Prognostic Factors in the Survival of 1,484 Stroke Cases Observed for 30 to 48 Months

Abu-Zeid, Hassan A.H.; Choi, N. W.; Hsu, Ping-Hwa; Maini, Kuldip K.

doi:10.1001/archneur.1978.00500270003001

Cited by 41 publications

(4 citation statements)

References 9 publications

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“…However, recent observational reports suggested that self-fulfilling prognostic pessimism may lead to withdrawal of life support in patients who otherwise may have had an acceptable clinical outcome if managed aggressively [ 11 ]. Part of the pessimism surrounding the prognostication of hemorrhagic stroke is hypothesized to be a tendency not to consider factors such as age, previous comorbidities, etiology of the bleeding, and socioeconomic factors [ 12 ], which are known to affect outcome [ 16 ].…”

Section: Introductionmentioning

confidence: 99%

The critical care management of spontaneous intracranial hemorrhage: a contemporary review

et al. 2016

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Spontaneous intracerebral hemorrhage (ICH), defined as nontraumatic bleeding into the brain parenchyma, is the second most common subtype of stroke, with 5.3 million cases and over 3 million deaths reported worldwide in 2010. Case fatality is extremely high (reaching approximately 60 % at 1 year post event). Only 20 % of patients who survive are independent within 6 months. Factors such as chronic hypertension, cerebral amyloid angiopathy, and anticoagulation are commonly associated with ICH. Chronic arterial hypertension represents the major risk factor for bleeding. The incidence of hypertension-related ICH is decreasing in some regions due to improvements in the treatment of chronic hypertension. Anticoagulant-related ICH (vitamin K antagonists and the newer oral anticoagulant drugs) represents an increasing cause of ICH, currently accounting for more than 15 % of all cases. Although questions regarding the optimal medical and surgical management of ICH still remain, recent clinical trials examining hemostatic therapy, blood pressure control, and hematoma evacuation have advanced our understanding of ICH management. Timely and aggressive management in the acute phase may mitigate secondary brain injury. The initial management should include: initial medical stabilization; rapid, accurate neuroimaging to establish the diagnosis and elucidate an etiology; standardized neurologic assessment to determine baseline severity; prevention of hematoma expansion (blood pressure management and reversal of coagulopathy); consideration of early surgical intervention; and prevention of secondary brain injury. This review aims to provide a clinical approach for the practicing clinician.Electronic supplementary materialThe online version of this article (doi:10.1186/s13054-016-1432-0) contains supplementary material, which is available to authorized users.

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Section: Introductionmentioning

confidence: 99%

The critical care management of spontaneous intracranial hemorrhage: a contemporary review

et al. 2016

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“…The reason for this difference may be a target within reach to be studied on a cell-biologic level, to further explore the basic nature and cause of cerebral vascular disease. 35 …”

Section: Discussionmentioning

confidence: 99%

“…Data on these issues are scarce and contradictory, as studies so far have been rather small, [8][9][10][11] were restricted to patients from clinical trials, 12,13 were retrospective, 5,14 were not able to fully pursue ascertainment of recurrent stroke subtype, 3,[15][16][17][18] were restricted to lacunar stroke, 10,[19][20][21][22][23][24][25] did not use patients with first-ever stroke, 8,15,18,20,[26][27][28][29][30][31][32][33] or included stroke subtyping that was not clear. 11,[27][28][29][30][31][34][35][36] Some of these studies, especially the early ones, had insufficient computed tomography (CT) validation of index and/or recurrent stroke, included hemorrhage or transient ischemic attack in index stroke, or used restricted age populations. Frequency, stroke type, and risk factors may tell something about heterogeneity of the underlying vascular pathology, and how this develops over time.…”

mentioning

confidence: 99%

Homogeneity of large and small vessel disease over time: Arguments from a study on recurrent stroke in 998 patients with first cerebral infarct

Jong

Lodder

Kessels

et al. 2004

Journal of Stroke and Cerebrovascular Diseases

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“…It is important to identify clinical features that may predict early mortality, as well as eventual functional recovery, in the subsequent management of patients with stroke, particularly in a community where there is a shortage of acute and convalescent beds. There are many studies among Caucasian populations dealing with predictors of stroke mortality (2)(3)(4)(5) and functional outcome (2,(6)(7). In earlier studies, classification of stroke subtypes by CT scan was not available.…”

Section: Introductionmentioning

confidence: 99%

Predictors of Survival and Barthel Score at Three Months After Acute Stroke

Woo

Kay

Teoh

et al. 1992

Neurorehabilitation and Neural Repair

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Out of 303 consecutive patients with acute stroke admitted over a six-month period to a regional general hospital, 28% had died by three months, 30% had regained full functional independence, and 42% had residual disability that was severe (Barthel score <15) in half of the patients. Eighty-six percent of deaths occurred within the first month after ictus, while 84% of those who were functionally independent by three months achieved their recovery within one month after ictus. Independent factors predicting mortality at three months include the Glasgow coma score, speech deficit and loss of consciousness on presentation, age, a past history of diabetes mellitus, and glucose concentration on admission. Using discriminant function analysis, 83% of patients were placed in correct outcome groups (alive or dead at three months). Independent factors predicting full functional recovery (assessed using the Barthel score) at three months include age, loss of consciousness, a past history of diabetes mellitus, and the Glasgow coma score. Sixty-six percent of patients were correctly grouped. These easily determined variables should be of use in the practical management of stroke patients.

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Prognostic Factors in the Survival of 1,484 Stroke Cases Observed for 30 to 48 Months

Cited by 41 publications

References 9 publications

The critical care management of spontaneous intracranial hemorrhage: a contemporary review

The critical care management of spontaneous intracranial hemorrhage: a contemporary review

Homogeneity of large and small vessel disease over time: Arguments from a study on recurrent stroke in 998 patients with first cerebral infarct

Predictors of Survival and Barthel Score at Three Months After Acute Stroke

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