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Prediction of in-hospital stroke mortality in critical care unit.

Ho WM, Lin JR, Wang HH, Liou CW, Chang KC, Lee JD, Peng TY, Yang JT, Chang YJ, Chang CH, Lee TH - Springerplus (2016)

Bottom Line: In hemorrhagic stroke, NIHSS score (OR 1.12; 95 % CI 1.09-1.14; P < 0.01), systolic BP (OR 0.25; 95 % CI 0.15-0.41; P < 0.01), heart disease (OR 1.94; 95 % CI 1.11-3.39; P = 0.02) and creatinine (OR 1.16; 95 % CI 1.01-1.34; P = 0.04) were related to in-hospital mortality.Nomograms using these significant predictors were constructed for easy and quick evaluation of in-hospital mortality.Variables in acute stroke can predict in-hospital mortality and help decision-making in clinical practice using nomogram.

View Article: PubMed Central - PubMed

Affiliation: Dementia Center and Department of Neurology, Linkou Medical Center, Chang Gung Memorial Hospital, No.5, Fuxing St., Guishan Dist., Taoyuan City, 333 Taiwan, ROC.

ABSTRACT

Background: Critical stroke causes high morbidity and mortality. We examined if variables in the early stage of critical stroke could predict in-hospital mortality.

Methods: We recruited 611 ischemic and 805 hemorrhagic stroke patients who were admitted within 24 h after the symptom onset. Data were analyzed with independent t test and Chi square test, and then with multivariate logistic regression analysis.

Results: In ischemic stroke, National Institutes of Health Stroke Scale (NIHSS) score (OR 1.08; 95 % CI 1.06-1.11; P < 0.01), white blood cell count (OR 1.11; 95 % CI 1.05-1.18; P < 0.01), systolic blood pressure (BP) (OR 0.49; 95 % CI 0.26-0.90; P = 0.02) and age (OR 1.03; 95 % CI 1.00-1.05; P = 0.03) were associated with in-hospital mortality. In hemorrhagic stroke, NIHSS score (OR 1.12; 95 % CI 1.09-1.14; P < 0.01), systolic BP (OR 0.25; 95 % CI 0.15-0.41; P < 0.01), heart disease (OR 1.94; 95 % CI 1.11-3.39; P = 0.02) and creatinine (OR 1.16; 95 % CI 1.01-1.34; P = 0.04) were related to in-hospital mortality. Nomograms using these significant predictors were constructed for easy and quick evaluation of in-hospital mortality.

Conclusion: Variables in acute stroke can predict in-hospital mortality and help decision-making in clinical practice using nomogram.

No MeSH data available.


Related in: MedlinePlus

Flow chart of patient recruitment. ED emergency department, ICU intensive care unit
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Fig1: Flow chart of patient recruitment. ED emergency department, ICU intensive care unit

Mentions: Acute stroke patients who could not follow order clearly or who were at the risk of stroke progression and cardiopulmonary failure such as large ischemic or hemorrhagic stroke or brain stem ischemic or hemorrhagic stroke were arranged for ICU admission. We aimed to investigate variables that might affect the pathophysiology of acute severe stroke and short-term mortality in critical stroke patients without major comorbidity at stroke onset. Therefore, patients who were under the age of eighteen; attended ED beyond 24 h after stroke onset; underwent peritoneal or hemodialysis; who were admitted to neurology ward with minor stroke initially and then were transferred to ICU due to comorbidity, such as infection or gastrointestinal bleeding were excluded (Fig. 1). Ischemic stroke patients who received recombinant tissue plasminogen activator (rt-PA) or who had intracranial or extracranial vascular stent placement were not included under the consideration that these interventions might alter disease progression. Subarachnoid hemorrhage (SAH), traumatic intracranial hemorrhage (ICH), aneurysm or arteriovenous malformation (AVM) were excluded because of the different mechanisms and treatments from primary hemorrhagic stroke.Fig. 1


Prediction of in-hospital stroke mortality in critical care unit.

