Propensity Score Matching Analysis Research Articles

Abstract 7451: Efficacy of chemoradiotherapy in older patients with advanced stage head and neck cancer: A propensity and machine learning analysis

Abstract Background: The rising incidence of head and neck squamous cell carcinoma (HNSCC) is linked with both human papillomavirus and aging population. As a result, there is an emerging need for developing management strategies for older patients with advanced-stage HNSCC. This study aims to use machine learning (ML) techniques to examine the efficacy of definitive, concurrent chemoradiotherapy (CRT) for older patients (≥65 years) with stage III-IV HNSCC. We used permutation feature importance (PFI) to compare the efficacy of CRT with single-modality radiotherapy (RT) for the overall survival (OS) of this HNSCC subgroup. Finally, we compared the results obtained using ML analysis with propensity-score matched (PSM) analysis to clarify the efficacy of CRT in this patient population. Methods: A total of 3570 patients with HNSCC were obtained from the Surveillance, Epidemiology, and End Results (SEER) Program to build the ML model. We compared voting ensemble and extreme gradient boosting algorithms for stratifying older (≥65 years) HNSCC patients into OS risk groups. Furthermore, the PFI analysis was based on stacked ML models to evaluate the efficacy of CRT regarding OS of older (≥65 years) HNSCC patients. Then, we performed a 1:1 propensity-score matched (PSM) analysis to reduce treatment selection bias and analyze the prognostic role of CRT. Results: Our ML model showed a performance accuracy of 85.2% in predicting OS in this subgroup of HNSCC. The aggregate feature importance showed that CRT is the most important feature for OS in this group of HNSCC patients. In addition, patients with stage IV disease showed better survival than those with stage III. The PSM confirmed the efficacy of CRT compared to RT alone. Conclusions: This study showed that CRT may be more feasible and effective than RT alone for older patients with stage III-IV HNSCC. This further emphasized that advanced-stage treatment decisions should rather be made according to other patient-related factors than chronologic (calendar) age alone. Therefore, validating these models with multi-institutional datasets and testing them in the context of clinical trials is warranted to confirm the efficacy of CRT over RT alone for older patients (≥65 years) with stage III-IV HNSCC. Citation Format: Rasheed Omobolaji Alabi, Alhadi Almangush, Antti Mäkitie. Efficacy of chemoradiotherapy in older patients with advanced stage head and neck cancer: A propensity and machine learning analysis [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2025; Part 1 (Regular Abstracts); 2025 Apr 25-30; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2025;85(8_Suppl_1):Abstract nr 7451.

Pulsatile cardiopulmonary bypass using a centrifugal pump reduces acute kidney injury after cardiac surgery: a propensity score-matched analysis.

Acute kidney injury (AKI) affects approximately 30% of patients undergoing cardiac surgery with conventional non-pulsatile cardiopulmonary bypass (CPB). Pulsatile flow has long been proposed for mitigating this complication. While the 2019 EACTS guidelines recommend pulsatile perfusion for high-risk renal patients, most evidence is based on intra-aortic balloon pump (IABP) studies, with limited evidence for centrifugal pumps. We aimed to evaluate whether pulsatile CPB using a centrifugal pump reduces postoperative AKI in patients undergoing cardiac surgery. This retrospective study analyzed 824 patients who underwent cardiac surgery between December 2008 and December 2023. The patients were divided into pulsatile perfusion (PP) and non-pulsatile perfusion (NP) groups. Propensity score matching was adjusted for the baseline characteristics, resulting in 265 matched pairs. The primary endpoint was postoperative AKI, defined by the Kidney Disease: Improving Global Outcomes (KDIGO) criteria. Subgroup analyses were performed based on estimated glomerular filtration rate (eGFR). In the matched cohort, the PP group had a significantly lower incidence of AKI than the NP group (20.8 vs. 34.3%; odds ratio, 0.5; 95% confidence interval, 0.33-0.75; P < 0.001). A subgroup analysis showed that patients with a preoperative eGFR of 15-60 had a significantly lower incidence of AKI in the PP group (28.3 vs. 47.1%; P = 0.005). No significant differences were observed in secondary outcomes, including hemodialysis, cerebrovascular events, and in-hospital mortality. Pulsatile CPB using a centrifugal pump significantly reduced the incidence of postoperative AKI in cardiac surgery patients, particularly in those with preoperative renal impairment.

