medigraphic.com
ISSN 2225-4676 (Electronic)

2019, Number 2

<< Back Next >>

Rev Cubana Neurol Neurocir 2019; 9 (2)

Prognostic factors of death in patients with cardioembolic cerebral infarction

Morales CE, Bustamante SA, Vargas AGA

Language: Spanish
References: 28
Page: 1-15
PDF size: 455.20 Kb.


ABSTRACT

Objective: To determine the prognostic factors of death in cardioembolic cerebral infarction.
Methods: An observational, analytical, cohort type study was carried out at the Dr. Carlos J. Finlay hospital, from January 2016 to December 2017, whose sample was represented by 63 patients. Variables such as age, sex, severity and size of the infarction, neurological and non-neurological complications, latency at admission, use of antithrombotic drugs and status at discharge were taken into account. Univariate statistical analysis was performed using the Chi-square test, and those variables with value of p <0.05 were subjected to a binomial multivariate logistic regression study.
Results: Univariate analysis showed a significant association with death in patients with severe stroke, late onset of anticoagulation and the presence of non-neurological complications. In multivariate processing it was obtained that patients with respiratory failure were 17 times more likely to die, followed by decompensated heart failure with which the risk of dying was almost 8 times higher. Likewise, in patients with internal disorder, the risk increased 6 times.
Conclusions: Prognostic factors of death were respiratory failure, decompensated heart failure and internal disorders, mainly respiratory acidosis.


REFERENCES

  1. Kamel H, Healey JS. Cardioembolic Stroke. Circ. Res. 2017;120(3):514-26.

  2. Feigin VL, Norrving B, Mensah GA. Global Burden of Stroke. Circ. Res. 2017;120(3):439-48.

  3. Ministerio de Salud Pública. Anuario Estadístico de Salud 2016. Anuario estadístico. 2016 [citado: 16/07/2018]. Disponible en: http://files.sld.cu/dne/files/2017/05/Anuario_Estadístico_de_Salud_e_2016

  4. Bogiatzi C, Hackam D, McLeod A, Spence J. Secular trends in ischemic stroke subtypes and stroke risk factors. Stroke. 2014;45:3208-13.

  5. Guzmán JD. Ictus cardioembólico: epidemiología. Neurología. 2012;27(Supl 1):4-9.

  6. Álvarez Expósito D. Factores pronósticos en el infarto cerebral cardioembólico. Hospital “Clínico Quirúrgico Manuel Ascunce Domenech”. [Tesis para optar por el Título de Especialista de I Grado en Neurología]. Camagüey: Universidad de Ciencias Médicas; 2013.

  7. O’Carroll CB, Barrett KM. Cardioembolic Stroke. CONTINUUM. 2017;23(1):111-32.

  8. Ferro JM. Cardioembolic stroke: an update. Lancet Neurol. 2003;2(3):177-88.

  9. Jerjes-Sánchez C, Cantú-Brito C, Arauz A, Sánchez A, Zárate J, Riveray A. Guías para Anticoagulación y Trombolisis del Tromboembolismo Venoso, Infarto con Elevación del ST, Cardioembolismo Cerebral y del Infarto Cerebral Agudo. Arch.Cardiol. Mex. 2017;87(1):1-66.

  10. Lyden P, Brott T, Tilley B, Welch KM, Mascha EJ, Levine S, et al. Improved reliability of the NIH Stroke Scale using video training. NINDS TPA Stroke Study Group. Stroke. 1994;25(11):2220-6.

  11. Stepke FL. Pautas éticas internacionales para la investigación biomédica en seres humanos. Consejo de Organizaciones Internacionales de las Ciencias Médicas (CIOMS). Ginebra; 2002.

  12. Henninger N, Goddeau RP, Karmarkar A, Helenius J, McManus DD. Atrial Fibrillation Is Associated with a Worse 90-Day Outcome Than Other Cardioembolic Stroke Subtypes. Stroke. 2016;47(6):1486-92.

