PREDICTING FACTORS OF PROLONGED MECHANICAL VENTILATION AFTER ENDOVASCULAR TREATMENT IN LARGE VESSEL OCCLUSION STROKE
European Stroke Journal
; 7(1 SUPPL):189, 2022.
Article
in English
| EMBASE | ID: covidwho-1928080
ABSTRACT
Background and aims:
Intensive Care Units(ICUs) are a necessary resource for many patients with large vessel occlusion stroke(LVOS) after endovascular treatment(EVT). However, ICUs have a limited availability of beds and ventilators, situation that has been worsened by the current Covid-19 pandemic. We analyze predicting factors for prolonged mechanical ventilation(PMV) after EVT in patients with LVOS.Methods:
Retrospective study of patients admitted to our stroke center from 2012-2019 for LVOS who were treated with EVT. We identified patients that required PMV(defined as >24h intubation with admission in ICU) after EVT, and evaluated the association with clinical and radiological factors on admission.Results:
N=438. 236(53.9%) women. Mean age 69(DE 14.6). 411(93.8%) anterior circulation stroke, 27(6.2%) posterior. 82(19%) required general anesthesia and intraprocedural intubation, and 47 of them(10.7%) required PMV. Median length of stay(LOS) in ICU 3 days(1-7). 12/47(25.5%) had prolonged LOS for another reason (6 neurological worsening, 4 hemodynamic instability, 1 respiratory infection, 1 no available beds at Stroke Unit). 19/47(44%) died and 22/47(52.4%) were functionally dependent at three months. Factors associated to a higher risk of PMV after EVT were basilar occlusion (OR=12.3, IC95%[5.3-28.4],p<0,001);ASPECTS ≤7 (OR=3, IC95%[1.4-6.1],p=0,003) and NIHSS ≥18 (OR=2.8, IC95%[1.3- 5.8],p=0,006). Patients with PMV had a higher risk of mortality (OR=6.5, IC95%[3.3-12.8],p<0,001) and functional dependence (OR=5.1, IC95%[2.4-1],p<0,001) at three months.Conclusions:
In our study, patients with basilar occlusion, high NIHSS and lower ASPECTS had higher probability of requiring PMV after EVT, which also led to worse outcome. These are aspects to consider in scenarios with limited availability of ICU beds.
aged; anterior circulation stroke; artificial ventilation; blood vessel occlusion; cerebrovascular accident; clinical evaluation; conference abstract; controlled study; female; general anesthesia; hemodynamics; human; IC95; intubation; length of stay; major clinical study; male; mortality risk; National Institutes of Health Stroke Scale; neurologic disease; outcome assessment; probability; respiratory tract infection; retrospective study; stroke unit
Full text:
Available
Collection:
Databases of international organizations
Database:
EMBASE
Type of study:
Prognostic study
Language:
English
Journal:
European Stroke Journal
Year:
2022
Document Type:
Article
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