Research Of The Death Risk Factors In Patients With Stroke In The Neurological Intensive Care Unit

Background Stroke with high morbidity and high mortality and morbidity, not only seriously affect the patient’s health, but also bring heavy burden to the society and family. Worldwide, as people focus on stroke, the incidence of European countries has declined, but in our country, as the aging process continues to accelerate, the incidence of stroke and other chronic diseases of the elderly is growing rapidly. In addition, as people living standard continuously provide, also make the risk factors such as hypertension, hyperlipidemia and diabetes increased year by year, rising incidence of stroke. There are many patients suffering from stroke each year, resulting in disability or death. In recent years, with the neurological intensive care unit (NICU) to carry out, the mortality of hospitalized patients with stroke was declined. However, the patients admitted to NICU always with severe symptoms, or appear serious complications In a short period of time, most of the final outcomes were disability and death. Therefore, to analysis the risk factors of poor prognosis in patients with stroke and investigate the death causes of stroke, to reduce the neurology mortality in patients with stroke to provide clinical basis to improve its prognosis.Purpose:To investigate the risk factors of death in patients with stroke in the neurological intensive care unit (NICU)so as to reduce the mortality of stroke and improve clinical outcomes.Methods:To collect stroke-patient’s conditions in hospital from July 2005 to March 2014 in neurological intensive care unit (NICU) of Zhong da Hospital. The cases of death group and control group were 207 respectively. Collected the clinical and laboratory data, including gender, age, type of stroke (cerebral hemorrhage, cerebral infarction), treatment, mechanical ventilation, nasogastric tube, catheter), past medical history, history of diabetes, a history of stroke, hypertension, heart disease, chronic obstructive pulmonary disease), midline shift, coma, high fever, blood routine, blood glucose, mean arterial pressure, plasma albumin, potassium, uric acid, APACHE Ⅱ score and complications (lung infection, gastrointestinal bleeding, brain herniation and thromboembolism).The collecting data was analyzed with single factor logistic regression analysis and the multi-factor Logistic regression analysisResults:1.Single factor logistic regression analysis showed that there were no significant difference between two groups of white blood cell count on admission, mean arterial pressure, uric acid, plasma albumin, potassium (P>0.05).age, coma, high fever, midline shift, pulmonary infection, mechanical ventilation, brain herniation, history of stroke, heart disease, indwelling gastric tube and tube urine, blood glucose on admission, APACHE Ⅱ scoring 13 indexes such as the difference between death and the death group was statistically significant (P< 0.05).2. The multi-factor Logistic regression analysis showed that coma, lung infection, mechanical ventilation, history of heart disease, nasogastric tube, fever, catheter, brain herniation, APACHE Ⅱ score for independent related factors of death in patients with severe stroke (P< 0.05), the OR value and 95% CI according to the strength:40.095 (95%CI:12.770～125.887)、10.736 (95%CI:3.287～35.063),8.772 (95%CI:1.745～44.091)、7.034 (95%CI:3.239～15.280),6.884 (95%CI:2.978～15.913),5.433 (95%CI:2.632～11.213),3.255 (95%CI: 5.201～50.798)、2.884 (95%CI:1.210～6.873)、2.959 (95%CI:2.690～13.200)Conclusions:Factors influencing the severe risk of death in patients with cerebral apoplexy has a variety of. Use of mechanical ventilation, catheters, nasogastric tube of invasive operation, such as hospital pulmonary infection, brain herniation, fever, coma, APACHE Ⅱ score higher on admission and always has a history of heart disease is a risk factor for death of NICU stroke patients was. Risk factors for the timely take effective preventive measures, improve the treatment, active treatment at the same time the complication of treatment of the primary disease and basic diseases, can reduce the mortality of severe stroke patients, to improve its prognosis.