Defect closure after endoscopic submucosal dissection decreased the adverse events in patients with large rectal neoplasms: a propensity score matching analysis.

The effectiveness of defect closure in preventing postoperative complications in rectal lesions exceeding 30 mm in size following endoscopic submucosal dissection (ESD) remains uncertain; this study aimed to assess the effectiveness of defect closure in reducing postoperative complications after ESD in patients with large rectal neoplasms. A retrospective review was conducted on consecutive patients with large rectal neoplasms who underwent ESD at our center from January 2013 to December 2024. Patients were divided into two groups: the closure group and the non-closure group. Propensity score matching (PSM) was used to minimize selection bias. The study compared adverse events, postoperative fever, and postoperative hospital stay between the two matched groups. A total of 215 patients were enrolled in the study and included in the analysis. The baseline characteristics of the 83 matched patient pairs were comparable after PSM. The incidence of adverse events was significantly lower in the closure group than in the non-closure group (1.2% vs. 9.6%, P = 0.040). While no statistically significant differences were observed between the two groups in terms of postoperative fever and prolonged postoperative hospital stay, the rates were lower in the closure group compared to the non-closure group (9.6% vs. 10.8%, P = 0.798; 22.9% vs. 33.7%, P = 0.121, respectively). Moreover, defect closure was independently associated with a reduced risk of delayed bleeding (OR, 0.181; 95% CI, 0.035-0.932; P = 0.041). Defect closure after ESD decreased the adverse events in patients with large rectal neoplasms. Moreover, defect closure was independently associated with a reduced risk of delayed bleeding. Future prospective studies with larger samples are needed to provide more definitive guidance for clinical practice.

Updated perspectives on visceral pleural invasion in non-small cell lung cancer: A propensity score-matched analysis of the SEER database.

Updated perspectives on visceral pleural invasion in non-small cell lung cancer: A propensity score-matched analysis of the SEER database.

Early acetaminophen administration is associated with lower mortality among ARDS patients after coronary artery bypass grafting: a retrospective study

BackgroundAcetaminophen (APAP) is widely used in the treatment of patients after surgery, but the prognosis of patients with coronary artery bypass grafting (CABG)-related acute respiratory distress syndrome (CABG-ARDS) is still unclear. This study aims to explore the role of APAP in the management of CABG related ARDS.MethodsWe collected clinical data on patients with CABG-ARDS from the Medical Information Mart for Intensive Care-IV (MIMIC-IV) database. The primary outcome was early mortality after ARDS, and the secondary outcomes were length of hospital stay and duration of mechanical ventilation (MV). Multivariate logistic regression and Cox regression models were used for statistical analysis, and inverse probability processing weighting (IPTW), overlap weighting (OW) and propensity score matching (PSM) were used to explore the robustness of the outcomes.ResultsA total of 5459 patients were enrolled in the analysis. Multivariate logistic regression analysis revealed that the 14-day mortality in APAP group was significantly lower than that in non-APAP group (0.5% vs. 2.7%, OR = 0.301; 95% CI, 0.170–0.531; P < 0.001). The APAP group also showed a significant advantage in Cox regression analysis (0.5% vs. 2.7%, HR = 0.329; 95% CI, 0.187–0.577; P < 0.001). IPTW, OW, and PSM analyses were conducted between the two groups, and the differences remained significant. These results were consistent in 30-, 60-, and 90-day mortality analyses. Meanwhile, exposure to APAP was associated with a shorter length of hospital stay and a reduced duration of MV (P < 0.001).ConclusionThe administration of APAP was associated with reduced early mortality in patients with CABG-ARDS, as well as shorter length of hospital stay and duration of MV.

Sociodemographic and hospital-level predictors of muscle flap reconstruction in spinal fusion surgeries: a propensity score-matched analysis.

