Long-Term Mortality Among ICU Patients With Stroke Compared With Other Critically Ill Patients
| Autor: | Sylvia Brinkman, Walther N.K.A. van Mook, Janneke Horn, Arjen J. C. Slooter, Bob Siegerink, M. Sesmu Arbous, Mariëlle K van Valburg, Marieke J.H. Wermer, Wilson F. Abdo, Bart F. Geerts, Fabian Termorshuizen, Walter M. van den Bergh |
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| Přispěvatelé: | Intensive Care, MUMC+: MA Medische Staf IC (9), RS: SHE - R1 - Research (OvO), Clinical sciences, Neuroprotection & Neuromodulation, Critical care, Anesthesiology, Peri-operative and Emergency medicine (CAPE), Medical Informatics, APH - Methodology, APH - Quality of Care, Intensive Care Medicine, Amsterdam Neuroscience - Neurovascular Disorders, Anesthesiology, ACS - Diabetes & metabolism, APH - Personalized Medicine |
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
lnfectious Diseases and Global Health Radboud Institute for Molecular Life Sciences [Radboudumc 4]
Comorbidity Critical Care and Intensive Care Medicine intensive care unit Stroke/mortality law.invention Brain ischemia 0302 clinical medicine law Risk Factors PREDICTORS Stroke Netherlands Aged 80 and over Hazard ratio Age Factors Middle Aged Intensive care unit stroke Hemorrhagic Stroke Intensive Care Units ISCHEMIC-STROKE Intensive Care Units/statistics & numerical data SURVIVAL Regression Analysis TRIAL Adult medicine.medical_specialty Critical Illness intracranial hemorrhages Netherlands/epidemiology 03 medical and health sciences Sex Factors Intensive care medicine INJURY Humans Glasgow Coma Scale Aged Ischemic Stroke Intracerebral hemorrhage Ischemic Stroke/mortality HOSPITAL DISCHARGE Proportional hazards model business.industry Hemorrhagic Stroke/mortality 030208 emergency & critical care medicine CARE medicine.disease mortality brain ischemia RECORD LINKAGE critical care Critical Illness/mortality SEVERITY 030228 respiratory system Socioeconomic Factors ENDOVASCULAR TREATMENT Emergency medicine business |
| Zdroj: | Critical Care Medicine, 48(10), E876-E883. LIPPINCOTT WILLIAMS & WILKINS Critical Care Medicine Critical Care Medicine, 48, 10, pp. e876-e883 Critical Care Medicine, 48, e876-e883 Critical care medicine, 48(10), e876-e883. Lippincott Williams and Wilkins |
| ISSN: | 0090-3493 |
| Popis: | Contains fulltext : 225472.pdf (Publisher’s version ) (Closed access) 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. |
| Databáze: | OpenAIRE |
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