scholarly journals Outcome Predictors of Stroke Mortality in the Neurocritical Care Unit

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.

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

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Alfred Anselme Dabilgou ◽  
Alassane Dravé ◽  
Julie Marie Adeline Kyelem ◽  
Saïdou Ouedraogo ◽  
Christian Napon ◽  
...  
Keyword(s):  
Risk Factors ◽  
Emergency Department ◽  
Ischemic Stroke ◽  
Mortality Rate ◽  
Acute Ischemic Stroke ◽  
Mortality Risk ◽  
Average Length ◽  
University Teaching ◽  
Vascular Risk ◽  
The Mean

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.

scholarly journals "EMMA Study: a Brazilian community-based cohort study of stroke mortality and morbidity"

2016 ◽  
Vol 134 (6) ◽  
pp. 543-554 ◽  
Author(s):  
Alessandra Carvalho Goulart ◽  
Keyword(s):  
Risk Factors ◽  
Ischemic Stroke ◽  
Hemorrhagic Stroke ◽  
Local Community ◽  
Hospital Setting ◽  
Public Healthcare ◽  
Stroke Mortality ◽  
Community Based ◽  
Mortality And Morbidity ◽  
Risk Of Death

ABSTRACT CONTEXT AND OBJECTIVE: Stroke has a high burden of disability and mortality. The aim here was to evaluate epidemiology, risk factors and prognosis for stroke in the EMMA Study (Study of Stroke Mortality and Morbidity). DESIGN AND SETTINGS: Prospective community-based cohort carried out in Hospital Universitário, University of São Paulo, 2006-2014. METHODS: Stroke data based on fatal and non-fatal events were assessed, including sociodemographic data, mortality and predictors, which were evaluated by means of logistic regression and survival analyses. RESULTS: Stroke subtype was better defined in the hospital setting than in the local community. In the hospital phase, around 70% were first events and the ischemic subtype. Among cerebrovascular risk factors, the frequency of alcohol intake was higher in hemorrhagic stroke (HS) than in ischemic stroke (IS) cases (35.4% versus 12.3%, P < 0.001). Low education was associated with higher risk of death, particularly after six months among IS cases (odds ratio, OR, 4.31; 95% confidence interval, CI, 1.34-13.91). The risk of death due to hemorrhagic stroke was greater than for ischemic stroke and reached its maximum 10 days after the event (OR: 3.31; 95% CI: 1.55-7.05). Four-year survival analysis on 665 cases of first stroke (82.6% ischemic and 17.4% hemorrhagic) showed an overall survival rate of 48%. At four years, the highest risks of death were in relation to ischemic stroke and illiteracy (hazard ratio, HR: 1.83; 95% CI: 1.26-2.68) and diabetes (HR: 1.45; 95% CI: 1.07-1.97). Major depression presented worse one-year survival (HR: 4.60; 95% CI: 1.36-15.55). CONCLUSION: Over the long term, the EMMA database will provide additional information for planning resources destined for the public healthcare system.

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

2017 ◽  
Vol 7 (2) ◽  
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.

scholarly journals Profil Pasien Stroke Hemoragik yang Dirawat di ICU RSUP Prof. Dr. R.D. Kandou Manado Periode Desember 2014 sampai November 2015

e-CliniC ◽  
2016 ◽  
Vol 4 (1) ◽  
Author(s):  
Maria Estefina Siwi ◽  
Diana Lalenoh ◽  
Harold Tambajong
Keyword(s):  
Mortality Rate ◽  
Blood Vessels ◽  
Medical Record ◽  
Cause Of Death ◽  
Cerebral Edema ◽  
Hemorrhagic Stroke ◽  
Stroke Mortality ◽  
Probability Sampling ◽  
The Brain ◽  
Very High