Spinal fusion is associated with risks of surgical site infection and wound dehiscence. Muscle flap reconstruction during surgery may mitigate these risks. While the benefits of muscle flap reconstruction have been established, sociodemographic and hospital-level influences on access to this procedure remain unexplored. This study identifies sociodemographic predictors of muscle flap reconstruction after spinal fusion surgeries using a nationwide database. Patients who underwent spinal fusion of two or more vertebral levels (n = 606,408) were identified from the 2012-2020 National Inpatient Sample database. The primary investigated outcome was utilization of muscle flap reconstruction. Cases without and with muscle flap reconstruction were 2:1 propensity score matched based on covariates for clinical severity and surgical complexity. Binary logistic regression identified significant sociodemographic and hospital-level predictors of receiving muscle flap reconstruction (p < 0.05). Of 606,408 discharges with spinal fusion cases, 1991 (0.3%) included muscle flap reconstruction. After matching (n = 5973), patient-level factors including private insurance status, residence in large metropolitan counties, and high median zip code income quartile, and hospital-level factors including urban teaching hospital status, higher institutional plastic surgery case volume, and private not-for-profit hospital ownership, all predicted a higher likelihood of muscle flap reconstruction (p < 0.05). Multiple sociodemographic variables predict use of muscle flap reconstruction after spinal fusion surgery. These disparities may stem from multiple underlying factors, including lack of access to specialized plastic surgery care and centralization of more complex cases at quaternary care hospitals. A better understanding of these factors may help inform further efforts to increase access to muscle flap reconstruction, thereby reducing the risk of wound healing complications.

From genes to clinic: Genomic and cross-sectional cohort analysis of oxidative stressors and lipid metabolism in European ancestry.

From genes to clinic: Genomic and cross-sectional cohort analysis of oxidative stressors and lipid metabolism in European ancestry.

Efficacy of a flow diverter versus stent-assisted coiling for treating small- and medium-sized intracranial wide-neck cystic aneurysms.

Efficacy of a flow diverter versus stent-assisted coiling for treating small- and medium-sized intracranial wide-neck cystic aneurysms.

The combined effect of nutritional status and body mass index on 90-day adverse events following long-segments fusion for adult spinal deformity: a propensity score-matched analysis.

The aim of this study was to investigate the individual and combined effects of PNI (prognostic nutritional index) and BMI (body mass index) on 90-day adverse events (AEs) following adult spinal deformity (ASD) surgery. A retrospective analysis was conducted on prospectively collected data from patients who underwent open long-segment fusion surgery for ASD. Patients were stratified into four groups based on BMI and PNI: low BMI with low PNI (LBLP), high BMI with low PNI (HBLP), low BMI with high PNI (LBHP), and high BMI with high PNI (HBHP). The primary outcome was the incidence of postoperative AEs within 90 days of ASD surgery. The LBLP group had a significantly higher risk of overall AEs (58.7% vs. 33.3%, p = 0.004) and infectious complications (20.6% vs. 7.9%, p = 0.042) compared to the LBHP group. The HBHP group exhibited a higher rate of major AEs (28.1% vs. 12.3%, p = 0.036) and infectious complications (15.6% vs. 3.5%, p = 0.026) within 90 days postoperatively than the LBHP group. Multivariate logistic regression analysis identified male, higher American Society of Anesthesiologists class, increased intraoperative blood loss, and HBHP status (compared to LBHP) as independent predictors of 90-day major AEs. In patients with low PNI, those with low BMI had a significantly higher risk of overall adverse events and infectious complications. Conversely, among patients with high PNI, those with high BMI were more prone to major adverse events and infectious complications within 90 days postoperatively.

A comparative study on clinical outcomes and safety of accurate anterior cervical ossified posterior longitudinal ligament en bloc resection versus piecemeal resection in patients with ossification of the cervical posterior longitudinal ligament: a propensity score-matching analysis

ObjectiveThe anterior approach for cervical ossification of posterior longitudinal ligament (OPLL) excision can improve long-term neurofunctional recovery by providing direct spinal cord decompression. The objective of the present study was to compare the clinical outcomes and complications between accurate anterior cervical ossified posterior longitudinal ligament en bloc resection (ACOE) versus piecemeal resection (ACOP) using propensity score-matching analysis.MethodsIncluded in this study were 189 OPLL patients (65 female) who underwent anterior cervical surgery, with a mean age of 54.85 years. Of them, 105 patients (39 female) with a mean age of 55.69 years underwent ACOE, and the remaining 84 patients (26 female) with a mean age of 53.80 underwent ACOP. Of the 189 patients, 70 patients (37%) had a canal occupying ratio (COR) ≥ 50%, and therefore the patient data were stratified by COR with 50%. The clinical outcomes were compared between the two groups during a at least 27-month follow-up period.ResultsThe mean final follow-up JOA score in ACOE group was higher than that in ACOP group. The JOA recovery rate of patients with COR ≥ 50% was higher in ACOE group. The mean operative time and intraoperative blood loss were both lower in ACOE group. However, postoperative complications were not significantly different between the two groups.ConclusionThis study demonstrated that the ACOE technique gained higher JOA recovery rates and better neurological recovery than ACOP for OPLL patients with COR ≥ 50%. In addition, ACOE offered a shorter operative time and less intraoperative blood loss as compared with ACOP. Therefore, the postoperative complications were not more common between two groups.

