertiary surgical centre during the period 2011-2021 were retrospectively reviewed to obtain baseline data. Primary endpoints of the study were CBT metastasizing and/or local recurrence after radical surgery (composite endpoint) and overall survival. Secondary endpoint of the study was primary patency of carotid arteries that had been repaired/reconstructed as a result of CBT removal. Suspected predictors of CBT metastasizing/recurrence were young age of CBT onset, positive family history, multifocal paraganglioma, Shamblin type III CBT, carotid bifurcation and/or internal carotid artery (ICA) reconstruction as a result of CBT excision. To detect CBT metastasizing/recurrence, prospective imaging-based whole-body screening was suggested to patients.ResultsFifty-three patients met the eligibility criteria. The overall survival rate was 100% at a median follow-up time of 68 months (interquartile range [IQR] 27‒104.5 months). The primary patency of repaired carotid arteries (n = 9) was 88.9% at a median follow-up time of 99 months (IQR 15.5‒116.5 months). Thirty-nine patients underwent the prospective whole-body screening. Eight (20.5%) patients were diagnosed with metastatic disease (n = 6) or local recurrence (n = 2). Patients with CBT metastasizing/recurrence were younger at age of CBT onset (p = .011), more frequently had Shamblin type III CBT (p = .004) and the necessity for carotid artery repair/reconstruction (p = .041) than patients without metastasizing/recurrence. These two groups were similar in terms of gender (p = .682), the prevalence of multifocal paraganglioma (p = .167) and positive family history (p = .180). Only the belonging of a CBT to Shamblin type III was defined as a statistically significant predictor of CBT metastasizing/recurrence in both univariable and multivariable binary logistic regression analyses (odds ratio 30; 95% confidence interval: 2.649-339.739; p = .006 and odds ratio 75.409; 95% confidence interval: 1.082-5254.557; p = .046, respectively). Multifocal paraganglioma as a predictor exhibited a strong tendency towards statistical significance (p = .09 and p = .072, respectively). Other suspected predictors didn't reach the level of statistical significance either in univariable (p = .151 for positive family history) or in multivariable (p = .211 for age of CBT onset; p = .734 for carotid artery reconstruction/repair) binary logistic regression analyses.ConclusionShamblin type III CBT has high potential for metastasizing and recurrence. Patients with Shamblin type III CBT and/or multifocal paraganglioma should be considered for genetic testing as well as preoperative whole-body radiological imaging and long-term postoperative whole-body imaging-based follow-up.

BackgroundZinc finger E-box binding homeobox 1 (ZEB1) is a molecule involved in the progression of epithelial-to-mesenchymal transition (EMT) in various kinds of cancers. Here, we aimed to determine whether the expression of the ZEB1 protein is related to the response of patients to neoadjuvant therapy as well as their survival outcome.MethodsImmunohistochemistry (IHC) was performed on paraffin-embedded tumor samples from core needle biopsy before neoadjuvant therapy (NAT). Univariate and multivariate logistic regression analyses were used to analyze the associations between the protein expression of ZEB1 and the pathological complete response (pCR) outcome. Kaplan–Meier plots and log-rank tests were used to compare disease-free survival (DFS) between groups. A Cox proportional hazards model was used to calculate the adjusted hazard ratio (HR) with a 95% confidential interval (95% CI).ResultsA total of 75 patients were included in the IHC test. High ZEB1 protein expression was associated with a low pCR rate in both univariate (OR = 0.260, 95% CI 0.082–0.829, p = 0.023) and multivariate (OR = 0.074, 95% CI 0.011–0.475, p = 0.006) logistic regression analyses. High ZEB1 protein expression was also associated with a short DFS according to both the log-rank test (p = 0.023) and Cox proportional hazard model (HR = 9.025, 95% CI 1.024–79.519, p = 0.048). In hormone receptor positive (HorR-positive) patients, high ZEB1 protein expression was also associated with a lower pCR (OR = 0.054, 95% CI 0.007–0.422, p = 0.005) and a poorer DFS (HR = 10.516, 95% CI 1.171–94.435, p = 0.036) compared with low ZEB1 protein expression. In HER2-overexpressing patients, ZEB1 protein expression was also associated with poor survival (p = 0.042).ConclusionsOur results showed that high ZEB1 protein expression was a negative predictive marker of pCR and DFS in neoadjuvant therapy in breast cancer patients and in HorR-positive and HER2-overexpressing subgroups.Trial registration NCT, NCT02199418. Registered 24 July 2014—Retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT02199418?term=NCT02199418&rank=1. NCT, NCT 02221999. Registered 21 August 2014—Retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT02221999?term=NCT02221999&rank=1

