[Prognosis of stroke patients undergoing intubation and mechanical ventilation]

Abstract

Background: To determine the outcome of patients with acute stroke requiring intubation and mechanical ventilation.

Design: review of the medical records of 33 patients with stroke intubated at presentation in hospital and not requiring neurosurgery or angiography.

Setting: intensive care unit (ICU) of a non teaching hospital.

Interventions: none.

Measurements: the mean age (SD) was 73.3 (7.7), min 46 max 87, 18 males and 15 females, mean Glasgow coma scale (GCS) (min-max) was 4.5 (3-8).

Results: The hospital mortality of intubated patients was 78.7% (26/33), mortality in the ICU was 69.69% (23/33). In survivors: infarction/hemorrhage (INF/HEM) were 4/3, mean age (SD) 75.2 (5.6), males/females 4/3, mean GCS (min-max) 5.2 (3-7), days in the ICU mean (DS) 18 (20.2). In patients who died: INF/HEM were 10/16, mean age (SD) 72.8 (8.2), males/females 14/12, mean GCS (min-max) 4.3 (3-8), days in the ICU mean (DS) 5.5 (8). The difference between groups was significant (p < 0.05) only for ICU staying. The evolution to brain death was observed in 10 cases (30.3%).

Conclusions: The overall prognosis of patients with acute stroke intubated and ventilated at presentation in hospital for deterioration is severe but the observed survival rate is sufficient to justify this treatment even in cases not requiring other invasive procedures like neurosurgery or angiography. A significant fraction of stroke patients is part of the potential organ donors pull.