Cardiovascular disease risk in patients with psoriasis receiving biologics targeting TNF-α, IL-12/23, IL-17, and IL-23: A population-based retrospective cohort study.

Psoriasis is associated with various cardiovascular diseases (CVDs). The aim of this study was to compare the risk of CVD in patients with psoriasis who were prescribed biologics or oral therapies, and to assess the association between different classes of biologics and CVD risk. This retrospective cohort study utilized the TriNetX Global Collaborative Network (2014-2025). Patients with psoriasis newly prescribed biologics (BIO-cohort) and those newly initiating oral anti-psoriatic drugs without biologic exposure (Non-BIO-cohort) were enrolled. A propensity score-matched analysis was conducted, accounting for age, sex, race, comorbidities, body mass index, serum lipid profile, and inflammatory marker levels. Cardiovascular risk was compared between the BIO- and Non-BIO-cohorts using Cox regression to calculate hazard ratios (HRs) with 95% confidence intervals (CIs). After matching, each cohort comprised 12,732 patients, with approximately 50% being female, a mean age of 57 years, and 55% identifying as White. The 5-year cumulative incidence of any CVDs was significantly lower in the BIO-cohort (10.68%; 95% CI [10.03%, 11.36%]) than in the Non-BIO-cohort (16.17%; 95% CI: [15.34%, 17.05%]) (p < 0.001). The BIO-cohort had attenuated risks of any CVDs (HR 0.621; 95% CI [0.571, 0.676]), cerebrovascular diseases (HR 0.616; 95% CI [0.519, 0.731]), arrhythmias (HR 0.632; 95% CI [0.565, 0.706]), inflammatory heart diseases (HR 0.566; 95% CI [0.360, 0.891]), ischemic heart diseases (HR 0.579; 95% CI [0.465, 0.721]), heart failure (HR 0.637; 95% CI [0.521, 0.780]), non-ischemic cardiomyopathy (HR 0.654; 95% CI [0.466, 0.918]), thrombotic disorders (HR 0.570; 95% CI [0.444, 0.733]), peripheral arterial occlusive diseases (HR 0.501; 95% CI [0.383, 0.656]), and major adverse cardiac events (HR 0.697; 95% CI [0.614, 0.792]). Receiving only anti-tumor necrosis factor (TNF)-α (HR 0.886; 95% CI [0.807, 0.973]), anti-interleukin (IL)-17 (HR 0.724; 95% CI [0.599, 0.875]), or anti-IL-23 (HR 0.739; 95% CI [0.598, 0.914]) was associated with reduced risks of any CVDs, whereas no significant association was observed for only anti-IL-12/23 (HR 0.915; 95% CI [0.742, 1.128]). This risk reduction remained consistent across various subgroups, including age (≤45 or >45 years), sex (male or female), regions of research data (the United States, Europe, Middle East and Africa, and Asia-Pacific), and comorbidities (psoriatic arthritis, hypertension, diabetes, hyperlipidemia, overweight or obesity). Eight sensitivity analyses, such as extending the washout period or tightening medication definitions, validated our findings. The main limitation of our study is the observational design, which can only establish associations, not causation. Patients with psoriasis prescribed biologics exhibited a lower risk of CVDs versus those on oral therapy. Anti-TNF-α, anti-IL-17, and anti-IL-23 were associated with decreased cardiovascular hazards, while anti-IL-12/23 was not.