An association between preoperative markers of systemic inflammation and inferior mortality following abdominal aortic aneurysm (AAA) repair has been observed. The prognostic value of the postoperative inflammatory response remains unreported in patients with AAA. This study aimed to describe the association between the perioperative inflammatory response and mortality in patients undergoing endovascular aneurysm repair and open surgical repair (OSR) for infrarenal AAA. Consecutive patients undergoing either emergency (endovascular aneurysm repair or OSR) or elective (OSR) intervention for infrarenal AAA were retrospectively recruited from 3 centers. Preoperative systemic inflammation was assessed using the modified Glasgow Prognostic Score. Day 3 postoperative C-reactive protein (CRP) (≤300mg/L, >300mg/L) was chosen as the covariate of interest. The primary outcome was 30-day mortality in the emergency cohort and 12-month mortality in the elective cohort. There were 167 emergency cases (120 (72%) OSR) and 207 elective (207 (100%) OSR) cases, with a median (interquartile range) follow-up of 85 (52) months in the emergency cohort and 63 (57) months in the elective cohort. There were 56% versus 44% of patients in the emergency cohort day 3 CRP ≤300mg/l versus >300mg/L compared with 82% versus 18% of patients in the elective cohort (P<0.001). On univariate binary logistic regression analyses in the emergency cohort, open repair (P<0.05), preoperative modified Glasgow Prognostic Score 2 (P<0.05), postoperative mesenteric ischemia (P<0.01), and day 3 postoperative CRP >300mg/L (P<0.05) were associated with increased odds of 30-day mortality. On multivariate binary logistic regression analyses, only preoperative modified Glasgow Prognostic Score 2 (odds ratio [OR]: 2.11, 95% confidence interval [CI]: 1.12-3.98, P<0.05) retained independent association with 30-day mortality. In the elective cohort, mean (95% CI) survival in the day 3 CRP ≤300mg/l versus >300mg/L was 112.0 (101.8-122.2) months versus 67.2 (54.1-80.2) months (P<0.001). On univariate binary logistic regression analyses in the elective cohort, age ≥75 (P<0.05), ischemic heart disease (P<0.05), and day 3 postoperative CRP >300mg/L (P<0.001) were associated with increased odds of 12-month mortality. On multivariate binary logistic regression analyses, both age ≥75 (OR: 5.15, 95% CI: 1.25-21.30, P<0.05) and day 3 postoperative CRP >300mg/L (OR: 15.68, 95% CI: 3.61-68.15, P<0.001) retained independent association with 12-month mortality. Preoperative and postoperative markers of systemic inflammation were independently associated with inferior survival following emergency and elective repair of AAA, respectively. Further investigation of the perioperative systemic inflammatory response is warranted in this patient group, with a particular focus on identifying targets for intervention.

Background: Brain-derived neurotrophic factor (BDNF) is involved in obesity, type 2 diabetes mellitus (T2DM), and cognitive dysfunction. The present study sought to assess the role of serum levels of BDNF in the pathophysiological process of mild cognitive impairment (MCI), a preclinical phase of dementia in 715 Chinese patients with T2DM. Methods: Cross-sectional data were obtained from 715 patients with T2DM recruited from a Chinese diabetes center. Serum levels of BDNF were measured with sandwich enzyme-linked immunosorbent assay. The influence of BDNF on MCI was examined using univariate and multivariate binary logistic regression analyses. Results: In univariate and multivariate logistic regression analyses, for each one-unit increase of BDNF, the unadjusted and adjusted risk of MCI decreased by 9% (OR 0.91; 95% CI 0.88–0.93, p < 0.001) and 6% (0.94; 0.87–0.98, p < 0.001) respectively. In multivariate models comparing the first (Q1), second and third quartiles against the fourth quartile of BDNF, BDNF in Q1 and Q2 were associated with MCI, and increased risk of MCI by 275% (OR 3.75; 95% CI 2.38–6.03) and 155% (2.55; 1.32–4.02). These results suggested that for each 1 ng/mL increase of serum level of BDNF, the association became stronger among obese diabetic patients (OR 0.91, 95% CI 0.85–0.96; p < 0.001) versus nonobese diabetic patients (OR 0.95, 95% CI 0.86–0.98; p = 0.001). Conclusion: The present data demonstrated that reduced serum levels of BDNF were associated with increased risk of MCI and might be useful for identifying diabetic patients at risk of dementia for early prevention strategies.

