Publication details

Prognosis of Stroke Patients Requiring Mechanical Ventilation


PEŠKA Stanislav URBÁNEK Igor DUŠEK Ladislav

Year of publication 2005
Type Article in Periodical
Magazine / Source Cerebovascular Diseases
MU Faculty or unit

Faculty of Medicine

Field Neurology, neurosurgery, neurosciences
Keywords Stroke; mechanical ventilation; prognosis
Description About 10% of hospitalized acute stroke patients require critical care treatment including mechanical ventilation. Prognosis of these patients has often been reported to be poor. This study was performed to assess clinical outcome of stroke patients who require invasive support ventilation in a neurological intensive care unit and to identify predictors of 30day mortality. Analysis was retrospectively made of 40 consecutive acute stroke patients who required mechanical ventilation over a 1year period. Initial clinical data, history of previous diseases, vascular risk factors, subtype of stroke, vital functions, body temperature, and laboratory parameters were assessed. Factors significantly affecting 30-day mortality were identified in a univariate analysis. The Mann-Whitney U test and the Fishers exact test were used. Thirty-day mortality was 60% overall and did not differ significantly by stroke subtype. Glasgow Coma Scale score < 10 on the day of intubation (P < 0.01), subsequent neurological deterioration (P < 0.01), intubation within 24 hours after admission (P < 0.01) and age > 65 years (P = 0.023) were identified as significant predictors of 30-day mortality. Functional status of most survivors was poor; at 1 month, three quarters were severely disabled and completely dependent, a quarter of the patients were slightly or moderately disabled. High-level neurointensive care including mechanical ventilation in acute severe stroke patients is associated with high mortality, and poor quality of life in the majority of survivors. In spite of these facts, this care has a positive effect on not negligible part of patients. Older age, coma on the day of intubation and subsequent neurological deterioration are significant predictors of poor outcome.
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