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Erschienen in: Internal and Emergency Medicine 4/2017

01.06.2017 | IM - ORIGINAL

Predictors of in-hospital mortality and dependence at discharge in patients with MCA stroke with intravenous thrombolysis

verfasst von: Renata Dal-Prá Ducci, Marcos Christiano Lange, Viviane de Hiroki Flumignan Zétola

Erschienen in: Internal and Emergency Medicine | Ausgabe 4/2017

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Abstract

Early risk stratification of mortality and dependence is important for guiding medical decision-making in stroke care. The study aim is to evaluate whether there are any differences between risk factors for in-hospital mortality and dependence at discharge in patients with first-episode ischemic stroke in the middle cerebral artery (MCA) receiving intravenous thrombolysis (IVT) treatment. The study comprised a single-center cohort of patients admitted consecutively for first-episode MCA ischemic stroke. A logistic regression analysis was performed to determine the variables associated with in-hospital mortality and dependence at discharge. We included 169 patients (50.9% women) with a mean age of 64.1 ± 12.9 years and a median National Institute of Health Stroke Scale (NIHSS) score of 13 (range 3–26) at admission. Nineteen patients (11.2%) died as inpatients [the main cause of death was found to be infection (47.4%)]. The independent predictors for in-hospital mortality were: age (OR 1.09, 95% CI 1.03–1.15, p = 0.004) and NIHSS score (>17) at admission (OR 1.17, 95% CI 1.05–1.30, p = 0.004). Two other crude models used to analyze in-hospital mortality (age and symptoms-to-needle time, and age and symptomatic intracerebral hemorrhage) were significant. NIHSS score (>11) at admission (OR 1.29, 95% CI 1.17–1.42, p < 0.001) and large artery atherosclerosis stroke (OR 3.10, 95% CI 1.10–8.76, p = 0.031) were independently associated with dependence at discharge. Overall, the predictors for mortality and dependence in patients with first-episode MCA ischemic stroke treated with IVT were different. This knowledge might help to improve the management of this devastating disease.
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Metadaten
Titel
Predictors of in-hospital mortality and dependence at discharge in patients with MCA stroke with intravenous thrombolysis
verfasst von
Renata Dal-Prá Ducci
Marcos Christiano Lange
Viviane de Hiroki Flumignan Zétola
Publikationsdatum
01.06.2017
Verlag
Springer International Publishing
Erschienen in
Internal and Emergency Medicine / Ausgabe 4/2017
Print ISSN: 1828-0447
Elektronische ISSN: 1970-9366
DOI
https://doi.org/10.1007/s11739-016-1590-8

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