Predictors of Early Death in Childhood Acute Promyelocytic Leukemia: Results of an International Retrospective Study

To explore the risk factors of intensive care unit acquired weakness (ICUAW) in patients with sepsis, and to evaluate the predictive value of each risk factor for ICUAW. A case control study was conducted, 60 septic patients admitted to the intensive care unit (ICU) of Henan Provincial People's Hospital from October 20, 2020 to February 20, 2021 were enrolled. The patients were divided into two groups: sepsis ICUAW group and sepsis non-ICUAW group. The data of gender, age, body mass index (BMI), acute physiology and chronic health evaluation II (APACHE II) score, complications, mechanical ventilation, duration of ICUAW, length of stay in ICU, fasting blood glucose, blood lactic acid (Lac), procalcitonin (PCT), C-reactive protein (CRP), sequential organ failure assessment (SOFA) score, outcome, antimicrobial agent, glucocorticoid, sedatives and analgesics drugs and vasoactive drugs were collected. Risk factors were screened by univariate Logistic regression analysis, and odds ratio (OR) was adjusted by multivariate binary logistic regression, P < 0.05 was considered as independent risk factors. Finally, the receiver operating characteristic curve (ROC curve) was drawn to analyze the predictive value of independent risk factors. The APACHE II score of the sepsis ICUAW group was significantly higher than that of the sepsis non-ICUAW group (23.05±8.17 vs. 15.33±4.89, P < 0.05), the total length of stay in the ICU was significantly longer than that of the sepsis non-ICUAW group (days: 15.1±9.2 vs. 8.5±3.4, P < 0.05), the improvement rate of patients was significantly lower than that of the sepsis non-ICUAW group [45.0% (9/20) vs. 95.0% (38/40), P < 0.05]. After univariate Logistic regression and multicollinearity test analysis, 7 factors including APACHE II score, average SOFA score, blood lactic acid, proportion of mechanical ventilation, sedatives and analgesics drugs, type of antibiotics and type of vasoactive drugs were included in the binary Logistic regression model [OR: 1.21, 2.05, 2.26, 0.21, 1.54, 2.07, 1.38, 95% confidence interval (95%CI): 1.09-1.35, 1.42-2.94, 1.12-4.57, 0.05-0.66, 1.03-2.29, 1.27-3.37, 0.96-2.00, all P < 0.05]. Hosmer-Lemchaw test P = 0.901, and the correct percentage of prediction was 85%, indicating good model fit. Multivariate binary Logistic regression analysis showed that APACHE II score and average SOFA score were independent risk factors for the occurrence of ICUAW in septic patients (APACHE II score: OR = 1.17, 95%CI was 1.004-1.376, P = 0.044; average SOFA score: OR = 1.86, 95%CI was 1.157-2.981, P = 0.01). ROC curve analysis showed that the mean value of APACHE II score, average SOFA score and their combined detection had a certain predictive value for the occurrence of ICUAW in sepsis patients, areas under ROC curve (AUC) were 0.787, 0.881, 0.905, 95%CI was 0.646-0.928, 0.791-0.972, 0.828-0.982, all P < 0.05. When the cut-off value was 19.500, 6.225, 0.375, the sensitivity was 75%, 90%, 90%, and the specificity were 80%, 80%, 85%, respectively. APACHE II score and average SOFA score can be used as independent risk factors for the occurrence of ICUAW in sepsis, and their combined predictive value is better than that of individual index.

