Characterization of patients with an anatomopathological diagnosis of cerebrovascular disease
Keywords:
cerebrovascular diseases, intensive care unit, diagnosis, autopsy.Abstract
Introduction: In Cuba, cerebrovascular diseases (CVD) are very common non-communicable chronic conditions.
Objectives: Characterize patients from intensive care unit with a pathological diagnosis of CVD.
Methods: Observational, descriptive and transversal study in a sample of 176 patients. Variables: Age (19-39 years, 40-59 years, 60-100 years), sex, type of CVD (hemorrhagic, ischemic), APACHE II scale (= 15, > 15 score) and Glasgow coma on admission (= 8, > 8 score), mechanical ventilation (yes, no), length of stay (= 7, > 7 days) and direct cause of death. Frequencies, measures of central tendency, chi-square and Student's t tests (significance level of 5%) were calculated.
Results: Hemorrhagic cerebrovascular disease, male sex (52.8%) and the age group of 60-100 years (64.8%) predominated. The mean age was 63.8 years. The average value of the APACHE II and Glasgow scales was 21.6 and 6.5. 97.6% received mechanical ventilation. The mean stay was 7.0 days. Severe cerebral edema was the main cause of direct death (79.3%).
Conclusions: There is a predominance of hemorrhagic CVD, in male patients, aged 60-100 years, APACHE II score > 15, Glasgow score = 8, ventilated patients, stay = 7 days and intense cerebral edema.
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References
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2. Rahbar MH, Medrano M, Diaz Garelli F, Gonzalez Villaman C, Saroukhani S, Kim S, et al. Younger age of stroke in low-middle income countries is related to healthcare access and quality. Annals Clin Transl Neurol. 2022; 9(3): 415-27. DOI: 10.1002/acn3.51507
3. Jacob MA, Ekker MS, Allach Y, Cai M, Aarnio K, Arauz A, et al. Global Differences in Risk Factors, Etiology, and Outcome of Ischemic Stroke in Young Adults-A Worldwide Meta-analysis: The GOAL Initiative. Neurology. 2022; 98(6):e573-e588. DOI: 10.1212/WNL.0000000000013195
4. Kleindorfer DO, Towfighi A, Chaturvedi S, Cockroft KM, Gutierrez J, Lombardi-Hill D, et al. 2021 Guideline for the Prevention of Stroke in Patients With Stroke and Transient Ischemic Attack: A Guideline From the American Heart Association/American Stroke Association. Stroke. 2021; 52(7):e364-e467. DOI: 10.1161/STR.0000000000000375
5. Qin C, Yang S, Chu YH, Zhang H, Pang XW, Chen L, et al. Signaling pathways involved in ischemic stroke: molecular mechanisms and therapeutic interventions. Signal Transduct Target Ther. 2022; 7(1):215. DOI:10.1038/s41392-022-01064-1
6. Béjot Y, Duloquin G, Thomas Q, Mohr S, Garnier L, Graber M, et al. Temporal Trends in the Incidence of Ischemic Stroke in Young Adults: Dijon Stroke Registry. Neuroepidemiology. 2021; 55(3):239-44. DOI: 10.1159/000516054.
7. Feigin VL. Anthology of stroke epidemiology in the 20th and 21st centuries: Assessing the past, the present, and envisioning the future. Int J Stroke. 2019; 14(3):223-37. DOI: 10.1177/1747493019832996.
8. Pucciarelli G, Rebora P, Arisido MW, Ausili D, Simeone S, Vellone E, et al. Direct Cost Related to Stroke: A Longitudinal Analysis of Survivors After Discharge From a Rehabilitation Hospital. J Cardiovasc Nurs. 2020; 35(1):86-94. DOI: 10.1097/JCN.0000000000000620
9. Wang X, Liang M, Zeng F, Wang Y, Yang Y, Nie F, et al. Predictive role of modifiable factors in stroke: an umbrella review. BMJ Open. 2022; 12(6):e056680. DOI: 10.1136/bmjopen-2021-056680
10. Dabilgou AA, Dravé A, Kyelem JMA, Zoungrana R, Napon C, Millogo A, et al. Frequency of recurrent stroke in Burkina Faso: an observational hospital based study of 6 months. Pan Afr Med J. 2021; 40:108. DOI: 10.11604/pamj.2021.40.108.23098
11. Hernández Ruiz A, Le'Clerc Nicolás J, González González M, Poyo Indra JD, Viñas Rodríguez D. Factores pronósticos de mortalidad en pacientes graves con enfermedades neurológicas agudas no traumáticas. AMC. 2020 [acceso: 04/11/2022]; 24(6): e7570. Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S1025-02552020000600005&lng=es
