Prognosis of stroke patients undergoing mechanical ventilation.

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.