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Revista Habanera de Ciencias Médicas
On-line version ISSN 1729-519X
Abstract
HERNANDEZ OLIVA, Mijail; PADRON MORA, Maidolys; HERNANDEZ JIMENEZ, Airón and NURQUEZ MERLAN, Adrián. Prognostic factors for mortality in patients with cerebrovascular disease in Intensive Care Units. Rev haban cienc méd [online]. 2018, vol.17, n.4, pp. 567-578. ISSN 1729-519X.
Introduction:
Cerebrovascular diseases (CVD) are the second cause of mortality in the Western world, which are only surpassed by cardiovascular diseases and cancer.
Objective:
To identify prognostic factors for mortality in patients admitted to Intensive Care Units with cerebrovascular diseases.
Material and Methods:
An observational, analytic, retrospective study was conducted in a population of 163 patients (deceased,73; and alive, 90).
Results:
The mean age was 64±13,9 (p=0,300). A total of 72(44, 2%) patients presented a complication, and 46(28, 2%) needed ventilation (p=0,000). The greater number of deceased resulted from hemorrhagic CVD 46(63%). Mortality in the ventilated patients was 83, 3%. The greater number of the 71 patients that presented complications died of respiratory sepsis, reporting 14(50%) patients. From the univariate analysis, the deceased patients presented an APACHE II≥ 15 (OR=10,4; p=0,000; CI 95%=4,9-21,7); a Glasgow scale ≤ 9 (OR=11,4; p=0,000; CI 95%=5,5-23,8); a hemorrhagic cerebrovascular disease (OR=3,9; p=0,000; CI 95%=2,1-7,7); and/or needed ventilation (OR=11,1; p=0,000; CI 95%=4,7-26,3). The multivariate analysis determined that the variables that were significantly related to mortality were the APACHE II ≥15 points (OR=4,4; p=0,001; CI 95%=1,9-10,2); and Glasgow ≤ 9 (OR=4,4; p=0,001; CI 95%=1,8-10,6).
Conclusions:
The prognostic factors for mortality identified in the patients were the APACHE II ≥15 points at 24 hours after admission, and the Glasgow coma scale ≤ 9 points on admission. Pneumonia was the major complication in the deceased patients.
Keywords : Cerebrovascular diseases; prognostic factors; mortality; Intensive Care Unit; Cuba.