To evaluate if the detection rate (DR) of (18)F-choline (18F-CH) PET/CT is influenced by androgen-deprivation therapy (ADT) in patients with prostate cancer (PC) already treated with radical intent and presenting biochemical relapse. We have retrospectively evaluated (18)F-CH PET/CT scans of 325 consecutive PC patients enrolled in the period November 2009 to December 2012 previously treated with radical intent and referred to our centre to perform (18)F-CH PET/CT for biochemical relapse. Two different groups of patients were evaluated. group A included the whole sample of 325 patients (mean age 70 years, range: 49-86) who presented trigger PSA between 0.1 and 80 ng/ml (mean 5.5 ng/ml), and group B included 187 patients (mean age 70 years, range 49-86) with medium-low levels of trigger PSA ranging between 0.5 and 5 ng/ml (mean PSA 2.1 ng/ml); group B was chosen in order to obtain a more homogeneous group of patients in terms of PSA values also excluding both very low and very high PSA levels avoiding the "a priori" higher probability of negative or positive PET scan, respectively. At the time of examination, 139 patients from group A and 72 patients from group B were under ADT: these patients were considered to be hormone-resistant PC patients because from their oncologic history (>18 months) an increase of PSA levels emerged despite the ongoing ADT. The relationship between (18)F-CH PET/CT findings and possible clinical predictors was investigated using both univariate and multivariate binary logistic regression analyses, including trigger PSA and ADT. Considering the whole population, overall DR of (18)F-CH PET was 58.2 % (189/325 patients). In the whole sample of patients (group A), both at the univariate and multivariate logistic regression analysis, trigger PSA and ADT were significantly correlated with the DR of (18)F-CH PET (p < 0.05). Moreover, the DR in patients under ADT (mean PSA 7.8 ng/ml) was higher than in patients not under ADT (mean PSA 3.9 ng/ml), (DR was 70.5 % and 48.9 %, respectively; p < 0.001), therefore, demonstrating the existence of a significant correlation between the DR of (18)F-CH PET and ADT. In group B patients only trigger PSA resulted a reliable predictor of the (18)F-CH positivity, since ADT was not correlated to the DR of (18)F-CH PET (p = 0.061). Also in group B the DR of (18)F-CH PET in patients under ADT was higher than in patients not under ADT (65.3 % and 51.3 %, respectively) but the difference was not significant without a statistically significant correlation in the Mann Whitney test (p = 0.456) therefore, suggesting the lack of correlation between DR (18)F-CH PET/CT and ADT. Similarly to previous published studies, in our series the overall DR of (18)F-CH PET/CT was 58 % and was significantly correlated to trigger PSA. The most important finding of the present study is that ADT does not negatively influence DR of (18)F-CH PET/CT in PC patients with biochemical relapse; therefore, it can be suggested that it is not necessary to withdraw ADT before performing (18)F-CH PET/CT.

Platelet to lymphocyte ratio (PLR) has been introduced as a useful index to estimate the current inflammatory burdens in various diseases. In this study, we investigate whether PLR is associated with the severity of ANCA-associated vasculitis (AAV). We retrospectively reviewed the medical records of 163 patients with AAV, collected clinical, laboratory and radiological data and calculated Birmingham vasculitis activity score (BVAS). We defined the lower limit of the highest tertile of BVAS as the cut-off for severe AAV (BVAS ≥ 16). The optimal cut-off of PLR for severe AAV was set as 272.0. The odds ratio (OR) of PLR for severe AAV was assessed using the univariable and multivariable logistic regression analyses. The median age at diagnosis was 58.0years and 51 patients (31.3%) were men. Patients with severe AAV exhibited higher rate of ANCA positivity and higher blood urea nitrogen (BUN), creatinine (Cr), erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) than those without. Patients with severe AAV exhibited significantly increased median PLR compared to those without (299.3 vs. 184.0). In the univariable binary logistic regression analysis, BUN ≥ 17.45mg/dL (OR 3.730), Cr ≥ 1.12mg/dL (OR 3.519), ESR ≥ 83.5mm/h (OR 2.785), CRP ≥ 20.0mg/L (OR 2.612), PLR ≥ 272.0 (OR 4.231) and ANCA positivity (OR 2.306) were associated with severe AAV. In the multivariable binary logistic regression analysis, only PLR ≥ 272.0 was an independent predictor of severe AAV at diagnosis (OR 2.734, 95% CI 1.247, 5.993). In conclusion, PLR at diagnosis is associated with the current activity of vasculitis in AAV patients.

Risk factors for clinical failure in patients hospitalized with cellulitis and cutaneous abscess

BackgroundCardiovascular and cerebrovascular diseases significantly contribute to global mortality and disability. The shift to outpatient postoperative care, accelerated by the COVID-19 pandemic, emphasizes the need for effective management of postoperative outcomes. The high rates of cardiovascular and cerebrovascular diseases in Korea necessitate focused transitional care during patient discharge periods. However, limited research exists on the postoperative experiences of discharged patients, underscoring the necessity of establishing evidence-based services to optimize transitional care.ObjectiveThe objective of this paper was to analyze the emotional experiences of patients who underwent cardiovascular and cerebrovascular surgeries using data from Naver, a major South Korean web portal.MethodsPosts were collected using specific keywords and processed with the Korean Bidirectional Encoder Representations from Transformers (KoBERT) model based on Transformer, which classified sentiments into positive, neutral, and negative categories. Model performance was validated according to precision, recall, F1-score, and support. Sentiment analysis was conducted within the Transitional Care Model (TCM) framework, divided into 5 domains: health status, care resources, care demand, interaction, and mental state.ResultsThe KoBERT model demonstrated high classification performance, achieving a precision of 96%, recall of 94%, and an F1-score of 94%. Sentiment analysis revealed that compared with cardiovascular surgery patients, cerebrovascular surgery patients experienced higher negative emotions regarding health status, whereas cardiovascular surgery patients expressed more negative sentiments in care demands.ConclusionsDifferent patient groups experience distinct emotional and practical challenges postdischarge. Particularly, keywords within the TCM framework highlight that cerebrovascular surgery patients require robust rehabilitation and caregiver support, whereas cardiovascular surgery patients need better cost management. These findings underscore the importance of personalized transitional care strategies tailored for cardiovascular and cerebrovascular diseases. The insights derived from this study can guide health care policymakers in designing more targeted and patient-centered interventions to improve postdischarge care and patient-centered transitional care, ensuring continuous and effective postoperative management.

