Frequency and Mortality Risk Factors of Acute Ischemic Stroke in Emergency Department in Burkina Faso

Objective. To determine the prevalence of ischemic stroke deaths and their predictive factors in the Emergency Department at Yalgado Ouedraogo University Teaching Hospital (YOUTH). Methodology. This was a retrospective study with an analytical and descriptive focus over a period of three years from January 1, 2015, to December 31, 2017. Results. During the study period, 302 acute ischemic stroke patients with a mean age of 62.2±14.26 years were included. Atrial hypertension was the most common vascular risk factor in 52.5%. On admission, 34.8% of patients had loss of consciousness. The mean time to perform brain CT was 1.5 days. The average length of stay was 4 days. Electrocardiogram, echocardiography, and cervical Doppler were not performed during hospitalization in ED. The mortality rate was 39%, respectively, 37.6% in male and 41.6% in female. The mean age of patients who died in ED was 63.6±13.52 years. Hypertension was the most common vascular risk factors in 54.2% of death. After logistic regression, the predictors of death were past history of heart disease, consciousness disorders, hyperthermia, hyperglycemia on admission, poststroke pneumonia, and urinary tract infection. Conclusions. Acute ischemic stroke was frequent in Emergency Department with high mortality rate. The mortality risk factors were the same than those found in literature. This higher mortality can be avoided by early diagnosis and an adequate management.

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Outcome Predictors of Stroke Mortality in the Neurocritical Care Unit

Frontiers in Neurology ◽

10.3389/fneur.2020.579733 ◽

2020 ◽

Vol 11 ◽

Author(s):

Dmitriy Viderman ◽

Alpamys Issanov ◽

Talgat Temirov ◽

Ewan Goligher ◽

Philip la Fleur

Keyword(s):

Risk Factors ◽

Ischemic Stroke ◽

Mortality Rate ◽

Cerebral Edema ◽

Mortality Risk ◽

Critically Ill Patients ◽

Hemorrhagic Stroke ◽

Neurocritical Care ◽

Stroke Mortality ◽

The Mean

Background: Risk factors for medium to long-term mortality after stroke are well-established but predictors of in-hospital stroke mortality are less clearly characterized. Kazakhstan has the highest age-standardized mortality rate from ischemic stroke in the world.Methods: We performed a retrospective analysis of patients with stroke who were admitted over a 3.5-years period to the neurocritical care unit of a tertiary care hospital in Nur-Sultan, Kazakhstan.Results: In total, 148 critically ill patients were included in the analysis (84 ischemic stroke, 64 hemorrhagic stroke). The mean age was 63 years, 45% were male and the mean Glasgow Coma Score (±SD) at baseline was 10.3 (±3.4). The in-hospital mortality rate was similar in patients with ischemic (36%) and hemorrhagic (39%) stroke (HR 0.88, 95%CI 0.48–1.60). Median survival was 38 days (range: 1–89 days) in patients with ischemic stroke and 39 days (range: 1–63 days) in patients with hemorrhagic stroke. Univariable analysis found that patients who had a lower Glasgow Coma Scale, were in coma and who had cerebral edema were more likely to die in-hospital (P = 0.04, 0.02, <0.01, respectively).Conclusions: Our analysis showed that mortality risk in critically ill patients with hemorrhagic stroke was closer to mortality risk in patients with ischemic stroke than has been reported in other analyses. Hypertension, chronic heart failure, ischemic heart disease and atrial fibrillation were the most frequent comorbidities in patients who developed severe (life-threatening) stroke. Coma and cerebral edema on admission appear to be associated with poor outcome. This is the first publication of in-hospital stroke mortality from a Central Asian population and could form the basis for future research including development of risk scores and identifying modifiable risk factors.

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Sex differences in vascular risk factors, in‐hospital management, and outcomes of patients with acute ischemic stroke in China

European Journal of Neurology ◽

10.1111/ene.15124 ◽

2021 ◽

Author(s):

Hong‐Qiu Gu ◽

Chun‐Juan Wang ◽

Xin Yang ◽

Chelsea Liu ◽

Xia Wang ◽

...