Dexmedetomidine administration reduced mortality in patients with acute respiratory distress syndrome: a propensity score-matched cohort analysis

Dexmedetomidine administration reduced mortality in patients with acute respiratory distress syndrome: a propensity score-matched cohort analysis

Spinal Drainage and Combined Pharmacotherapy as Potential Strategies to Improve Outcomes for Patients with Poor-Grade Subarachnoid Hemorrhage Treated with Clipping or Coiling but Not Receiving Nimodipine

Background/Objectives: The outcome for aneurysmal subarachnoid hemorrhage (SAH) remains poor, particularly for patients presenting with World Federation of Neurological Surgeons (WFNS) grades IV–V. This study was designed to identify independent prognostic factors in this group of patients with poor-grade SAH. Methods: We prospectively analyzed 357 SAH patients with admission WFNS grades IV–V enrolled in nine primary stroke centers in Mie prefecture, Japan, from 2013 to 2022. This study compared clinical variables, including treatments for angiographic vasospasm and delayed cerebral ischemia (DCI), between patients with favorable (modified Rankin Scale [mRS] scores 0–2) and unfavorable (mRS scores 3–6) outcomes at 90 days post-onset. Multivariate analyses were then performed to identify independent determinants of favorable 90-day outcomes, followed by propensity score matching analyses. Results: The median age was 68 years, and 53.5% of patients had admission WFNS grade V. DCI occurred in 12.9% of patients, and 66.9% had unfavorable outcomes. Independent variables related to unfavorable outcomes were older age, admission WFNS grade V, ventricular drainage, edaravone administration, and delayed cerebral infarction, while those for favorable outcomes were spinal drainage (adjusted odds ratio [aOR] 6.118, 95% confidence interval [CI] 2.687–13.927, p &lt; 0.001), modified Fisher grade 3 (aOR 2.929, 95% CI 1.668–5.143, p &lt; 0.001), and triple prophylactic anti-DCI medication consisting of cilostazol, fasudil hydrochloride and eicosapentaenoic acid (aOR 1.869, 95% CI 1.065–3.279, p = 0.029). Nimodipine is not approved in Japan, and statin and cerebral vasospasm did not influence outcomes. As spinal drainage and the triple prophylactic anti-DCI medication were intervenable variables, propensity score matchings were performed, and they confirmed that both spinal drainage and the triple prophylactic anti-DCI medication were useful to achieve favorable outcomes. Conclusions: In poor-grade SAH, spinal drainage and the triple prophylactic anti-DCI medication may be effective in improving outcomes, possibly by suppressing DCI pathologies other than cerebral vasospasm.

Comparison of outcomes between total en bloc spondylectomy and palliative spinal surgery in metastatic spinal tumor patients: propensity score matching analysis

BackgroundTotal en bloc spondylectomy (TES) was considered aggressive spinal surgery aim to achieved marginal and wide surgical margin in spinal tumor treatment. However, there was limited comparison information between TES and other palliative spinal surgery treatments. This study aimed to report the comparison between TES and Palliative Spinal Surgery (PSS) in terms of clinical and oncologic outcomes.MethodsA retrospective cohort study was conducted. The medical records of Spinal Metastasis (SM) treated by a single surgeon were reviewed between January 2014 and December 2020. The propensity score matching was calculated. survivorship, local recurrence, surgical complications, operative blood loss, and time between TES and PSS were reviewed and analyzed.ResultsA total of 44 patients with a mean age of 56 were included. Twenty-two TES and 22 PSS patients were recruited into the study—no significant difference in demographics data. The TES showed significantly better survival at 6 (p = 0.010) and 12 months (p = 0.020). The local recurrence in the TES group was 4.6% (1 of 22). However, TES showed significantly longer operative time (6 h (5.5–6.5) and 3 h (2.0-3.5), p-value < 0.001) and more intraoperative blood loss (1150 mL (1000–1800) and 575 mL (350–800), p-value = 0.0002).ConclusionsTES showed better survivorship after 6 and 12 months than PSS. The TES also achieved favorable local control of tumors after surgery. Further randomized control of more patients should be conducted to clarify the benefits of TES vis-à-vis metastasis.

Early prescription of quadruple therapy in acute decompensated heart failure with reduced ejection fraction: A propensity score-matched analysis.

