Related Experiment Video
Updated: Dec 9, 2025
Optimized Management of Endovascular Treatment for Acute Ischemic Stroke
Published on: January 18, 2018
Long-Term Mortality Among ICU Patients With Stroke Compared With Other Critically Ill Patients
Mariëlle K van Valburg1, Fabian Termorshuizen2,3, Sylvia Brinkman2,3
1Department of Anesthesiology, University Medical Center Utrecht, Utrecht, The Netherlands.
Insights
Intensive care unit (ICU) patients with stroke face high short-term mortality. However, their long-term survival improves significantly compared to other critical conditions like sepsis.
Area of Science:
- Neurology
- Critical Care Medicine
- Epidemiology
Background:
- Intracerebral hemorrhage (ICH) and ischemic stroke (IS) are critical conditions requiring intensive care unit (ICU) admission.
- Comparative mortality data for stroke patients versus other critically ill populations are essential for resource allocation and outcome prediction.
Purpose of the Study:
- To assess the all-cause mortality of ICH and IS patients admitted to the ICU.
- To compare stroke patient mortality with that of other critically ill patients in six diagnostic subgroups and the general Dutch population.
Main Methods:
- An observational cohort study utilizing data from the Dutch National Intensive Care Evaluation database (2010-2015).
- Inclusion of all adult ICU patients, with follow-up until February 2017.
- Statistical analysis using left-truncation and multivariable Cox regression to assess mortality risk over time.
Main Results:
- Out of 370,386 ICU patients, 7,046 (1.9%) had stroke (4,072 IS, 2,974 ICH).
- Short-term mortality at 30 days was high: 31% for IS and 42% for ICH.
- After surviving the initial 3 months, stroke patients demonstrated favorable long-term survival compared to sepsis or severe community-acquired pneumonia patients.
Conclusions:
- ICU-admitted stroke patients have a high short-term mortality risk.
- Survival prognosis for stroke patients improves significantly with longer survival duration post-ICU admission.
- Compared to other critical illnesses, stroke patients who survive the initial ICU period show better long-term outcomes.
Objectives:
Assessment of all-cause mortality of intracerebral hemorrhage and ischemic stroke patients admitted to the ICU and comparison to the mortality of other critically ill ICU patients classified into six other diagnostic subgroups and the general Dutch population.
Design:
Observational cohort study.
Setting:
All ICUs participating in the Dutch National Intensive Care Evaluation database.
Patients:
All adult patients admitted to these ICUs between 2010 and 2015; patients were followed until February 2017.
Interventions:
None.
Measurements And Main Results:
Of all 370,386 included ICU patients, 7,046 (1.9%) were stroke patients, 4,072 with ischemic stroke, and 2,974 with intracerebral hemorrhage. Short-term mortality in ICU-admitted stroke patients was high with 30 days mortality of 31% in ischemic stroke and 42% in intracerebral hemorrhage. In the longer term, the survival curve gradient among ischemic stroke and intracerebral hemorrhage patients stabilized. The gradual alteration of mortality risk after ICU admission was assessed using left-truncation with increasing minimum survival period. ICU-admitted stroke patients who survive the first 30 days after suffering from a stroke had a favorable subsequent survival compared with other diseases necessitating ICU admission such as patients admitted due to sepsis or severe community-acquired pneumonia. After having survived the first 3 months after ICU admission, multivariable Cox regression analyses showed that case-mix adjusted hazard ratios during the follow-up period of up to 3 years were lower in ischemic stroke compared with sepsis (adjusted hazard ratio, 1.21; 95% CI, 1.06-1.36) and severe community-acquired pneumonia (adjusted hazard ratio, 1.57; 95% CI, 1.39-1.77) and in intracerebral hemorrhage patients compared with these groups (adjusted hazard ratio, 1.14; 95% CI, 0.98-1.33 and adjusted hazard ratio, 1.49; 95% CI, 1.28-1.73).
Conclusions:
Stroke patients who need intensive care treatment have a high short-term mortality risk, but this alters favorably with increasing duration of survival time after ICU admission in patients with both ischemic stroke and intracerebral hemorrhage, especially compared with other populations of critically ill patients such as sepsis or severe community-acquired pneumonia patients.
More Related Videos
10:38Observational Study Protocol for Repeated Clinical Examination and Critical Care Ultrasonography Within the Simple Intensive Care Studies
Published on: January 16, 2019
04:38A Middle Cerebral Artery Occlusion Technique for Inducing Post-stroke Depression in Rats
Published on: May 22, 2019
Related Concept Videos
01:28Acute Coronary Syndrome IV: Interprofessional Care
01:22Cardiac Output II: Effect of Stroke Volume on Cardiac Output
Preload
Preload refers to the initial elongation of the cardiac myocytes before contraction and is related to the volume of blood filling the heart at the end of diastole, or end-diastolic volume. The...