Keyword(s):

Risk Factors ◽

Sex Differences ◽

Ischemic Stroke ◽

Acute Ischemic Stroke ◽

Hospital Management ◽

Vascular Risk Factors ◽

Vascular Risk

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Emphysematous cystitis: mortality, risk factors, and pathogens of a rare disease

Clinics and Practice ◽

10.4081/cp.2017.930 ◽

2017 ◽

Vol 7 (2) ◽

Cited By ~ 10

Author(s):

Andreas Schicho ◽

Christian Stroszczynski ◽

Philipp Wiggermann

Keyword(s):

Risk Factors ◽

Escherichia Coli ◽

Mortality Rate ◽

Mortality Risk ◽

Conservative Management ◽

Mortality Rates ◽

Emphysematous Pyelonephritis ◽

Emphysematous Cystitis ◽

The Mean ◽

High Degree

Although high mortality rates have been reported for emphysematous pyelonephritis (EP), information on emphysematous cystitis (EC), which is less common, is sparse. Here, we report one new case of severe EC and 136 cases of EC that occurred between 2007 and 2016, and review information about the characteristics, diagnosis, treatment and mortality of these patients, and the pathogens found in these patients. The mean age of the 136 patients was 67.9±14.2 years. Concurrent emphysematous infections of other organs were found in 21 patients (15.4%), with emphysematous pyelonephritis being the most common of these infections. The primary pathogen identified was <em>Escherichia coli</em> (54.4%). Patients were mainly treated by conservative management that included antibiotics (n=105; 77.2%). Ten of the 136 patients with EC died, yielding a mortality rate of 7.4%. Despite the relatively low mortality rate of EC compared with that of EP, a high degree of suspicion must be maintained to facilitate successful and conservative management.

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Abstract T P19: “Futile” Interhospital Transfer for Endovascular Recanalization Treatment in Acute Ischemic Stroke. The Madrid Stroke Network

Stroke ◽

10.1161/str.45.suppl_1.tp19 ◽

2014 ◽

Vol 45 (suppl_1) ◽

Author(s):

Blanca Fuentes ◽

Maria Alonso de Leciñana ◽

Alvaro Ximenez-Carrillo ◽

Patricia Martínez-Sánchez ◽

Antonio Cruz-Culebras ◽

...

Keyword(s):

Risk Factors ◽

Ischemic Stroke ◽

Acute Ischemic Stroke ◽

Intravenous Thrombolysis ◽

Vascular Risk Factors ◽

Stroke Onset ◽

Vascular Risk ◽

Interhospital Transfer ◽

Hospital Transfer ◽

Arterial Recanalization

Objectives: The complexity of endovascular revascularization treatment (ERT) in acute ischemic stroke (IS) and the small number of patients eligible for that treatment justifies the development of Stroke Center networks with interhospital transfer of eligible patients. But it is possible that this approach generate “futile“ transfers (i.e. shift of patients who finally do not receive ET) generating unnecessary costs. Our aim is to analyze the frequency of “futile” transfers, the reasons for rejection for ERT and to identify the possible associated factors. Methods: We analyzed a prospective registry of ERT from a Stroke Network integrated by three hospitals with facilities for ERT for acute stroke patients. These hospitals share a common stroke protocol and have established a weekly rotatory shift with inter-hospital transference to the on-call center for ERT in those patients in whom this therapy is indicated, both primarily, after completing IV thrombolysis or in patients attended in outside hospitals (drip and shift). We analyzed: demographic data, vascular risk factors, stroke severity, frequency of prior intravenous thrombolysis, time from stroke onset and reasons for rejection. Study period: 1/02/2012 to 07/05/2013. Results: ERT protocol was activated in 199 patients, receiving ERT 129 (64.8%). 120 (60.3%) patients required inter-hospital transfer, among them 50 (41%) were not finally treated (futile transfer). These were more often male (74.1% vs. 25.9%, P = 0.04), with no differences in age, vascular risk factors, time-lapse from stroke onset or delay of inter-hospital transfer, baseline NIHSS, baseline ASPECTS or rate of prior intravenous thrombolysis between transferred patients treated with ERT and those non-treated. Reasons for rejection were: clinical improvement (16%), arterial recanalization (24%), clinical deterioration (8%); ASPECTS <7 in the 2nd TC (20%), absence of mismatch (20%); delay in shipment (2%), revocation of consent (1%). Conclusions: 40% of shipments for ERT are “futile”. None of the baseline patient characteristics predict this fact, being arterial recanalization and findings in a second imaging test done in the receiving hospital the main reasons for ERT rejection.

