Severe stroke: prognosis of ventilated patients

Objective. To determine the outcome of patients with severe stroke who required invasive mechanical ventilation. Materials and Methods. A retrospective study including all stroke patients admitted to the ICU during the last 4 years (2020 and 2023). The primary endpoint was ICU mortality. Results. Thirty-five patients, 20 of them male (sex ratio: 1,3), aged 56,7 ± 18,8 [5 - 79] years were included. Stroke was hemorrhagic in 15 patients (42,8%). 30 patients were intubated. Glasgow score before intubation was 7,4 ± 2,7 [5-13]. Arterial hypertension was found in 65,7 % and diabetes in 42,8% of patients. Three patients were on vitamin K antagonist and three others on antiplatelets. Blood glucose on admission was 1.94 ± 0.72 g/l and systolic blood pressure 152 ± 31 mm Hg. Glasgow score was 6.6 ± 1.9 in intubated patients and 12.4 ± 1.7 in non-intubated patients. Tracheostomy was performed in 28.5% and prolonged the length of stay by 25.2 ± 8.3 days (p: 0.005). The case fatality rate for ventilated patients was 93.5%. No patients were managed by the organ and tissue procurement coordinating team. Conclusion. The prognosis of ventilated strokes is extremely poor, raising the question of early diagnosis and medical and neuro-intensive management in the acute phase