PROGNOSIS OF STROKE PATIENTS UNDERGOING MECHANICAL VENTILATION

Objective: to determine the outcome of stroke patients undergoing mechanical ventilation. Design: retrospective chart review and follow-up telephone interview. Setting: medical ICU in a multidisciplinary university hospital. Patients and participants: 199 stroke patients from 1984-1989 where the final diagnosis was stroke. Interventions: all patients were admitted for the need of mechanical ventilation. Measurements and results: demographic information, previous relevant diseases, stroke type, general clinical and neurological data, biochemical variables, severity of illness were recorded for the first 24 h following ICU admission. A 1-year follow-up was performed, including mortality and functional status of survivors. Of 170 eventually analyzable patients, 123 (72.4%) died during their ICU stay and 156 (91.8%) during the first year. Three variables were independently associated with one-year mortality: Glasgow score <10 (p<0.003), bradycardia (p<0.001), absence of brainstem reflexes (p<0.0004). Conclusion: overall prognosis of stroke needing mechanical ventilation is poor, strongly linked to symptoms of neurological impairment.