  13. Arboix A, Alio J. Acute cardioembolic cerebral infarction: answers to clinical questions. Curr. Cardiol. Rev. 2012;8(1):54-67.

  14. Sánchez OC, Sauceda SF, Zepeda VA. Utilidad pronóstica de la escala neurológica para evaluación de la enfermedad vascular cerebral. Medicina Interna de México. 2011;27(4):344.

  15. Cantú-Brito C, Ruiz-Sandoval J, Murillo-Bonilla L, Chiquete E, León-Jiménez C, Arauz A. Manejo agudo y pronóstico a un año en pacientes mexicanos con un primer infarto cerebral: resultados del estudio multicéntrico PREMIER. Rev. Neurol. 2010;51(11):641-9.

  16. Ambrosy AP, Fonarow GC, Butler J, Chioncel O, Greene SJ, Vaduganathan M, et al. The global health and economic burden of hospitalizations for heart failure: lessons learned from hospitalized heart failure registries. J. Am. Coll. Cardiol. 2014;63(12):1123-33.

  17. Goldstein L, Husseini NE. Neurología y Cardiología: puntos de contacto. Rev. Esp. Cardiol. 2011;64(4):319-27.

  18. Ruiz GP, Verdecía AT, Pérez YV, Brito GC. Mortalidad en la enfermedad cerebrovascular en el Hospital General Docente «Enrique Cabrera», La Habana. Revista Uruguaya de Enfermería. 2017 [citado: 29/08/2018];12(1):46-58. Disponible en: http://rue.fenf.edu.uy/index.php/rue/article/view/213

  19. Morady F, Zipes DP. Fibrilación auricular: manifestaciones clínicas, mecanismos y tratamiento. Cap. 38. En: Mann D, Zipes D, Libby P, Bonow R. Tratado de cardiología. Braunwald. 10. ed. España: Elsevier Health Sciences; 2016. p.798-806.

  20. Spence JD. Cardioembolic stroke: everything has changed. Stroke and Vascular Neurology. 2018;3(2):76-83.

  21. Gladstone DJ, Bui E, Fang J, Laupacis A, Lindsay MP, Tu JV, et al. Potentially preventable strokes in high-risk patients with atrial fibrillation who are not adequately anticoagulated. Stroke. 2009;40(1):235-40.

  22. Benavente L, Calleja S, de la Vega V, García J, Lahoz CH. Oral anticoagulation in elderly patients as secondary prevention of cardioembolic strokes. Int. Arch. Med. 2010;3:8.

  23. Palm F, Kraus M, Safer A, Wolf J, Becher H, Grau AJ. Management of oral anticoagulation after cardioembolic stroke and stroke survival data from a population based stroke registry (LuSSt). BMC Neurol. 2014;14:199.

  24. Hallevi H, Albright KC, Martin-Schild S, Barreto AD, Savitz SI, Escobar MA, et al. Anticoagulation after cardioembolic stroke: to bridge or not to bridge? Arch.Neurol. 2008;65(9):1169-73.

  25. Kirchhof P, Benussi S, Kotecha D, Ahlsson A, Atar D, Casadei B, et al. Guía ESC 2016 sobre el diagnóstico y tratamiento de la fibrilación auricular, desarrollada en colaboración con la EACTS. Rev. Esp. Cardiol. 2017;70(1):50.E1-50.E84.

  26. Nakase T, Ishikawa T. The Introduction Timing of Oral Anticoagulants in the Early Phase of Acute Stroke Patients. J. Cardiol. Clin. Res. 2017;5(1):1093.

  27. Hart RG, Diener HC, Coutts SB, Easton JD, Granger CB, O’Donnell MJ, et al. Embolic strokes of undetermined source: the case for a new clinical construct. Lancet Neurol. 2014;13:429-38.

  28. Tobe J, Bogiatzi C, Munoz C, Tamayo A, Spence JD. Transcranial Doppler is Complementary to Echocardiography for Detection and Risk Stratification of Patent Foramen Ovale. Can. J. Cardiol. 2016;32(8):986.e9-986.e16.




2020     |     www.medigraphic.com