Risk factors for in-hospital mortality after stroke
Notice bibliographique
Résumé
Introduction: Stroke is the most prevalent neurological disorder in Brazil and worldwide. It is characterized by focal involvement in cerebral blood circulation, leading to sensory, motor, and cognitive alterations. Ischemic stroke (IS) is the most prevalent type, characterized by the interruption of blood flow due to vessel obstruction, resulting in the formation of ischemic areas in the brain and, consequently, temporary or permanent clinical repercussions. Objective: To assess risk factors for in-hospital mortality in patients after IS. Method: This is a prospective cohort study that included patients with a primary diagnosis of IS, admitted within 24 hours of symptom onset, and diagnosed using cranial computed tomography. Data were collected prospectively on a daily basis, actively seeking patients in the hospital's emergency sectors from admission to discharge. Sociodemographic, clinical, previous history, severity, complications, hospitalization, and outcomes variables were analyzed using various statistical methods, including the Mann-Whitney test, Pearson's Chi-square test, Fisher's exact test, and Poisson regression models to evaluate relationships between dependent and independent variables. Results: The study included 91 patients, with 53% females and 47% males, with a mean age of 65 (SD=13.9) years. Regarding IS types and complications, IS without other alterations stood out (84.6%), followed by extensive or malignant IS (9.9%), and lastly, IS with hemorrhagic transformation (5.5%). Concerning reperfusion therapy, the study showed that 22% of patients underwent intravenous thrombolysis, with 44.8% arriving within four hours and 30 minutes of symptom onset. Regarding complications and outcomes during hospitalization, 73.6% were discharged, and 25.3% died in the hospital. Patients with a higher likelihood of in-hospital death were those with malignant or extensive IS (Consciousness Impairment [CI] = 42, p < 0.001), patients with National Institutes of Health Stroke Scale (NIHSS) (CI = 4.89, p = 0.008), absence of bilateral pupillary light reflex (CI = 5.90, p = 0.009), anticoagulant use (CI = 6.84, p = 0.005), respiratory infection (CI = 8.85, p = 0.017), elevated C-reactive protein levels (CI = 248, p < 0.001), need for Intensive Care Unit (ICU) (CI = 25.39, p < 0.001), mechanical ventilation (CI = 138, p < 0.001), and use of hospital neuromuscular blockers (CI = 12.59, p = 0.033). Additionally, patients with Alberta Stroke Program Early Computed Tomography Score between 0 and 5 and NIHSS greater than 16 had a significantly higher odds ratio for in-hospital death. Conclusion: Patients with more severe conditions, greater cerebral involvement, and at least one complication during hospitalization had a higher risk of in-hospital death. Distance did not significantly influence the mortality of IS patients, and not reaching the therapeutic window or not undergoing thrombolysis were not risk factors for death.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,002 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,003 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».