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01-08-2003 | Original

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: Pedro Navarrete-Navarro, Ricardo Rivera-Fernández, Maria Teresa López-Mutuberría, Inmaculada Galindo, Francisco Murillo, José María Dominguez, Angeles Muñoz, José Manuel Jimenez-Moragas, Belén Nacle, Guillermo Vázquez-Mata

Published in: Intensive Care Medicine | Issue 8/2003

Abstract

Objectives

To analyse 1-year mortality and functional disability outcomes and resource use in critical stroke patients admitted to ICU.

Design and setting

Multi-centre, prospective, observational study in 28 Spanish hospitals.

Patients

Patients admitted for acute stroke from March–August 1999.

Intervention

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.

Measurement and results

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.

Conclusions

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.

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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: Pedro Navarrete-Navarro
Ricardo Rivera-Fernández
Maria Teresa López-Mutuberría
Inmaculada Galindo
Francisco Murillo
José María Dominguez
Angeles Muñoz
José Manuel Jimenez-Moragas
Belén Nacle
Guillermo Vázquez-Mata
Publication date: 01-08-2003
Publisher: Springer-Verlag
Published in: Intensive Care Medicine / Issue 8/2003
Print ISSN: 0342-4642
Electronic ISSN: 1432-1238
DOI: https://doi.org/10.1007/s00134-003-1755-6

ACC 2024 Congress

Springer Medicine

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)

Abstract

Objectives

Design and setting

Patients

Intervention

Measurement and results

Conclusions

ACC 2024 Congress

Springer Medicine

Abstract

Objectives

Design and setting

Patients

Intervention

Measurement and results

Conclusions

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