Publications by authors named "Courtney M Hrdlicka"

2 Publications

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Neurological Complications of Cardiac Procedures.

Semin Neurol 2021 Jun 15. Epub 2021 Jun 15.

Department of Neurology, Harvard Medical School, Beth Israel Deaconess Medical Center, Boston, Massachusetts.

Neurological complications after cardiac surgery and percutaneous cardiac interventions are not uncommon. These include periprocedural stroke, postoperative cognitive dysfunction after cardiac surgery, contrast-induced encephalopathy after percutaneous interventions, and seizures. In this article, we review the incidence, pathophysiology, diagnosis, and management of these complications. Improved understanding of these complications could lead to their prevention, faster detection, and facilitation of diagnostic workup and appropriate treatment.
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June 2021

Why Are Women Less Represented in Intracerebral Hemorrhage Trials?

Stroke 2021 Jan 25;52(2):442-446. Epub 2021 Jan 25.

Division of Stroke and Cerebrovascular Diseases, Department of Neurology, Beth Israel Deaconess Medical Center, Boston, MA (T.G., C.N., J.W., C.M.H., M.S.).

Background And Purpose: Fewer women than men tend to be enrolled in clinical trials of intracerebral hemorrhage. It is unclear whether this reflects lower prevalence of intracerebral hemorrhage in women, selection bias, or poor recruitment efforts. We undertook this study to examine differences between men and women in the reasons for exclusion from the iDEF trial (Intracerebral Hemorrhage Deferoxamine).

Methods: The screen failure log included 29 different reasons for exclusion. Chi-square statistics were used to evaluate the differences in reasons for exclusion between men and women.

Results: A total of 38.2% of participants in iDEF were women. Three thousand nine hundred eighty-two women (45.7%) and 4736 men (54.3%) were screen failures (<0.0001). Similar proportions of women (1.28%) and men (1.73%) were excluded due to inability to obtain consent (=0.1). Patients or families declined participation in 1.26% of women versus 1.31% of men (=0.9). More women than men failed screening because of age>80 (22.40% versus 12.61%; adjusted =0.0007) and preexisting do-not-resuscitate/do-not-intubate (3.69% versus 2.83%; adjusted =0.067).

Conclusions: Lower rates of women enrollment in the iDEF trial may be attributed to older age. Inability to obtain consent or declining participation was similar between women and men, arguing against selection bias. Our findings should be confirmed in other intracerebral hemorrhage trials to determine best strategies to improve women's representation in future trials.
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January 2021