12. Vila García LO, Hernández Pedroso W, Castillo López B, Ramos Ravelo D, Lemes Rodríguez A, Santana Sánchez R. Caracterización de los factores modificables asociados a la letalidad hospitalaria del ictus. Rev Cub Med Mil. 2017 [acceso: 04/11/2022]; 46(2):163-76. Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S0138-65572017000200007&lng=es
13. Giralt Steinhauer E, Jiménez Balado J, Fernández Pérez I, Rey Álvarez L, Rodríguez Campello A, Ois Á, Cuadrado Godia E, et al. Genetics and Epigenetics of Spontaneous Intracerebral Hemorrhage. Int J Mol Sci. 2022; 23(12):6479. DOI: 10.3390/ijms23126479
14. Bushnell CD, Kucharska Newton AM, Jones SB, Psioda MA, Johnson AM, Daras LC, et al. Hospital Readmissions and Mortality Among Fee-for-Service Medicare Patients With Minor Stroke or Transient Ischemic Attack: Findings From the COMPASS Cluster-Randomized Pragmatic Trial. J Am Heart Assoc. 2021; 10:e023394. DOI: 10.1161/JAHA.121.023394
15. Herath HMMTB, Rodrigo C, Alahakoon AMBD, Ambawatte SB, Senanayake S, Senanayake B, et al. Outcomes of stroke patients undergoing thrombolysis in Sri Lanka; an observational prospective study from a low-middle income country. BMC Neurol. 2021; 21(1):434. DOI: 10.1186/s12883-021-02475-3
16. Stamenkovic M, Radmilo L, Jovicevic M, Rabi-Žikic T, Žarkov M, Ružicka-Kaloci S, et al. Clinical Characteristics of Patients with Acute Ischemic Stroke Previously Vaccinated Against COVID-19. J Stroke Cerebrovasc Dis. 2022; 31(6):106483. DOI: 10.1016/j.jstrokecerebrovasdis.2022.106483
17. Silina EV, Rumyantceva SA, Stupin VA, Parfenov VA, Bolevich SB. Early predictive blood markers of hemorrhagic stroke - influence of cytoflavin therapy. Can J Physiol Pharmacol. 2021; 99(1):72-9. DOI: 10.1139/cjpp-2020-0277
18. Masiliunas R, Dapkute A, Grigaite J, Lape J, Valancius D, Bacevicius J, et al. High Prevalence of Atrial Fibrillation in a Lithuanian Stroke Patient Cohort. Medicina (Kaunas). 2022; 58(6):800. DOI: 10.3390/medicina58060800
19. Ohya Y, Matsuo R, Sato N, Irie F, Nakamura K, Wakisaka Y, Investigators for Fukuoka Stroke Registry. Causes of ischemic stroke in young adults versus non-young adults: A multicenter hospital-based observational study. PLoSOne. 2022; 17(7):e0268481. DOI: 10.1371/journal.pone.0268481
20. Pérez Ponce LJ, Barletta Farías RC, Iturralde González LO, Castro Vega G, Santana Guerra DR, León Estela RM. Caracterización clínica de pacientes fallecidos por enfermedad cerebrovascular. Rev Finlay. 2019 [acceso: 04/11/2022]; 9(3):161-71. Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S222124342019000300161&lng=es
21. Torres Serrano KR. Características clínicas, epidemiológicas y de neuroimagen en infarto cerebral maligno extenso y su asociación a mortalidad en pacientes hospitalizados en servicio de medicina y emergencia del Hospital Hipólito Unanue Tacna 2017-2019 [Tesis de médico cirujano]. Perú: Universidad Nacional Jorge Basadre Grohmann; 2021. [acceso: 04/11/2022]. Disponible en: http://repositorio.unjbg.edu.pe/bitstream/handle/UNJBG/4288/1960_2021_torres_-serrano_kr_facs_medicina_humana.pdf?sequence=1&isAllowed=y
22. Martínez Llópiz YI, García Cañete IM. Morbilidad y mortalidad en pacientes con ventilación mecánica invasiva en la Unidad de Cuidados Intensivos del Hospital "Celia Sánchez Manduley". MEDISAN. 2017 [acceso: 04/11/2022]; 21(6): 664-71. Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S1029-30192017000600004&lng=es
23. Ramírez Ramírez G, Garrido Tapia EJ, Manso López AM, Graña Mir JL, Martínez Vega A. Mortalidad por accidentes cerebrovasculares en el Hospital Clínico Quirúrgico Lucía Íñiguez Landín, Holguín, Cuba, 2012-2017. CCM. 2019 [acceso: 04/11/2022]; 23(1):159-74. Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S156043812019000100159&lng=es
24. Garrote M, Lovesio C, Jure L. Accidentes cerebrovasculares isquémicos. En: Lovesio C, editor. Medicina Intensiva. Séptima edición. Ciudad autónoma de Buenos Aires: Corpus Libros Médicos y Científicos; 2017. p. 1663-724.
Published
2023-11-04
How to Cite
1.
Sanabria Blanco OL, Leal Capdesuñer O, García Gómez A, García Alvarez PJ, Adelá Rives Y, Martínez Prieto J. Characterization of patients with an anatomopathological diagnosis of cerebrovascular disease. Rev Cubana Med Milit [Internet]. 2023 Nov. 4 [cited 2025 Feb. 3];52(4):e02302904. Available from: https://revmedmilitar.sld.cu/index.php/mil/article/view/2904
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