Ho WM, Lin JR, Wang HH, Liou CW, Chang KC, Lee JD, Peng TY, Yang JT, Chang YJ, Chang CH, Lee TH - Springerplus (2016)

Flow chart of patient recruitment. ED emergency department, ICU intensive care unit
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4940351&req=5

Fig1: Flow chart of patient recruitment. ED emergency department, ICU intensive care unit
Mentions: Acute stroke patients who could not follow order clearly or who were at the risk of stroke progression and cardiopulmonary failure such as large ischemic or hemorrhagic stroke or brain stem ischemic or hemorrhagic stroke were arranged for ICU admission. We aimed to investigate variables that might affect the pathophysiology of acute severe stroke and short-term mortality in critical stroke patients without major comorbidity at stroke onset. Therefore, patients who were under the age of eighteen; attended ED beyond 24 h after stroke onset; underwent peritoneal or hemodialysis; who were admitted to neurology ward with minor stroke initially and then were transferred to ICU due to comorbidity, such as infection or gastrointestinal bleeding were excluded (Fig. 1). Ischemic stroke patients who received recombinant tissue plasminogen activator (rt-PA) or who had intracranial or extracranial vascular stent placement were not included under the consideration that these interventions might alter disease progression. Subarachnoid hemorrhage (SAH), traumatic intracranial hemorrhage (ICH), aneurysm or arteriovenous malformation (AVM) were excluded because of the different mechanisms and treatments from primary hemorrhagic stroke.Fig. 1

Bottom Line: In hemorrhagic stroke, NIHSS score (OR 1.12; 95 % CI 1.09-1.14; P < 0.01), systolic BP (OR 0.25; 95 % CI 0.15-0.41; P < 0.01), heart disease (OR 1.94; 95 % CI 1.11-3.39; P = 0.02) and creatinine (OR 1.16; 95 % CI 1.01-1.34; P = 0.04) were related to in-hospital mortality.Nomograms using these significant predictors were constructed for easy and quick evaluation of in-hospital mortality.Variables in acute stroke can predict in-hospital mortality and help decision-making in clinical practice using nomogram.

View Article: PubMed Central - PubMed

Affiliation: Dementia Center and Department of Neurology, Linkou Medical Center, Chang Gung Memorial Hospital, No.5, Fuxing St., Guishan Dist., Taoyuan City, 333 Taiwan, ROC.

ABSTRACT

Background: Critical stroke causes high morbidity and mortality. We examined if variables in the early stage of critical stroke could predict in-hospital mortality.

Methods: We recruited 611 ischemic and 805 hemorrhagic stroke patients who were admitted within 24 h after the symptom onset. Data were analyzed with independent t test and Chi square test, and then with multivariate logistic regression analysis.

Results: In ischemic stroke, National Institutes of Health Stroke Scale (NIHSS) score (OR 1.08; 95 % CI 1.06-1.11; P < 0.01), white blood cell count (OR 1.11; 95 % CI 1.05-1.18; P < 0.01), systolic blood pressure (BP) (OR 0.49; 95 % CI 0.26-0.90; P = 0.02) and age (OR 1.03; 95 % CI 1.00-1.05; P = 0.03) were associated with in-hospital mortality. In hemorrhagic stroke, NIHSS score (OR 1.12; 95 % CI 1.09-1.14; P < 0.01), systolic BP (OR 0.25; 95 % CI 0.15-0.41; P < 0.01), heart disease (OR 1.94; 95 % CI 1.11-3.39; P = 0.02) and creatinine (OR 1.16; 95 % CI 1.01-1.34; P = 0.04) were related to in-hospital mortality. Nomograms using these significant predictors were constructed for easy and quick evaluation of in-hospital mortality.

Conclusion: Variables in acute stroke can predict in-hospital mortality and help decision-making in clinical practice using nomogram.

No MeSH data available.


Related in: MedlinePlus