Document Detail


Long-term outcome in intensive care unit survivors after mechanical ventilation for intracerebral hemorrhage.
MedLine Citation:
PMID:  14605538     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To evaluate long-term survival and functional outcome in intensive care unit survivors after mechanical ventilation for intracerebral hemorrhage. DESIGN: Retrospective chart review and prospective follow-up study. SETTING: Outpatient follow-up. PATIENTS: Between 1997 and 2000, 120 patients were mechanically ventilated for an intracerebral hemorrhage at our intensive care unit. Sixty-two patients were discharged from hospital (in-hospital mortality = 48%). Sixty patients were evaluated for survival and functional outcome (two were lost to follow-up). Time between discharge and follow-up was > or =1 yr and was a mean of 27 +/- 14 months (range, 12-56). INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Patients' physicians were first asked about survival, and patients or proxies were interviewed by phone. Barthel Index and modified Rankin Scale scores were collected, and demographic information and general data were reviewed. The estimated life-table survival curve after discharge was 64.6% at 1 yr and 57% at 3 yrs. In the 24 patients who died, the mean time between discharge and death was 5 +/- 6 months. Probability of death after discharge significantly increased if age at admission was >65 yrs (p <.01; odds ratio, 3.5; 95% confidence interval, 1.4-9.1) and if Glasgow Coma Scale score at discharge was <15 (p <.01; odds ratio, 3.9; 95% confidence interval, 1.6-9.5). In the 36 long-term survivors, Barthel Index was 67.5 +/- 15 (median +/- median absolute dispersion) and modified Rankin Scale score was 2.6 +/- 0.5. Fifteen patients (42%) had a slight or no disability (Barthel Index > or =90 and modified Rankin Scale score < or =2), whereas 21 patients (58%) had moderate or severe disability (Barthel Index < or =85 and modified Rankin Scale score >2). CONCLUSIONS: Probability of survival at 3 yrs after mechanical ventilation for an intracerebral hemorrhage was >50%. Age was an important determinant of long-term survival. Forty-two percent of long-term survivors were independent for activities of daily living. Only a few long-term survivors had a very high degree of disability.
Authors:
Antoine Roch; Pierre Michelet; Anne Céline Jullien; Xavier Thirion; Fabienne Bregeon; Laurent Papazian; Pierre Roche; William Pellet; Jean-Pierre Auffray
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Critical care medicine     Volume:  31     ISSN:  0090-3493     ISO Abbreviation:  Crit. Care Med.     Publication Date:  2003 Nov 
Date Detail:
Created Date:  2003-11-07     Completed Date:  2003-12-10     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0355501     Medline TA:  Crit Care Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2651-6     Citation Subset:  AIM; IM    
Affiliation:
Service de Réanimation Polyvalente, Hôpitaux Sud, Marseilles, France.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Cerebral Hemorrhage / mortality,  therapy*
Confidence Intervals
Female
Follow-Up Studies
Hospital Mortality*
Humans
Intensive Care Units
Male
Middle Aged
Probability
Respiration, Artificial*
Retrospective Studies
Survival Rate
Time Factors
Comments/Corrections
Comment In:
Crit Care Med. 2004 Jun;32(6):1431   [PMID:  15187541 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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