Article
Predictors and consequences of pneumonia in critically ill patients with stroke.
Department of Medicine, Bridgeport Hospital, Yale-New Haven Health, Bridgeport, CT 06610, USA.
Journal of Critical Care (impact factor:
2.13).
04/2004;
19(1):16-22.
Source: PubMed
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Citations (0)
- Cited In (4)
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Article: Association of severe hypertension with pneumonia in elderly patients with acute ischemic stroke.
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ABSTRACT: Pneumonia is one of the most frequent complications in elderly patients with acute ischemic stroke. Although severe hypertension is often observed in the early phase of acute stroke, there are few studies of acute hypertension as a factor influencing the incidence of stroke-associated pneumonia (SAP) in elderly subjects with acute ischemic stroke. To assess the association of acute phase blood-pressure elevation with the incidence of SAP, we compared 10 elderly patients with acute ischemic stroke complicated with severe hypertension (≥ 200/120 mm Hg) with 43 patients with moderate hypertension (160-199/100-119 mm Hg), as well as with 65 control normotensive or mildly hypertensive (<160/100 mm Hg) controls on admission. Data were collected on known risk factors, type of ischemic stroke and underlying chronic conditions. The significance of differences in risk factors was analyzed using univariate and multivariate comparisons of 38 SAP cases and others, 8 SAP death cases and others, and 28 patients with poor outcome associated with in-hospital death or artificial feeding at discharge and others. After adjustment for potential confounding factors, the relative risk estimates for SAP, SAP death and poor outcome were 2.83 (95% confidence interval 1.14-7.05), 5.20 (1.01-26.8) and 6.84 (1.32-35.4), respectively, for severe hypertension relative to normotensive or mildly hypertensive controls. We conclude that severe hypertension on admission is an independent predictive factor for SAP in elderly patients with acute ischemic stroke.Hypertension Research 02/2012; 35(6):648-53. · 2.58 Impact Factor -
Article: Gastrointestinal disorders in elderly patients.
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ABSTRACT: Gastrointestinal disorders are common in elderly patients, and the clinical presentation, complications, and management may differ from those in younger patient. Most impairment occurs in the proximal and distal tract of the gastrointestinal system. Swallowing abnormalities with a wide span of symptoms and pelvic floor pathologies involving all the pelvic compartments are common. Acute abdomen, often from small bowel obstruction or mesenteric ischemia, can pose a diagnostic challenge, because a mild clinical presentation may hide serious visceral involvement. In this setting, the radiologist often is asked to suggest the appropriate management options and to guide the management.Radiologic Clinics of North America 08/2008; 46(4):755-71, vi. · 2.59 Impact Factor -
Article: Ventilator-associated pneumonia in critically ill stroke patients: frequency, risk factors, and outcomes.
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ABSTRACT: Our main objective was to assess incidence, risk factors, and outcomes of ventilator-associated pneumonia (VAP) in stroke patients. After obtaining approval from the Human Studies Committee, we reviewed the electronic records from our intensive care unit database of 111 stroke patients on mechanical ventilation for more than 48 hours. Thirty-six risk factors related to disease and general health status, and 8 related to care-all assigned a priori-were collected and analyzed. Selected factors with univariate statistical significance (P < .05) were then analyzed with multivariate logistic regression. Thirty-one patients developed pneumonia (28%). Methicillin-resistant Staphylococcus aureus (n = 12) and methicillin-sensitive S aureus (n = 7) were the most common pathogenic bacteria. Chronic lung disease, neurological status at admission as assessed by the National Institutes of Health Stroke Scale, and hemorrhagic transformation were the independent risk factors contributing to VAP. Worsening oxygenation index (arterial partial pressure of oxygen/fraction of inspired oxygen) and proton pump inhibitor use for ulcer prophylaxis were other potentially important factors. Pneumonia appears as a frequent problem in mechanically ventilated stroke patients. Chronic lung disease history, severity of stroke level at admission, and hemorrhagic transformation of stroke set the stage for developing VAP. The duration of both mechanical ventilation and intensive care unit stay gets significantly prolonged by VAP, but it does not affect mortality.Journal of critical care 11/2010; 26(3):273-9. · 2.13 Impact Factor
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Keywords
55 patients
acute stroke
additional 17 patients
adversely impacted
Aggressive preventive measures
brain-stem stroke
consequences
critically ill patients
higher admission acuity
mechanical ventilation
median 74
median 77
nosocomial pneumonia
Patients
pneumonia
pneumonia occurrence
Predictors
stroke patients
swallowing evaluation
