Prognostic factors for mortality in patients with cerebrovascular disease in Intensive Care Units

Abstract

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.