Letters recovery after ischemic stroke. Sze et al showed that wors- We agree with the important limitations of self-reported ening frailty indices are strongly associated with worse out- measures that were mentioned by Sharma and Sivakumaran. comes in patients hospitalized with heart failure (a compa- However, the covariates we examined in this analysis were de- rable long-term disabling consequence of MI). rived not only from self-reporting, but also from interviews, Studies in the future could compare the difference in poste- clinical examinations, medical record abstraction, and pub- vent frailty between patients with ischemic stroke and MI. As- licly released Medicare claims data, as described in the article. sessing a patient’s premorbid frailty status using simple vali- Also, in the main models, we did not adjust for physical activ- dated frailty assessment tools could contribute to predicting ity or energy intake. The disability scales that were used in this how patients with ischemic stroke might perform in their sub- study and others that are considered standard to assess ac- sequent rehabilitation. It may even contribute to predicting tivities of daily living are assessed by self-reporting and have clinical outcomes earlier in the pathway when assessing pa- been shown to have excellent measurement accuracy. tients for thrombectomy or thrombolysis. It is possible that the co-occurrence of both stroke and myo- cardial infarction may have accelerated long-term functional Daniel Pan, MBBS, BSc, PGCert decline, but we did not test for this specifically in the article. Liqun Zhang, MD, PhD Also, we did not have detailed information about stroke and Anthony C. Pereira, MA, MD myocardial infarction treatments used by patients. Hope- fully further research will be able to clarify the important ques- Author Affiliations: Department of Neurology, St George’s Hospital, London, tions raised by these readers. England. Corresponding Author: Daniel Pan, MBBS, BSc, PGCert, Department of Mandip S. Dhamoon, MD, DrPH Neurology, St George’s Hospital, Blackshaw Road, Tooting, London SW17 0QT, England (firstname.lastname@example.org). Author Affiliation: Department of Neurology, Icahn School of Medicine at Published Online: March 12, 2018. doi:10.1001/jamaneurol.2018.0199 Mount Sinai, New York, New York. Conflict of Interest Disclosures: None reported. Corresponding Author: Mandip S. Dhamoon, MD, DrPH, Department of 1. Dhamoon MS, Longstreth WT Jr, Bartz TM, Kaplan RC, Elkind MSV. Disability Neurology, Icahn School of Medicine at Mount Sinai, 1468 Madison Ave, trajectories before and after stroke and myocardial infarction: the Annenberg 301B, New York, NY 10029 (email@example.com). Cardiovascular Health Study. JAMA Neurol. 2017;74(12):1439-1445. Published Online: March 12, 2018. doi:10.1001/jamaneurol.2018.0202 2. Goyal M, Menon BK, van Zwam WH, et al; HERMES collaborators. Conflict of Interest Disclosures: None reported. Endovascular thrombectomy after large-vessel ischaemic stroke: a meta-analysis of individual patient data from five randomised trials. Lancet. 1. Dhamoon MS, Longstreth WT Jr, Bartz TM, Kaplan RC, Elkind MSV. Disability 2016;387(10029):1723-1731. trajectories before and after stroke and myocardial infarction: the Cardiovascular Health Study. JAMA Neurol. 2017;74(12):1439-1445. 3. Moorhouse P, Rockwood K. Frailty and its quantitative clinical evaluation. J R Coll Physicians Edinb. 2012;42(4):333-340. 4. Winovich DT, Longstreth WT Jr, Arnold AM, et al. Factors associated with CORRECTION ischemic stroke survival and recovery in older adults. Stroke. 2017;48(7):1818-1826. 5. Sze S, Zhang J, Pellicori P, Morgan D, Hoye A, Clark AL. Prognostic value of Errors in Figure 1: In the Original Investigation titled “Association of Folic Acid simple frailty and malnutrition screening tools in patients with acute heart failure Supplementation During Pregnancy With the Risk of Autistic Traits in Children Ex- due to left ventricular systolic dysfunction. Clin Res Cardiol. 2017;106(7):533-541. posed to Antiepileptic Drugs In Utero,” published online December 26, 2017, and in the February 2018 print issue, there were errors in Figure 1; “299 Women with AED exposure” should have been “298 Women with AED exposure,” “288 Women In Reply We agree with Pan et al that endovascular thrombec- with AED exposure” should have been “287 Women with AED exposure,” and “66 (7.0%) Siblings” should have been “66 (17.0%) Siblings.” This article has been cor- tomy for large vessel occlusions may improve long-term dis- rected online. ability trajectories for those who receive this treatment. How- 1. Bjørk M, Riedel B, Spigset O, et al. Association of folic acid supplementation ever, few patients with ischemic stroke currently receive this during pregnancy with the risk of autistic traits in children exposed to treatment, and it is not certain how much of an association en- antiepileptic drugs in utero [published online December 26, 2017]. JAMA Neurol. doi:10.1001/jamaneurol.2017.3897 dovascular thrombectomy will have with long-term disabil- ity trajectories for patients with ischemic stroke as a whole. It is certainly hoped that more trained specialists are available Missing Author Affiliation: In the Original Investigation titled “Disease Course and Treatment Responses in Children With Relapsing Myelin Oligodendrocyte Glyco- to provide the treatment, more capable stroke centers will be protein Antibody–Associated Disease,” published online January 5, 2018, and in developed, and more patients will present within an ame- this issue of JAMA Neurology, Dr Ganelin-Cohen’s second affiliation was missing. nable time window. However, even with perfect availability of In the Author Affiliations portion of the Article Information section, her affilia- the intervention, it will only benefit those patients who have tions should have been listed as “Pediatric Neurology Unit, Schneider Children’s Medical Center, Tel-Aviv, Israel,” and also as “Sackler School of Medicine, Tel-Aviv large vessel occlusion and not other subtypes or mechanisms University, Tel-Aviv, Israel.” This article was corrected online. of ischemic stroke. We also agree that frailty is an important 1. Hacohen Y, Wong YY, Lechner C, et al. Disease course and treatment concept with demonstrated associations with outcomes. How- responses in children with relapsing myelin oligodendrocyte glycoprotein ever, we chose to focus on a more narrowly-defined construct— antibody–associated disease [published online January 5, 2018]. JAMA Neurol. doi:10.1001/jamaneurol.2017.4601 disability—as an outcome. 518 JAMA Neurology April 2018 Volume 75, Number 4 (Reprinted) jamaneurology.com © 2018 American Medical Association. All rights reserved.
JAMA Neurology – American Medical Association
Published: Apr 26, 2018
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