Abstract: Hermorrhagic stroke is a disease caused by rupture of blood vessels of the brain that causes bleeding intro the brain parenchym tissue, cerebrospinal space around the brain or combination of both. Cause of death from hemorrhagic stroke is presence of complications or other comorbodities, like cerebral edema were reported the highest cause of death of hemorrhagic stroke. This study aimed to determine the profile of patients with hemorrhagic stroke in ICU, using descriptive retropective method. The samples were Prof. Dr. R.D. Kandou Manado ICU’s patients with hemorrhagic stroke based on the data in the medical record from December 2014 – November 2015. Hemorrhagic stroke mortality rate is very high (89%). From total 35 samples were examined, there 4 survivors (11%) and 31 deaths (89%), which consisted of 24 males (69%) and 11 females (31%). Most patients are 45-59 years old.Keywords: hemorrhagic stroke, ICUAbstrak: Stroke hemoragik adalah penyakit yang disebabkan oleh pecahnya pembuluh darah otak yang menyebabkan keluarnya darah ke jaringan parenkim otak, ruang serebrospinalis disekitar otak atau kombinasi keduanya. Penyebab kematian dari stroke hemoragik sendiri adalah adanya komplikasi atau penyakit penyerta lainnya, salah satu contohnya yaitu edema serebri yang dilaporkan merupakan penyebab kematian terbanyak. Penelitian ini bertujuan untuk mengetahui profil pasien stroke hemoragik yang dirawat di ICU RSUP Prof. Dr. R.D. Kandou Manado, menggunakan metode penelitian deskriptif retrospektif. Besar sampel ditentukan dengan metode non probability sampling yaitu purposive sampling. Sampel penelitian adalah pasien ICU RSUP Prof. Dr. R.D. Kandou Manado dengan diagnosa stroke hemoragik berdasarkan data di bagian Rekam Medik periode Desember 2014 sampai November 2015. Angka mortalitas stroke hemoragik sangatlah tinggi (89%). Total 35 sampel yang diteliti dengan 4 orang yang selamat (11%) dan 31 orang meninggal dunia (89%), terdiri dari 24 orang laki-laki (69%) dan 11 orang perempuan (31%). Sebagian besar adalah pasien umur 45-59 tahun.Kata kunci: stroke hemoragik, ruang rawat intensif

The physiopathology of spontaneous hemorrhagic stroke: a systematic review

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Alcivan Batista de Morais Filho ◽  
Thiago Luis de Holanda Rego ◽  
Letícia de Lima Mendonça ◽  
Sulyanne Saraiva de Almeida ◽  
Mariana Lima da Nóbrega ◽  
...  
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Ischemic Stroke ◽  
Subarachnoid Hemorrhage ◽  
Natural History ◽  
Hemorrhagic Stroke ◽  
Recent Literature ◽  
Clinical Manifestations ◽  
The Road ◽  
History Of

Abstract Hemorrhagic stroke (HS) is a major cause of death and disability worldwide, despite being less common, it presents more aggressively and leads to more severe sequelae than ischemic stroke. There are two types of HS: Intracerebral Hemorrhage (ICH) and Subarachnoid Hemorrhage (SAH), differing not only in the site of bleeding, but also in the mechanisms responsible for acute and subacute symptoms. This is a systematic review of databases in search of works of the last five years relating to the comprehension of both kinds of HS. Sixty two articles composed the direct findings of the recent literature and were further characterized to construct the pathophysiology in the order of events. The road to the understanding of the spontaneous HS pathophysiology is far from complete. Our findings show specific and individual results relating to the natural history of the disease of ICH and SAH, presenting common and different risk factors, distinct and similar clinical manifestations at onset or later days to weeks, and possible complications for both.

scholarly journals Oral contraceptive among risk factors for women with ischemic stroke

2021 ◽  
Vol 12 (1) ◽  
pp. 548
Author(s):  
Carla S. PALUDO ◽  
Amanda SACHETTI ◽  
Maiara S. PAIXÃO
Keyword(s):  
Risk Factors ◽  
Ischemic Stroke ◽  
Oral Contraceptive ◽  
Oral Contraceptives ◽  
Contraceptive Use ◽  
Cross Sectional Study ◽  
Mean Value ◽  
Northern Region ◽  
Cross Sectional ◽  
The Mean

Objective: To evaluate the frequency of use of oral contraceptives and other risk factors among women with ischemic stroke seen at a hospital in the northern region of the state of Rio Grande do Sul. Methods: Prospective, cross-sectional study. The population was characterized by patients admitted with a diagnosis of ischemic stroke during a period from March to August 2019 and the sample by female patients found in the population. The data were collected through an individual interview using a questionnaire developed by the researchers and tabulated for further analysis. All analyzes were performed using the statistical program Bioestat 5.0, considering p = 0.05. Results: In the characterization of the sample, an average age of 68.2 years was observed. The occurrence of gender was 52.4% for women. The mean hospital stay was 12.2 ± 8.91 days. Outcome of hospital discharge was 89.1%. The mean value of body mass index was 25 ± 4.89 kg / m², with an average of 27.4 kg / m² in patients who used oral contraceptives and 25.23 kg / m² in patients who did not use oral contraceptives. The sample had a 34.5%incidence of oral contraceptive use. The average age of those who used oral contraceptives was 62.4 years and of the patients who did not use it was 70.3 years. Conclusion: The study showed a high use of oral contraceptives in the sample, with percentage values very close to other factors evaluated, thus showing itself as a probable risk factor for the development of ischemic stroke.

scholarly journals Epidemiology, Risk Factors, and Predictors of Disability in a Cohort of Jordanian Patients with the First Ischemic Stroke

