Editors’ Pick in March 2025
Article information
Among the 12 papers published in the March issue of Journal of Korean Neurosurgical Society (JKNS) 2025, the following two papers, which deserve attention from readers, are selected by the editorial boards.
Epidemiology and functional outcome of acute stroke patients in Korea using nationwide data [4]
Given the high mortality, and significant portion of survivors suffering from disability, stroke has substantial social and economic burden. Another concern for stroke is rapid aging of Korea, which increases the risk of stroke occurrence. For this reason, many efforts have been made for prevention and optimal care of stroke. Despite these efforts, stroke is the 3rd most common cause of death [1].
It is well known that the incidence varies according to race and nationality. It is necessary for epidemiological studies on the proportions of subtypes of strokes such as subarachnoid hemorrhage (SAH), intracerebral hemorrhage (ICH), and acute ischemic stroke.
Nationwide survey was conducted using Acute Stroke Assessment Registry and the National Health Insurance Service’s data during 18 months from 2016, 2018, and between 2020 to 2021, focusing on acute SAH, acute ICH, and acute ischemic stroke. A total of 86568 patients were collected with demographic and clinical characteristics. Among these patients, 8.3% was SAH, 16.3% ICH, and 74.9% ischemic stroke. Trends showed decreasing SAH and increasing ICH cases over time. Sixty-eight point three percent of stroke patients had the clear onset time and 49.6% of stroke patients arrived within 4.5 hours of symptom onset. Good functional outcomes at discharge were obtained with 58.3% of acute stroke patients, 55.9% of SAH patients, 34.6% of ICH patients, and 63.8% of ischemic stroke patients. In summary, ischemic stroke was the most common subtype, followed by ICH and SAH. It was also found that the favorable outcomes were more common in ischemic stroke and SAH compared to ICH.
This study provides an overview of the epidemiological characteristics of stroke in Korea, contributing to the improvement of stroke treatment guidelines.
Early adequate nutrition in ICU is associated with survival gain : retrospective cohort study in patient with traumatic brain injury [3]
Patients with acute trauma usually suffer from altered mentality, which results in increased risk of aspiration. These factors impede appropriate nutritional support [2]. Although there are several critical care guidelines which deal with nutritional support in the intensive care unit (ICU), which recommends the amount of calorie and protein supplement. With respect to traumatic brain injury (TBI) patients, however, there has been no specific consideration for trauma patients.
They performed retrospective cohort study for TBI patients admitted to ICU from 2021 to 2023 in a regional trauma center. Among the 864 patients, 637 with factors that were not appropriate for data analysis were excluded. Overall mortality was 15% (34/227). Patients with younger age, high initial Glasgow coma scale (GCS), higher intake of calorie supplement showed better survival. In a subgroup analysis of patients with non-severe TBI (GCS >8), higher calorie and protein intake affected better survival rate.
This study shows that early nutritional support improves the prognosis of patients with TBI. It is also meaningful that the effect of nutritional support is maintained in subgroup analysis for patients with non-severe TBI.
Notes
Conflicts of interest
No potential conflict of interest relevant to this article was reported.
Author contributions
Conceptualization : HJY; Data curation : HJY; Formal analysis : HJY; Methodology : HJY; Project administration : HJY; Visualization : HJY; Writing - original draft : HJY; Writing - review & editing : HJY
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