Prediction of the survival and functional ability of severe stroke patients after ICU therapeutic intervention

<p>Abstract</p> <p>Background</p> <p>This study evaluated the benefits and impact of ICU therapeutic interventions on the survival and functional ability of severe cerebrovascular accident (CVA) patients.</p> <p>Methods</p> <p>Sixty-two ICU patients suffering from severe ischemic/haemorrhagic stroke were evaluated for CVA severity using APACHE II and the Glasgow coma scale (GCS). Survival was determined using Kaplan-Meier survival tables and survival prediction factors were determined by Cox multivariate analysis. Functional ability was assessed using the stroke impact scale (SIS-16) and Karnofsky score. Risk factors, life support techniques and neurosurgical interventions were recorded. One year post-CVA dependency was investigated using multivariate analysis based on linear regression.</p> <p>Results</p> <p>The study cohort constituted 6% of all CVA (37.8% haemorrhagic/62.2% ischemic) admissions. Patient mean(SD) age was 65.8(12.3) years with a 1:1 male: female ratio. During the study period 16 patients had died within the ICU and seven in the year following hospital release.</p> <p>The mean(SD) APACHE II score at hospital admission was 14.9(6.0) and ICU mean duration of stay was 11.2(15.4) days. Mechanical ventilation was required in 37.1% of cases. Risk ratios were; GCS at admission 0.8(0.14), (p = 0.024), APACHE II 1.11(0.11), (p = 0.05) and duration of mechanical ventilation 1.07(0.07), (p = 0.046). Linear coefficients were: type of CVA – haemorrhagic versus ischemic: -18.95(4.58) (p = 0.007), GCS at hospital admission: -6.83(1.08), (p = 0.001), and duration of hospital stay -0.38(0.14), (p = 0.40).</p> <p>Conclusion</p> <p>To ensure a better prognosis CVA patients require ICU therapeutic interventions. However, as we have shown, where tests can determine the worst affected patients with a poor vital and functional outcome should treatment be withheld?</p

Prediction of the survival and functional ability of severe stroke patients after ICU therapeutic intervention-3

<p><b>Copyright information:</b></p><p>Taken from "Prediction of the survival and functional ability of severe stroke patients after ICU therapeutic intervention"</p><p>http://www.biomedcentral.com/1471-2377/8/24</p><p>BMC Neurology 2008;8():24-24.</p><p>Published online 26 Jun 2008</p><p>PMCID:PMC2443378.</p><p></p

Prediction of the survival and functional ability of severe stroke patients after ICU therapeutic intervention-2

<p><b>Copyright information:</b></p><p>Taken from "Prediction of the survival and functional ability of severe stroke patients after ICU therapeutic intervention"</p><p>http://www.biomedcentral.com/1471-2377/8/24</p><p>BMC Neurology 2008;8():24-24.</p><p>Published online 26 Jun 2008</p><p>PMCID:PMC2443378.</p><p></p

Prediction of the survival and functional ability of severe stroke patients after ICU therapeutic intervention-4

<p><b>Copyright information:</b></p><p>Taken from "Prediction of the survival and functional ability of severe stroke patients after ICU therapeutic intervention"</p><p>http://www.biomedcentral.com/1471-2377/8/24</p><p>BMC Neurology 2008;8():24-24.</p><p>Published online 26 Jun 2008</p><p>PMCID:PMC2443378.</p><p></p