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Abstract: P1384 VASCULAR RISK FACTORS AND PREVALENCE OF CEREBRAL ARTERY CALCIFICATION IN PATIENTS WITH ACUTE ISCHEMIC STROKE

Atherosclerosis Supplements ◽

10.1016/s1567-5688(09)71392-3 ◽

2009 ◽

Vol 10 (2) ◽

pp. e1434

Author(s):

K-Y Park

Keyword(s):

Risk Factors ◽

Ischemic Stroke ◽

Acute Ischemic Stroke ◽

Cerebral Artery ◽

Vascular Risk Factors ◽

Vascular Risk

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Actions speak louder: Young female patients with acute ischemic stroke in the emergency department

Emergency Care Journal ◽

10.4081/ecj.2019.8300 ◽

2019 ◽

Vol 15 (2) ◽

Author(s):

Mor Saban ◽

Tal Shachar ◽

Heli Patito ◽

Lev Zaretsky

Keyword(s):

Risk Factors ◽

Emergency Department ◽

Ischemic Stroke ◽

Acute Ischemic Stroke ◽

Demographic Data ◽

Case Series ◽

Young Female ◽

Initial Examination ◽

Young Females ◽

Case Series Study

The aim was to explore the diagnostic cascade of young females with acute ischemic stroke (AIS) in the emergency department (ED) setting. A retrospective case series study was conducted between the years 2016-2018 in the ED of a tertiary hospital (N=10). We collected socio-demographic data, clinical risk factors and co-morbidities, ED characteristics and medical examination related data. Ten females presenting with AIS were identified. Results show that each case had a variety of characteristics, there are no similar medical background or clear-cut risk factors, and each case has been presented clinically different. All these factors, with the possible added effect of age and sex bias serve as possible hindrance for correct and efficient diagnosis of stroke in young females. In conclusion, clinical presentation of young female with AIS is misleading. Initial examination in the ED setting may appear to be the determining point of impact on the outcome severity in young females.

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Acute Ischemic Stroke and COVID-19

Stroke ◽

10.1161/strokeaha.120.031786 ◽

2021 ◽

Author(s):

Adnan I. Qureshi ◽

William I. Baskett ◽

Wei Huang ◽

Daniel Shyu ◽

Danny Myers ◽

...

Keyword(s):

Risk Factors ◽

Heart Failure ◽

Atrial Fibrillation ◽

Emergency Department ◽

Ischemic Stroke ◽

Relative Risk ◽

Acute Ischemic Stroke ◽

Health Care Facilities ◽

Stroke Patients ◽

Care Facilities

Background and Purpose: Acute ischemic stroke may occur in patients with coronavirus disease 2019 (COVID-19), but risk factors, in-hospital events, and outcomes are not well studied in large cohorts. We identified risk factors, comorbidities, and outcomes in patients with COVID-19 with or without acute ischemic stroke and compared with patients without COVID-19 and acute ischemic stroke. Methods: We analyzed the data from 54 health care facilities using the Cerner deidentified COVID-19 dataset. The dataset included patients with an emergency department or inpatient encounter with discharge diagnoses codes that could be associated to suspicion of or exposure to COVID-19 or confirmed COVID-19. Results: A total of 103 (1.3%) patients developed acute ischemic stroke among 8163 patients with COVID-19. Among all patients with COVID-19, the proportion of patients with hypertension, diabetes, hyperlipidemia, atrial fibrillation, and congestive heart failure was significantly higher among those with acute ischemic stroke. Acute ischemic stroke was associated with discharge to destination other than home or death (relative risk, 2.1 [95% CI, 1.6–2.4]; P <0.0001) after adjusting for potential confounders. A total of 199 (1.0%) patients developed acute ischemic stroke among 19 513 patients without COVID-19. Among all ischemic stroke patients, COVID-19 was associated with discharge to destination other than home or death (relative risk, 1.2 [95% CI, 1.0–1.3]; P =0.03) after adjusting for potential confounders. Conclusions: Acute ischemic stroke was infrequent in patients with COVID-19 and usually occurs in the presence of other cardiovascular risk factors. The risk of discharge to destination other than home or death increased 2-fold with occurrence of acute ischemic stroke in patients with COVID-19.

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