The optimal timing for prescribing guideline-directed medical therapy (GDMT) in patients with heart failure with reduced ejection fraction (HFrEF) during acute decompensated heart failure (ADHF) remains uncertain. This study evaluated the real-world impact of early in-hospital quadruple GDMT prescription in ADHF patients with HFrEF. In this retrospective cohort study using the Institutional aCute descompensAted heaRt failUre regiStry (ICARUS), we analysed 2051 HFrEF patients (71% male, median age 68years) hospitalized for ADHF between June 2022 and March 2024. Early quadruple therapy was defined as the prescription of beta-blockers, angiotensin-converting enzyme inhibitors (ACEIs)/angiotensin receptor blockers (ARBs)/angiotensin receptor-neprilysin inhibitors (ARNIs), mineralocorticoid receptor antagonists (MRAs) and sodium-glucose cotransporter-2 inhibitors (SGLT2is) within 48h of admission. Among included patients, 898 (43.8%) received early quadruple therapy. Using optimal full matching propensity score methodology, early quadruple therapy was associated with lower 30day mortality/rehospitalization [relative risk (RR) 0.73; 95% confidence interval (CI) 0.55-0.97, P=0.028], reduced in-hospital mortality (RR 0.29; 95% CI 0.15-0.56, P<0.001) and shorter hospital stay (β=-2.65days; 95% CI -3.67 to -1.63, P<0.001). Patients receiving early quadruple therapy showed higher rates of GDMT continuation at discharge (RR 3.82; 95% CI 3.01-4.86, P<0.001). In this HFrEF cohort, early initiation of comprehensive GDMT during ADHF hospitalization was associated with improved clinical outcomes. Future randomized trials including patients across the full spectrum of ejection fraction are needed to validate these findings and determine their applicability to other heart failure phenotypes.

Use of Sustained Compression to Mitigate Nonunion in Tibiotalocalcaneal Arthrodesis: A Propensity Score-Matched Nationwide Readmissions Database Analysis.

Tibiotalocalcaneal (TTC) arthrodesis is a critical surgical intervention for advanced hindfoot and ankle pathologies, offering pain relief, stabilization, and functional alignment restoration. Intramedullary nail fixation, particularly with dynamic compression (DC) nails, has emerged as a promising solution for addressing high nonunion rates associated with standard static compression (SC) nails. This study compares union and complication rates between DC and SC nails in TTC arthrodesis using the Nationwide Readmissions Database. This retrospective cohort study used the Nationwide Readmissions Database to identify cases of TTC fusion with DC and SC nails based on ICD-10-PCS codes. Propensity score matching (1:1) controlled for confounders, including age, sex, and comorbidities. Primary outcomes included complications such as thromboembolism, wound dehiscence, cellulitis, implant-related complications, nonunion, malunion, and infections. Secondary outcomes included 30-day and 31-90-day readmission rates. Statistical significance was set at P < 0.05. The study analyzed 311 cases (149 with DC, 162 with SC). Demographic and comorbidity distributions were balanced after matching. Nonunion rates were significantly lower in the DC group (6.0%) compared with the SC group (17.3%; P = 0.002). Overall complication rates were comparable (DC: 30.2% vs. SC: 35.2%, P = 0.350). DC devices demonstrated markedly reduced nonunion rates compared with SC nails, likely because of the continuous compression provided by the nitinol-based design. This novel finding validates the biomechanical advantages of devices using DC in TTC fusion and aligns with previous research advocating for such devices. DC nails offer an advancement in TTC arthrodesis by markedly reducing nonunion rates. Future studies should focus on cost-effectiveness, long-term outcomes, and patient-specific optimization to further refine treatment protocols.

Prognostic Value of Adding Magnetic Resonance Imaging to Computed Tomography in Acute Ischemic Stroke.

To assess if magnetic resonance imaging (MRI) provides additional benefits over computed tomography (CT) in patients with acute ischemic stroke (AIS). We retrospectively reviewed adult AIS patients who underwent an initial CT scan and received intravenous thrombolysis using rt-PA, dividing them into two groups: MRI plus CT and CT alone. Propensity-score matching (PSM) analysis was employed to reduce confounding biases. After PSM, two matched groups (168 pairs, n = 336 patients) were generated. There were no significant differences in the modified Rankin Scale (mRS) scores of 0-2 or 0-1 at 3 months between the two groups (both p > 0.05). Patients in the MRI plus CT group had significantly lower incidence rates of 7-day mortality (3.0% vs. 8.9%, p = 0.04), 30-day mortality (11.3% vs. 21.4%, p = 0.02), and symptomatic intracranial hemorrhage (SICH, 11.9% vs. 23.2%, p = 0.01). Multivariate logistic regression showed that the MRI plus CT-based regimen significantly reduced the risks of 7-day (OR = 0.02, 95% CI: 0.01-0.18; p < 0.01) and 30-day mortality (OR = 0.03, 95% CI: 0.01-0.13; p < 0.01), as well as SICH (OR = 0.27, 95% CI: 0.09-0.76; p = 0.01). The addition of MRI to CT enhances prognostic value in AIS patients, as it is associated with significantly reduced risks of mortality and SICH.

