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Prognosis of stroke patients undergoing mechanical ventilation
P Burtin1, P E Bollaert, L Feldmann
1Service de Réanimation Médicale, Hôpital Central, Centré Hospitalier Universitaire de Nancy, France.
Objective:
to determine the outcome of stroke patients undergoing mechanical ventilation.
Design:
retrospective chart review and follow-up telephone interview.
Setting:
medical ICU in a multidisciplinary university hospital.
Patients And Participants:
199 stroke patients from 1984-1989 where the final diagnosis was stroke.
Interventions:
all patients were admitted for the need of mechanical ventilation.
Measurements And Results:
demographic information, previous relevant diseases, stroke type, general clinical and neurological data, biochemical variables, severity of illness were recorded for the first 24 h following ICU admission. A 1-year follow-up was performed, including mortality and functional status of survivors. Of 170 eventually analyzable patients, 123 (72.4%) died during their ICU stay and 156 (91.8%) during the first year. Three variables were independently associated with one-year mortality: Glasgow score < 10 (p < 0.03), bradycardia (p < 0.001), absence of brainstem reflexes (p < 0.0004).
Conclusion:
overall prognosis of stroke needing mechanical ventilation is poor, strongly linked to symptoms of neurological impairment.