BACKGROUND: Patients with severe stroke defined as NIHSS score >17 constituting about 15-20% of cerebrovascular accident require admission into the Intensive Care Unit (ICU). However the benefit of ICU admission for stroke patients remains controversial. Aim & Objectives: To determine the characteristics and outcome of patients with cerebrovascular accident managed at the Intensive Care Unit of University of Benin Teaching Hospital. METHODOLOGY: Demographic characteristics, clinical features and course, treatment options and outcome of all stroke patients admitted in ICU from January 2002 to January 2012 were retrieved from the hospital records and analyzed. A patient before and after each stroke patient were selected as controls for the study. Primary outcome variable was ICU mortality, type of stroke whether ischemic or haemorrhagic, duration of stay, whether patients were transferred from the medical/stroke ward or from the accident and emergency department of the hospital. RESULTS: A total of thirty six (36) stroke patients were admitted into the ICU within the study period accounting for 5.6% of the total ICU admissions. The male: female ratio is 2:1 and patients aged >60 years accounted for 55.6%. Stroke patients admitted into ICU had a mortality rate of 77.8%. Patients with severe stroke admitted into the ICU were 4 times more likely to die compared to non-stroke patients in the ICU (p=0.002, OR=4.472). However, severe stroke had no significant impact on duration of ICU stay (p=0.454, OR=1.464). CONCLUSION: Stroke patients have a high mortality in the intensive care unit that is independent on the type and route of admission. Provision of the support equipment and instruments required for high dependency service in the intensive care unit and early admission should improve the outcome.
BACKGROUND:Patients with severe stroke defined as NIHSS score >17 constituting about 15-20% of cerebrovascular accident require admission into the Intensive Care Unit (ICU). However the benefit of ICU admission for strokepatients remains controversial. Aim & Objectives: To determine the characteristics and outcome of patients with cerebrovascular accident managed at the Intensive Care Unit of University of Benin Teaching Hospital. METHODOLOGY: Demographic characteristics, clinical features and course, treatment options and outcome of all strokepatients admitted in ICU from January 2002 to January 2012 were retrieved from the hospital records and analyzed. A patient before and after each strokepatient were selected as controls for the study. Primary outcome variable was ICU mortality, type of stroke whether ischemic or haemorrhagic, duration of stay, whether patients were transferred from the medical/stroke ward or from the accident and emergency department of the hospital. RESULTS: A total of thirty six (36) strokepatients were admitted into the ICU within the study period accounting for 5.6% of the total ICU admissions. The male: female ratio is 2:1 and patients aged >60 years accounted for 55.6%. Strokepatients admitted into ICU had a mortality rate of 77.8%. Patients with severe stroke admitted into the ICU were 4 times more likely to die compared to non-strokepatients in the ICU (p=0.002, OR=4.472). However, severe stroke had no significant impact on duration of ICU stay (p=0.454, OR=1.464). CONCLUSION:Strokepatients have a high mortality in the intensive care unit that is independent on the type and route of admission. Provision of the support equipment and instruments required for high dependency service in the intensive care unit and early admission should improve the outcome.
Entities:
Keywords:
High mortality; ICU admission; Nigeria; Severe cerebrovascular accident
Authors: David A Gruenberg; Wayne Shelton; Susannah L Rose; Ann E Rutter; Sophia Socaris; Glenn McGee Journal: Am J Crit Care Date: 2006-09 Impact factor: 2.228
Authors: J E Zimmerman; W A Knaus; J A Judson; J H Havill; R V Trubuhovich; E A Draper; D P Wagner Journal: Crit Care Med Date: 1988-04 Impact factor: 7.598