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A Magnetic Resonance Imaging Protocol for Stroke Onset Time Estimation in Permanent Cerebral Ischemia
Published on: September 16, 2017
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Evaluation of Physiological Variables Determining Time-to-Mortality after Stroke-Associated Pneumonia
Amit K Kishore1,2, Calvin Heal3, Anna Onochie-Williams1
1Greater Manchester Comprehensive Stroke Centre, Geoffrey Jefferson Brain Research Centre, Manchester Academic Health Science Centre, Northern Care Alliance, Salford Royal, Salford, UK.
Cerebrovascular Diseases (Basel, Switzerland)
|October 16, 2024
Summary
Higher respiratory rate and the National Early Warning Score (NEWS) 2 are linked to mortality in patients with stroke-associated pneumonia (SAP). These findings highlight potential targets for intervention to improve outcomes in SAP.
Area of Science:
- Neurology
- Critical Care Medicine
- Infectious Diseases
Background:
- Stroke-associated pneumonia (SAP) is a common and fatal complication of stroke.
- The National Early Warning Score (NEWS) is used to assess acutely ill patients, but its association with mortality in SAP is not well understood.
- Early identification of mortality risk factors in SAP is crucial for timely intervention.
Purpose of the Study:
- To investigate the association between the NEWS 2 score and its components and time-to-mortality in patients with SAP.
- To determine if physiological variables predict mortality in SAP patients prior to antibiotic treatment.
Main Methods:
- A cohort of 389 patients diagnosed with SAP within 7 days of hospital admission was analyzed.
- Kaplan-Meier survival curves and multivariable Cox-regression models were used to assess the impact of NEWS 2 parameters on mortality.
- The analysis accounted for pre-specified potential confounders.
Main Results:
- Mortality rates were high, with 52.4% at 1 year and 65.8% at 5 years.
- Increased respiratory rate (HR 1.04, 95% CI 1.01-1.08, p = 0.009) was independently associated with time-to-mortality.
- A higher total NEWS 2 score (HR 1.13, 95% CI 1.06-1.21, p < 0.001) was also independently associated with increased mortality risk.
Conclusions:
- Elevated respiratory rate and total NEWS 2 score before antibiotic initiation are significant independent predictors of mortality in SAP.
- These findings suggest that NEWS 2 parameters could aid in risk stratification and guide treatment decisions in SAP.
- Further research is needed to explore interventions targeting these physiological markers to improve SAP patient outcomes.
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