2020 ◽  
Vol 2020 ◽  
pp. 1-9
Author(s):  
Majdi Al Qawasmeh ◽  
Belal Aldabbour ◽  
Aiman Momani ◽  
Deema Obiedat ◽  
Kefah Alhayek ◽  
...  
Keyword(s):  
Risk Factors ◽  
Ischemic Stroke ◽  
Length Of Stay ◽  
Large Artery ◽  
Median Length ◽  
Nihss Score ◽  
Prolonged Length ◽  
Independent Variables ◽  
Stroke Etiology ◽  
The Mean

Objective. To identify the risk factors, etiologies, length of stay, severity, and predictors of disability among patients with the first ischemic stroke in Jordan. Methods. A retrospective cohort study of 142 patients who were admitted to the Neurology Department at King Abdullah University Hospital between July/2017 and March/2018 with a first ischemic stroke. Etiology was classified according to the TOAST criteria. Severity was represented by NIHSS score, disability by mRS score, and prolonged length of stay as hospitalizations more than 75th percentile of the cohort’s median length of stay. Analysis of the sample demographics and descriptive statistics were done, including frequencies of prevalence of independent variables (risk factors) and frequencies of stroke and etiology work-up. Chi-square and univariate analysis of variance “ANOVA” were used to investigate the relationship between risk factors and type of stroke. Finally, logistic regression analysis was used to measure the contribution of each of the independent variables. IRB approval was obtained as necessary. Results. The mean age for the cohort was 66.5 years. The most common risk factors were hypertension (78.8%), diabetes mellitus (60.5%), and ischemic heart disease (29.4%). The most common stroke etiology was small-vessel occlusion (54.2%). Median length of stay was 4 days. Prolonged length of stay was observed in 23.23% of patients, which was associated with several factors, the most common of which were persistent dysphagia (57.5%), nosocomial infection (39.3%), and combined dysphagia and nosocomial infection (21.2%). The mean admission NIHSS score was 7.94, and on discharge was 5.76. In-hospital mortality was 2.81%, while 50% of patients had a favorable outcome on discharge (mRS score between 0-2). The mean discharge mRS score for the cohort was 2.47 (SD±1.79). Large artery atherosclerosis was associated with the highest residual disability with a mean score of 3.67 (SD±1.88), while the stroke of undetermined etiology was associated with the lowest residual disability with a mean score of 1.60 (SD±1.78). Significant predictors of mRS score were smoking (t 3.24, P<0.001), age (t 1.98, P<0.049), and NIHSS score (t 9.979, P 0.000). Conclusion. Ischemic strokes have different etiologies that are associated with different levels of impact on the patient’s clinical status and prognosis. Large artery atherosclerosis was associated with the highest residual disability. Regarding predictors of prognosis, current smoking status, age above 50, gender, and NIHSS on admission appear to be the strongest predictors of prognosis. Finally, higher NIHSS score on admission resulted in a longer hospital stay.

Sex difference in types and distribution of risk factors in ischemic and hemorrhagic stroke

2017 ◽  
Vol 13 (1) ◽  
pp. 83-86 ◽  
Author(s):  
Alijan A Ahangar ◽  
Payam Saadat ◽  
Behzad Heidari ◽  
Seyedeh T Taheri ◽  
Shayan Alijanpour
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Cardiovascular Disease ◽  
Risk Factor ◽  
Ischemic Stroke ◽  
Sex Difference ◽  
Cause Of Death ◽  
Associated Factors ◽  
Hemorrhagic Stroke ◽  
Age Group

Background Stroke is the second leading cause of death worldwide and is associated with several risk factors with variable risk factor distribution by population. We report the types and frequency of the associated factors of stroke in north Iran. Methods Consecutive patients with stroke were recruited from 2014 to 2015. The two groups of ischemic and hemorrhagic stroke were compared with respect to age, sex, the prevalence, and distribution of the risk factors. Results Among 230 patients (84.3% ischemic stroke) with mean age of 61.2 years, hypertension (73%), diabetes mellitus (53%), cardiovascular disease (51%), and dyslipidemia (47%) were the most frequent risk factors. Hypertension was significantly more prevalent in males compared with females (88% vs. 60%, OR = 4.91, 95% CI: 2.48–9.71). Hypertension, smoking, and opioid consumption were associated with hemorrhagic stroke. Dyslipidemia was significantly higher in ischemic stroke (OR = 2.65, 95% CI: 1.21–5.8). Overall, 84.3% of stroke occurred in patients aged >50 years (92.8% of women vs. 74.5% of the men, OR = 4.43, 95% CI: 1.93–10.16, p = 0.001). Conclusion Stroke was more prevalent in females; hypertension was more prevalent in males. In the age group less than 50 years old, stroke is more prevalent in men.

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