We found a match
Your institution may have access to this item. Find your institution then sign in to continue.
- Title
Outcome prediction in terms of functional disability and mortality at 1 year among ICU-admitted severe stroke patients: a prospective epidemiological study in the south of the European Union (Evascan Project, Andalusia, Spain).
- Authors
Navarrete-Navarro, Pedro; Rivera-Fernández, Ricardo; López-Mutuberría, Maria Teresa; Galindo, Inmaculada; Murillo, Francisco; Dominguez, José María; Muñoz, Angeles; Jimenez-Moragas, José Manuel; Nacle, Belén; Vázquez-Mata, Guillermo; Rivera-Fernández, Ricardo; López-Mutuberría, Maria Teresa; Dominguez, José María; Muñoz, Angeles; Jimenez-Moragas, José Manuel; Nacle, Belén; Vázquez-Mata, Guillermo
- Abstract
<bold>Objectives: </bold>To analyse 1-year mortality and functional disability outcomes and resource use in critical stroke patients admitted to ICU.<bold>Design and Setting: </bold>Multi-centre, prospective, observational study in 28 Spanish hospitals. PATIENTS. Patients admitted for acute stroke from March-August 1999.<bold>Intervention: </bold>Collection of data on: severity by Apache III and Glasgow Coma Score; neurological lesion, hospital and 1-year mortality; functional disability at 1 year by Barthel Index and Glasgow Outcome Scale; ICU length of stay, life support techniques, and neurosurgical interventions.<bold>Measurement and Results: </bold>We studied 132 patients: 21% with subarachnoid haemorrhage (SAH), 58% intracerebral haemorrhage (ICH), 20% ischaemic stroke (ISC); Apache III 63+/-29 ICU stay 13+/-12 days; 74% required mechanical ventilation. Hospital and 1-year mortality was 33% (22%:ISC, 32%:SAH, 37%:ICH) and 53.8% (66%:ISC, 39%:SAH, 54%:ICH), respectively. Age, APACHE III, and diagnosis defined hospital mortality. Age, APACHE III, and Glasgow Coma Score defined 1-year mortality. Barthel Index score improved ( P<0.001) between discharge and 1 year; 73% of patients presented severe disability at discharge vs. 26% at 1 year; 8% minimal/no disability at discharge vs. 43.3% at 1 year. Only 17% of subarachnoid haemorrhage patients presented severe disability at 1 year. Admission Apache III and hospital-discharge Barthel Index scores were related to functional outcome at 1 year.<bold>Conclusions: </bold>Critical stroke patients are characterized by high severity of illness, elevated resource consumption, and poor outcomes that are mainly influenced by severity and age. Glasgow Coma Score-measured neurological severity is the main determinant of future functional capacity, which is greater at 1 year.
- Subjects
SPAIN; MORTALITY; CEREBROVASCULAR disease patients; ISCHEMIA; LENGTH of stay in hospitals; BLOOD circulation disorders; CEREBROVASCULAR disease; STROKE-related mortality; APACHE (Disease classification system); COMPARATIVE studies; INTENSIVE care units; LONGITUDINAL method; RESEARCH methodology; MEDICAL cooperation; HEALTH outcome assessment; PROGNOSIS; RESEARCH; STROKE; LOGISTIC regression analysis; EVALUATION research; TREATMENT effectiveness; GLASGOW Coma Scale; BARTHEL Index
- Publication
Intensive Care Medicine, 2003, Vol 29, Issue 8, p1237
- ISSN
0342-4642
- Publication type
journal article
- DOI
10.1007/s00134-003-1755-6