Predictors of survival and functional outcome in acute stroke patients admitted to the stroke intensive care unit

Jeng, Jiann‐Shing; Huang, Sheng‐Jean; Tang, Sung‐Chun; Yip, Ping-Keung

doi:10.1016/j.jns.2008.01.015

Cited by 50 publications

(54 citation statements)

References 37 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Newer studies with recruitment of patients after 12/1999 are scarce; an overview is given in table 2 . Interestingly, the reported mortality rates in these studies vary substantially depending on the originating country, with rather low short-term mortality in Asian countries [16,17] and markedly higher mortality rates up to 70% in studies originating from European countries [7] and the United States [18] . Two possible factors may account for this finding: first, although the incidence of ICH is known to be higher in Asians than in Caucasians, a recent study on racial/ethnic differences in the outcome of ICH patients found lower risk-adjusted, in-hospital mortality for Asian than white patients with ICH [19] .…”

Section: Discussion and Review Of The Literaturementioning

confidence: 98%

Outcome Predictors of Acute Stroke Patients in Need of Intensive Care Treatment

Alonso¹,

Ebert²,

Kern³

et al. 2015

Cerebrovasc Dis

View full text Add to dashboard Cite

Background: The prognosis of stroke patients admitted to intensive care units (ICU) is commonly regarded to be poor. However, only limited data regarding outcome predictors are available. Patients and Methods: Out of 4,958 consecutive patients admitted to our stroke unit with the diagnosis of acute stroke, after analysis we identified 347 patients (164 male) in need of ICU management. In-hospital and post-rehabilitation mortality as well as functional outcome at discharge and after rehabilitation were analyzed. Results: Ischemic stroke was diagnosed in 252 patients (72.6%) and intracerebral hemorrhage occurred in 95 patients (27.4%). The mean age in our cohort was considerably high (70.8 years). One hundred patients were comatose at admission. The median NIHSS score at admission in the remaining patients was 12. Apart from stroke-related disturbances of consciousness (47.1%), the most common reasons for ICU treatment were cardiac (23.4%) and respiratory (12.1%) complications or interventional procedures requiring mechanical ventilation (11%). In all, 231/347 patients (66.6%) were mechanically ventilated (mean 84 h). In-hospital mortality (143/347; 41.2%) was associated with old age, poor NIHSS score at admission, intracerebral hemorrhage and mechanical ventilation (p < 0.001 in all). Further, admission to ICU because of stroke-related impairment of consciousness increased in-hospital mortality (p < 0.001). Similarly, poor outcome after rehabilitation was associated with old age (p = 0.029) and mechanical ventilation (p < 0.001). In patients ≥80 years with either intracerebral hemorrhage or need of mechanical ventilation, outcome was unfavorable in nearly any case. However, the overall post-rehabilitation outcome did not differ between patients with intracerebral hemorrhage and ischemic stroke (p = 0.275). Conclusion: The stroke population in our study was associated with an increased early mortality; however, given the same conditions, it was old with a high percentage of patients requiring mechanical ventilation. This did not result in increased in-hospital mortality rates compared to younger and less severely affected cohorts. Thus, ICU management is a life-saving initiative even among the elderly. However, the functional outcome was poor in older patients, thus limiting the benefits of ICU care in these patients.

show abstract

Section: Discussion and Review Of The Literaturementioning

confidence: 98%

Outcome Predictors of Acute Stroke Patients in Need of Intensive Care Treatment

Alonso¹,

Ebert²,

Kern³

et al. 2015

Cerebrovasc Dis

View full text Add to dashboard Cite

show abstract

“…[17][18][19] Smoking and heavy alcohol consumption are well-known risk factors for stroke, 7,20,21 but few studies examined the relationship between stroke severity or outcome and prestroke smoking status or alcohol consumption. By the analysis of close to a thousand acute stroke cases from 3 Central-Eastern European countries, we tested whether prestroke smoking or alcohol consumption habits significantly influence initial stroke severity, disability at discharge from hospital, and case fatality at 30 days and at 1 year.…”

Section: Discussionmentioning

confidence: 99%

“…The median NIHSS score was similar in the total group and in those with ischemic stroke, in smokers and nonsmokers, and in alcohol consumers and nonconsumers/light consumers. We categorized strokes by the NIHSS score as mild (0-7), moderate (8)(9)(10)(11)(12)(13)(14), severe (15)(16)(17)(18)(19)(20)(21)(22), and very severe (.23). There was no difference in the distribution of patients among these severity categories between smokers and nonsmokers (P 5 .71) and alcohol consumers and nonconsumers (P 5 .65; Fig 1).…”

Section: The Effect Of Smoking and Alcohol Consumption On Stroke Sevementioning

confidence: 99%

Prestroke Alcohol Consumption and Smoking Are Not Associated with Stroke Severity, Disability at Discharge, and Case Fatality

Fekete

Szatmári

Szôcs³

et al. 2014

Journal of Stroke and Cerebrovascular Diseases

View full text Add to dashboard Cite

“…Previous studies have shown that the severity of initial neurological symptoms is a potent predictor of functional outcome [42,43]. Association between maximal lesion diameter and poor functional outcome can be understood in a similar context.…”

Section: Discussionmentioning

confidence: 96%

Diffusion-Perfusion Mismatch in Single Subcortical Infarction: A Predictor of Early Neurological Deterioration and Poor Functional Outcome

Kim¹,

Kim²,

Lee

et al. 2015

Eur Neurol

View full text Add to dashboard Cite

Background/Aims: Early neurological deterioration (END) is frequently observed and related to poor functional outcome in patients with single subcortical infarction (SSI). We evaluated the role of diffusion-perfusion mismatch (DPM) as a predictor of END and functional outcome in patients with SSI. Methods: We retrospectively analyzed data for 274 patients with acute SSI. DPM was positive in the presence of a lesion on the perfusion map that was larger than that on the corresponding slice on diffusion-weighted imaging. END was defined as an increase of <1 points in the motor portion of the National Institute of Health Stroke Scale (NIHSS) within 72 h from MRI acquisition. Patients with a modified Rankin Scale (mRS) score of 3 or more at day 30 were considered having a poor functional outcome. Results: DPM was more frequently observed in the END (+) than in the END (-) group (21/35 (60.0%) vs. 50/239 (20.9%); p < 0.001). After adjusting for covariates, the presence of DPM and NIHSS score on admission were independently associated with END (DPM, OR 5.03, p < 0.001; NIHSS, OR 1.14, p = 0.033) and poor functional outcome (DPM, OR 2.44, p = 0.018; NIHSS, OR 1.48, p < 0.001). Conclusions: The DPM concept is applicable to prediction of END and functional disability in patients with SSI.

show abstract

Predictors of survival and functional outcome in acute stroke patients admitted to the stroke intensive care unit

Cited by 50 publications

References 37 publications

Outcome Predictors of Acute Stroke Patients in Need of Intensive Care Treatment

Outcome Predictors of Acute Stroke Patients in Need of Intensive Care Treatment

Prestroke Alcohol Consumption and Smoking Are Not Associated with Stroke Severity, Disability at Discharge, and Case Fatality

Diffusion-Perfusion Mismatch in Single Subcortical Infarction: A Predictor of Early Neurological Deterioration and Poor Functional Outcome

Contact Info

Product

Resources

About