H Nagel1, J Pinho2, D Hasan1, H Ridwan1, P Habib2, J B Schulz2, M Wiesmann1, A Reich2, O Nikoubashman3. 1. From the Departments of Neuroradiology (H.N., D.H., H.R., M.W., O.N.). 2. Neurology (J.P., P.H., J.B.S., A.R.), University Hospital RWTH, Aachen, Germany. 3. From the Departments of Neuroradiology (H.N., D.H., H.R., M.W., O.N.) onikoubashman@ukaachen.de.
Abstract
BACKGROUND AND PURPOSE: Because stroke therapy has changed with the introduction of endovascular stroke treatment as a standard approach, studies on intrahospital causes of death from stroke are no longer up-to-date. The purpose of this observational study was to present the causes of death during hospitalization of patients with ischemic stroke who received endovascular stroke treatment, with the focus on a differentiation of curative and secondary palliative treatment. MATERIALS AND METHODS: We studied a total cohort of 1342 patients who received endovascular stroke treatment in a tertiary stroke center (Aachen, Germany) between 2010 and 2020 and analyzed the causes of death in all 326 consecutive deceased patients. We distinguished between curative treatment and a secondary palliative approach and analyzed causes of death and treatment numbers across the years. RESULTS: In the entire cohort of 326 deceased patients, the most common cause of death was of a cerebrovascular nature (51.5%), followed by pneumonia and sepsis (25.8%) and cardiovascular causes (8.3%). Neurovascular causes constituted 75.8% of reasons for palliation. In the group with a secondary palliative approach, causes of death were neurovascular in 54.0% of patients and pneumonia and sepsis in 26.0% of patients. CONCLUSIONS: Cerebrovascular causes in patients with stroke play a major role in the intrahospital causes of death and reasons for palliation. Considering the large proportion of secondarily palliative-treated patients, reasons for palliation should be considered instead of causes of death to avoid concealment by, for example, life-terminating measures.
BACKGROUND AND PURPOSE: Because stroke therapy has changed with the introduction of endovascular stroke treatment as a standard approach, studies on intrahospital causes of death from stroke are no longer up-to-date. The purpose of this observational study was to present the causes of death during hospitalization of patients with ischemic stroke who received endovascular stroke treatment, with the focus on a differentiation of curative and secondary palliative treatment. MATERIALS AND METHODS: We studied a total cohort of 1342 patients who received endovascular stroke treatment in a tertiary stroke center (Aachen, Germany) between 2010 and 2020 and analyzed the causes of death in all 326 consecutive deceased patients. We distinguished between curative treatment and a secondary palliative approach and analyzed causes of death and treatment numbers across the years. RESULTS: In the entire cohort of 326 deceased patients, the most common cause of death was of a cerebrovascular nature (51.5%), followed by pneumonia and sepsis (25.8%) and cardiovascular causes (8.3%). Neurovascular causes constituted 75.8% of reasons for palliation. In the group with a secondary palliative approach, causes of death were neurovascular in 54.0% of patients and pneumonia and sepsis in 26.0% of patients. CONCLUSIONS: Cerebrovascular causes in patients with stroke play a major role in the intrahospital causes of death and reasons for palliation. Considering the large proportion of secondarily palliative-treated patients, reasons for palliation should be considered instead of causes of death to avoid concealment by, for example, life-terminating measures.
Authors: Adrian R Parry-Jones; Lizz Paley; Benjamin D Bray; Alex M Hoffman; Martin James; Geoffrey C Cloud; Pippa J Tyrrell; Anthony G Rudd Journal: Int J Stroke Date: 2016-01-05 Impact factor: 5.266
Authors: Jonathan Emberson; Kennedy R Lees; Patrick Lyden; Lisa Blackwell; Gregory Albers; Erich Bluhmki; Thomas Brott; Geoff Cohen; Stephen Davis; Geoffrey Donnan; James Grotta; George Howard; Markku Kaste; Masatoshi Koga; Ruediger von Kummer; Maarten Lansberg; Richard I Lindley; Gordon Murray; Jean Marc Olivot; Mark Parsons; Barbara Tilley; Danilo Toni; Kazunori Toyoda; Nils Wahlgren; Joanna Wardlaw; William Whiteley; Gregory J del Zoppo; Colin Baigent; Peter Sandercock; Werner Hacke Journal: Lancet Date: 2014-08-05 Impact factor: 79.321