Focus on neuro-critical care: combined interventions to improve relevant outcomes

Robba, Chiara; Sonneville, Romain; Meyfroidt, Geert

doi:10.1007/s00134-020-06014-5

Cited by 5 publications

(3 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Nevertheless, the mortality pattern in ICU-admitted stroke patients compared with patients with other diseases necessitating ICU admission still warrants the attention of intensivists. We nonetheless agree that long-term quality of survival including functional disability is a preferred endpoint of study in the future in stroke-related neurocritical care, if possible (4).…”

mentioning

confidence: 77%

The authors reply

Valburg

Geerts

Arbous

2021

Critical Care Medicine

View full text Add to dashboard Cite

mentioning

confidence: 77%

The authors reply

Valburg

Geerts

Arbous

2021

Critical Care Medicine

View full text Add to dashboard Cite

“…Cardiac arrest patients accounted for only 25% of the cohort and the proportion of cardiac arrest patients treated with ECPR, who are likely to have a poor neurologic outcome ( 3 ), was low (7/103 patients, 7%). Second, contrary to previous studies that focused on hospital discharge outcomes, we used clinically relevant study endpoints, including short-term mortality, functional outcomes at 90 days, and stroke events diagnosed on neuroimaging ( 25 ). Our post hoc analyses revealed no significant interaction between NSE levels and pre-ECMO CPR.…”

Section: Discussionmentioning

confidence: 99%

Neuron-Specific Enolase Levels in Adults Under Venoarterial Extracorporeal Membrane Oxygenation

Reuter

Peoc’h

Bouadma

et al. 2020

Critical Care Explorations

Self Cite

View full text Add to dashboard Cite

show abstract

“…9 Patients admitted to ICU with a stroke follow a particular survival pattern with a high short-term mortality, but if they survive the first 30 days, a relatively favourable subsequent survival is observed compared with several other diseases necessitating ICU admission. 10 Although functional limitations exceed mortality risk in clinical relevance, 11 prognostic factors for functional outcome and mortality do correlate in stroke patients admitted to the ICU. [12][13][14][15] Therefore, it is highly relevant to develop a disease-specific model for ICU-admitted stroke patients to be able to predict which patients are most likely to survive the first critical 30 days.…”

Section: Introductionmentioning

confidence: 99%

Predicting 30-day mortality in intensive care unit patients with ischaemic stroke or intracerebral haemorrhage

van Valburg,

Termorshuizen,

Geerts

et al. 2023

European Journal of Anaesthesiology

View full text Add to dashboard Cite

BACKGROUND Stroke patients admitted to an intensive care unit (ICU) follow a particular survival pattern with a high short-term mortality, but if they survive the first 30 days, a relatively favourable subsequent survival is observed. OBJECTIVES The development and validation of two prognostic models predicting 30-day mortality for ICU patients with ischaemic stroke and for ICU patients with intracerebral haemorrhage (ICH), analysed separately, based on parameters readily available within 24 h after ICU admission, and with comparison with the existing Acute Physiology and Chronic Health Evaluation IV (APACHE-IV) model. DESIGN Observational cohort study. SETTING All 85 ICUs participating in the Dutch National Intensive Care Evaluation database. PATIENTS All adult patients with ischaemic stroke or ICH admitted to these ICUs between 2010 and 2019. MAIN OUTCOME MEASURES Models were developed using logistic regressions and compared with the existing APACHE-IV model. Predictive performance was assessed using ROC curves, calibration plots and Brier scores. RESULTS We enrolled 14 303 patients with stroke admitted to ICU: 8422 with ischaemic stroke and 5881 with ICH. Thirty-day mortality was 27% in patients with ischaemic stroke and 41% in patients with ICH. Important factors predicting 30-day mortality in both ischaemic stroke and ICH were age, lowest Glasgow Coma Scale (GCS) score in the first 24 h, acute physiological disturbance (measured using the Acute Physiology Score) and the application of mechanical ventilation. Both prognostic models showed high discrimination with an AUC 0.85 [95% confidence interval (CI), 0.84 to 0.87] for patients with ischaemic stroke and 0.85 (0.83 to 0.86) in ICH. Calibration plots and Brier scores indicated an overall good fit and good predictive performance. The APACHE-IV model predicting 30-day mortality showed similar performance with an AUC of 0.86 (95% CI, 0.85 to 0.87) in ischaemic stroke and 0.87 (0.86 to 0.89) in ICH. CONCLUSION We developed and validated two prognostic models for patients with ischaemic stroke and ICH separately with a high discrimination and good calibration to predict 30-day mortality within 24 h after ICU admission. TRIAL REGISTRATION Trial registration: Dutch Trial Registry (https://www.trialregister.nl/); identifier: NTR7438.

show abstract

Focus on neuro-critical care: combined interventions to improve relevant outcomes

Cited by 5 publications

References 20 publications

The authors reply

The authors reply

Neuron-Specific Enolase Levels in Adults Under Venoarterial Extracorporeal Membrane Oxygenation

Predicting 30-day mortality in intensive care unit patients with ischaemic stroke or intracerebral haemorrhage

Contact Info

Product

Resources

About