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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
One-year survival in acute stroke patients requiring mechanical ventilation: a multicenter cohort study
Annals of Intensive Care, Volume 10, No. 1, Article 53, Year 2020
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Description
Background: Most prognostic studies in acute stroke patients requiring invasive mechanical ventilation are outdated and have limitations such as single-center retrospective designs. We aimed to study the association of ICU admission factors, including the reason for intubation, with 1-year survival of acute stroke patients requiring mechanical ventilation. Methods: We conducted a secondary data use analysis of a prospective multicenter database (14 ICUs) between 1997 and 2016 on consecutive ICU stroke patients requiring mechanical ventilation at admission. We excluded patients with stroke of traumatic origin, subdural hematoma or cerebral venous thrombosis. The primary outcome was survival 1 year after ICU admission. Factors associated with the primary outcome were identified using a multivariable Cox model stratified on inclusion center. Results: We identified 419 patients (age 68 [58–76] years, males 60%) with a Glasgow coma score (GCS) of 4 [3–8] at admission. Stroke subtypes were acute ischemic stroke (AIS, 46%), intracranial hemorrhage (ICH, 42%) and subarachnoid hemorrhage (SAH, 12%). At 1 year, 96 (23%) patients were alive. Factors independently associated with decreased 1-year survival were ICH and SAH stroke subtypes, a lower GCS score at admission, a higher non-neurological SOFA score. Conversely, patients receiving acute-phase therapy had improved 1-year survival. Intubation for acute respiratory failure or coma was associated with comparable survival hazard ratios, whereas intubation for seizure was not associated with a worse prognosis than for elective procedure. Survival did not improve over the study period, but patients included in the most recent period had more comorbidities and presented higher severity scores at admission. Conclusions: In acute stroke patients requiring mechanical ventilation, the reason for intubation and the opportunity to receive acute-phase stroke therapy were independently associated with 1-year survival. These variables could assist in the decision process regarding the initiation of mechanical ventilation in acute stroke patients. © 2020, The Author(s).
Authors & Co-Authors
De Montmollin, E.
France, Paris
Infection, Anti-microbien, Modélisation, Évolution
France, Paris
Ap-hp Assistance Publique - Hopitaux de Paris
Dupuis, Claire
France, Clermont-ferrand
Hopital Gabriel Montpied
Garrouste-Orgeas, Maïté
Unknown Affiliation
Thiéry, Guillaume
France, Saint-etienne
Hôpital Nord Chu de Sainte-etienne
Oziel, Johanna
France, Paris
Ap-hp Assistance Publique - Hopitaux de Paris
Siami, Shidasp
Unknown Affiliation
Adrie, Christophe
France, Paris
Ap-hp Assistance Publique - Hopitaux de Paris
Ruckly, Stéphane
France, Paris
Infection, Anti-microbien, Modélisation, Évolution
Timsit, Jean Franc¸ois
France, Paris
Infection, Anti-microbien, Modélisation, Évolution
France, Paris
Ap-hp Assistance Publique - Hopitaux de Paris
Azoulay, Elie
Unknown Affiliation
Zahar, Jean Ralph
Unknown Affiliation
Clec'H, Christophe
Unknown Affiliation
Alberti, Corinne
Unknown Affiliation
Français, Adrien
Unknown Affiliation
Vésin, Aure´lien
Unknown Affiliation
Bailly, Sébastien D.Sign©bastien
Unknown Affiliation
Lecorre, Frederik
Unknown Affiliation
Nakache, Didier
Unknown Affiliation
Hernu, Romain
Unknown Affiliation
Allaouchiche, Bernard
Unknown Affiliation
Argaud, Laurent
Unknown Affiliation
Bouadma, Lila
Unknown Affiliation
Cheval, Christine
Unknown Affiliation
Dumenil, Anne Sylvie
Unknown Affiliation
Kallel, Hatem
Unknown Affiliation
Lautrette, Alexandre
Unknown Affiliation
Mourvillier, Bruno H.
Unknown Affiliation
Misset, Benoıˆt Y.
Unknown Affiliation
Neuville, Mathilde
Unknown Affiliation
Papazian, Laurent
Unknown Affiliation
Souweine, Bertrand
Unknown Affiliation
Schwebel, Carole
Unknown Affiliation
Troché, Gilles
Unknown Affiliation
Thuong, Marie
Unknown Affiliation
Thierry, Guillaume L.
Unknown Affiliation
Statistics
Citations: 20
Authors: 35
Affiliations: 11
Identifiers
Doi:
10.1186/s13613-020-00669-5
ISSN:
21105820
Research Areas
Environmental
Noncommunicable Diseases
Study Design
Cohort Study
Study Approach
Quantitative