BackgroundAlthough serum creatinine concentration has been traditionally used as an index of renal function in clinical practice, it is considered relatively inaccurate, especially in patients with mild renal dysfunction. This study investigated the usefulness of preoperative estimated glomerular filtration rate (eGFR) in predicting complications after cardiovascular surgery in patients with normal serum creatinine concentrations.MethodsThis study included 2208 adults undergoing elective cardiovascular surgery. Preoperative eGFR was calculated using Chronic Kidney Disease Epidemiology Collaboration equations. The relationships between preoperative eGFR and 90 day postoperative composite major complications were analyzed, including 90 day all-cause mortality, major adverse cardiac and cerebrovascular events, severe acute kidney injury, respiratory and gastrointestinal complications, wound infection, sepsis, and multi-organ failure.ResultsOf the 2208 included patients, 185 (8.4%) had preoperative eGFR < 60 mL/min/1.73 m2 and 328 (14.9%) experienced postoperative major complications. Multivariable logistic regression analyses showed that preoperatively decreased eGFR was independently associated with an increased risk of composite 90 day major postoperative complications (adjusted odds ratio: 1.232; 95% confidence interval [CI]: 1.148–1.322; P < 0.001). eGFR was a better discriminator of composite 90 day major postoperative complications than serum creatinine, with estimated c-statistics of 0.724 (95% CI: 0.694–0.754) for eGFR and 0.712 (95% CI: 0.680–0.744) for serum creatinine (P = 0.008).ConclusionsDecreased eGFR was significantly associated with an increased risk of major complications after cardiovascular surgery in patients with preoperatively normal serum creatinine concentrations.

Evaluation of Analgesic Drug Therapy for Postoperative Pain Management in Cardiovascular Surgery

(1) Background: Little is known about how left ventricular systolic dysfunction (LVSD) affects functional and clinical outcomes in acute ischemic stroke (AIS) patients undergoing thrombolysis; (2) Methods: A retrospective observational study conducted between 2006 and 2018 included 937 consecutive AIS patients undergoing thrombolysis. LVSD was defined as left ventricular ejection fraction (LVEF) < 50%. Univariate and multivariate binary logistic regression analysis was performed for demographic characteristics. Ordinal shift regression was used for functional modified Rankin Scale (mRS) outcome at 3 months. Survival analysis of mortality, heart failure (HF) admission, myocardial infarction (MI) and stroke/transient ischemic attack (TIA) was evaluated with a Cox-proportional hazards model; (3) Results: LVSD patients in comparison with LVEF ≥ 50% patients accounted for 190 and 747 patients, respectively. LVSD patients had more comorbidities including diabetes mellitus (100 (52.6%) vs. 280 (37.5%), p < 0.001), atrial fibrillation (69 (36.3%) vs. 212 (28.4%), p = 0.033), ischemic heart disease (130 (68.4%) vs. 145 (19.4%), p < 0.001) and HF (150 (78.9%) vs. 46 (6.2%), p < 0.001). LVSD was associated with worse functional mRS outcomes at 3 months (adjusted OR 1.41, 95% CI 1.03–1.92, p = 0.030). Survival analysis identified LVSD to significantly predict all-cause mortality (adjusted HR [aHR] 3.38, 95% CI 1.74–6.54, p < 0.001), subsequent HF admission (aHR 4.23, 95% CI 2.17–8.26, p < 0.001) and MI (aHR 2.49, 95% CI 1.44–4.32, p = 0.001). LVSD did not predict recurrent stroke/TIA (aHR 1.15, 95% CI 0.77–1.72, p = 0.496); (4) Conclusions: LVSD in AIS patients undergoing thrombolysis was associated with increased all-cause mortality, subsequent HF admission, subsequent MI and poorer functional outcomes, highlighting a need to optimize LVEF.