Autologous Transplant or CAR-T as Consolidation Options in MYC Rearranged Large B-Cell Lymphoma Patients in Remission After Salvage Treatments.

Although recent studies have demonstrated the efficacy of chimeric antigen receptor T-cell (CAR-T) therapy in relapsed large B-cell lymphoma (LBCL) with MYC rearrangement (R-MYC), the data comparing CAR-T to autologous hematopoietic cell transplant (auto-HCT) in such patients who achieve a complete or partial response (CR/PR) after salvage therapies are limited. We compared the clinical outcomes of patients with R-MYC LBCL (including double and triple hit lymphomas) who underwent CAR-T or auto-HCT after achieving a CR/PR with salvage therapies using the Center for International Blood & Marrow Transplant Research registry. Among the 252 patients (auto-HCT = 98, CAR-T = 154), relative to auto-HCT, CAR-T was associated with significantly lower overall survival (OS) (Hazard Ratio [HR] 2.09, 95% CI 1.38-3.15, p < 0.001) on multivariate analysis. There were no differences in progression-free survival (PFS) (HR 1.21, 95% CI 0.81-1.8 p = 0.36), risk of relapse (HR 1.1, 95% CI 0.71-1.69 p = 0.68), nonrelapse mortality (NRM) (HR 1.74, 95% CI 0.64-4.7 p = 0.28) while the post-relapse survival was longer in auto-HCT relative to CAR-T (HR 1.93, 95% CI 1.21-3.06 p = 0.01). On propensity score matched analysis accounting for differences in characteristics across the two cohorts, we detected no significant differences in OS (HR 1.72, 95% CI 0.92-3.21 p = 0.09), PFS (HR 1.04, 95% CI 0.64-1.68 p = 0.88), NRM (HR 1.22, 95% CI 0.35-4.2 p = 0.76), relapse (HR = 0.93, 95% CI 0.54-1.6 p = 0.8) and post-relapse survival (HR 2.25, 95% CI 0.98-5.17, p = 0.06). These data, although retrospective, support consideration for auto-HCT in patients with R-MYC LBCL who achieve a CR/PR after salvage therapies, particularly in regions with no or limited access to CAR-T.

A smartphone model for post-acute care decreases all-cause mortality with improved left ventricular ejection fraction in patients hospitalized with heart failure in Taiwan.

A smartphone model for post-acute care decreases all-cause mortality with improved left ventricular ejection fraction in patients hospitalized with heart failure in Taiwan.

Thiazolidinedione Use and Cardiovascular Outcomes in Patients With Type 2 Diabetes Who Underwent Carotid Artery Revascularization.

Thiazolidinediones are oral antidiabetic agents known for their wide-ranging pleiotropic effects, potentially offering cardiovascular protection. Using a nationwide health claims database in Korea, we evaluated whether thiazolidinedione treatment was associated with long-term cardiovascular prognosis after carotid revascularization. This retrospective cohort study included patients with type 2 diabetes who underwent carotid endarterectomy or stent insertion in Korea between 2009 and 2020. The use of medications, including thiazolidinediones, was determined from prescription records, identifying exposure to medications within 30 days following carotid revascularization. The primary outcome was the composite occurrence of stroke, myocardial infarction, and all-cause death following carotid revascularization. A multivariate Cox regression analysis was conducted to assess the primary outcomes. The cohort included 14 220 patients with type 2 diabetes who underwent carotid revascularization (2669 via carotid endarterectomy and 11 551 via carotid stent insertion). Among them, 1034 patients received thiazolidinedione treatment. Over a mean follow-up period of 4.13±3.14 years, 4087 patients experienced a primary outcome. Thiazolidinedione treatment was significantly associated with a reduced risk of primary outcomes (adjusted hazard ratio [HR], 0.81 [95% CI, 0.71-0.93]; P=0.002). The protective effect of thiazolidinediones was supported in a propensity score-matched analysis comparing thiazolidinedione users with nonusers (HR, 0.81 [95% CI, 0.68-0.95]; P=0.013). Thiazolidinedione treatment following carotid revascularization was associated with favorable cardiovascular outcomes in patients with type 2 diabetes. Further research is needed to explore the cardioprotective roles of thiazolidinediones in this high-risk group.