Predictors of intensive care unit admission and mortality in patients with ischemic stroke: investigating the effects of a pulmonary rehabilitation program

摘要

Background The aim of this study was to investigate the predictors of intensive care unit (ICU) admission and mortality among stroke patients and the effects of a pulmonary rehabilitation program on stroke patients. Methods This prospective study enrolled 181 acute ischemic stroke patients aged between 40 and 90 years. Demographical characteristics, laboratory tests, diffusion-weighed magnetic resonance imaging (DWI-MRI) time, nutritional status, vascular risk factors, National Institute of Health Stroke Scale (NIHSS) scores and modified Rankin scale (MRS) scores were recorded for all patients. One-hundred patients participated in the pulmonary rehabilitation program, 81 of whom served as a control group. Results Statistically, one- and three-month mortality was associated with NIHSS and MRS scores at admission and three months ( p r =0.440, r =0.432, r =0.339 and r =0.410, respectively). One and three months mortality- ICU admission had a statistically significant relationship with parenteral nutrition ( p r =0.346, r =0.300, respectively; r =0.294 and r =0.294, respectively). Similarly, there was also a statistically significant relationship between pneumonia onset and one- and three-month mortality- ICU admission ( p r =0.217, r =0.127, r =0.185 and r =0.185, respectively). A regression analysis showed that parenteral nutrition (odds ratio [OR] =13.434, 95% confidence interval [CI] =1.148–157.265, p =0.038) was a significant predictor of ICU admission. The relationship between pulmonary physiotherapy (PPT) and ICU admission- pneumonia onset at the end of three months was statistically significant ( p =0.04 and p =0.043, respectively). Conclusion This study showed that PPT improved the prognosis of ischemic stroke patients. We believe that a pulmonary rehabilitation program, in addition to general stroke rehabilitation programs, can play a critical role in improving survival and functional outcomes. Trial registration NCT03195907 . Trial registration date: 21.06.2017 ‘Retrospectively registered’.