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Master Thesis

Évolution à 6 mois des accidents vasculaires cérébraux ventilés en réanimation - Étude ancillaire monocentrique : évaluation du parcours de soins et identification de facteurs d’évolution neurologique

Abstract : Introduction: prognosis of stroke patients requiring resuscitation is poorly known. No prognostic score dedicated to this population is currently validated. The objective of this study was to assess the outcome of ventilated stroke and identify predictive factors of neurologic progression at admission to intensive care unit (ICU). Methods: this was an observational, prospective, unicentric study conducted between January and May 2018, ancillary to SPICE multicenter trial (Stroke Prognosis in Intensive CarE). Stroke patients over 18, under mechanical ventilation for more than 24h were included. Neurological evaluation was assessed by modified Rankin scale (mRS) at discharge from ICU, M3 and M6. Poor prognosis was defined by mRS=4, neurological progression by the difference of mRS between discharge from ICU and M6. Two-way ANOVA was used to test statistical association between mRS at discharge from ICU and M6. Univariate logistic regression with χ2 independence test identified risk factors for poor neurological prognosis, mortality, and progression at M6. Results: 56 patients were included. There were 44 hemorrhagic strokes (79%) and 12 ischemic strokes (21%). Intra hospital mortality was 36%. One patient was lost to follow-up and one patient died before M3. At M6, 22 patients (65%) had mRS<4. None of the studied factors were statistically associated with mRS=4 at M6. There was no significant change in mRS between discharge from ICU and M6 (p = 0.92). Conclusion: neurological evolution of patients admitted for ventilated stroke in our institution is not associated with the usual criteria of mortality prediction. There is no change in mRS between discharge from the ICU and M6.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-03197155
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Submitted on : Tuesday, April 13, 2021 - 3:30:49 PM
Last modification on : Friday, September 3, 2021 - 3:32:55 AM

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  • HAL Id : dumas-03197155, version 1

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Marie-Hélène Pari. Évolution à 6 mois des accidents vasculaires cérébraux ventilés en réanimation - Étude ancillaire monocentrique : évaluation du parcours de soins et identification de facteurs d’évolution neurologique. Médecine humaine et pathologie. 2019. ⟨dumas-03197155⟩

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