Analysis Of Factors Related To Respiratory Failure Caused By Medullary Infarction

Objective:To investigate the factors related to respiratory failure(RF)caused by medullary infarction(MI).Methods:We selected 62 patients with MI from 2,250 patients with first ischemic stroke for consecutive 3 years,and divided the patients into RF and non-RF groups.We compared the demographic characteristics,Risk factors,etiology,clinical signs and symptoms of the two groups,imaging characteristics,lesion side and hospital stay.Results:1.Demographic analysisA total of 62 patients with MI were collected,including 6 patients in RF group(9.6%)and 56 patients in non-RF group(90.4%).The onset age of RF group was(60.5±12.1)years old,and the ratio of male to female was 5:1.The age of onset in the non-RF group was(60.2±13.2)years old,and the ratio of male to female was 4:1.There was no statistically significant difference between the two groups(P values were P=0.802>0.05,P=0.862>0.05).2.Analysis of risk factorsFive patients(83.3%)in the RF group had hypertension,and 30 patients(53.6%)in the non-RF group had hypertension.Hypertension was the most common risk factor in both groups.There were no significant differences in hypertension,diabetes,hyperlipidemia,atrial fibrillation,coronary heart disease,and smoking between the two groups(P values were P=0.166,P=0.953,P=0.196,P=0.419,P=0.288,P=0.869).3.Etiological analysisFive patients(83.3%)in the RF group had atherosclerotic MI,1(16.7%)had cardiogenic MI;30 patients(53.6%)in the non-RF group had atherosclerotic MI,and21(37.5%)had Perforator arterial MI,atherosclerosis is the most common etiology in both groups.However,There was no significant difference in etiology between thetwo groups(P=0.637).4.Analysis of clinical symptoms and signsThe RF group was more prone to swallowing dysfunction than the non-RF group,and the difference was statistically significant(P=0.004<0.05).There was no significant difference in other clinical symptoms and signs between the groups.5.Analysis of imaging characteristicsWhen the RF group involved at least 2 levels,and the upper and middle segments,middle and lower segments,and the upper and middle and lower segments of the medulla,there were statistical differences with the non-RF group(P=0.000).The non-RF group often involved a single layer,there was a statistical difference between the groups(P=0.000).The horizontal infarction area in the RF group was usually located in the dorsolateral and posterior sides,while the horizontal infarction area in the non-rf group was mainly located in the dorsolateral side,and the dorsolateral side was the most common infarction area between the two groups.The difference of horizontal infarction between the two groups was not statistically significant(P=0.642).The upper part of the medullary infarction mostly involves the medial or anterolateral,middle and lower medullary infarction mostly involves the dorsolateral and posterior.6.Analysis of the lesion sideIn the RF group,3(50%)affected the left side of the medulla,2(33.3%)affected the right side of the medulla,and 1(16.7%)affected both sides;in the non-RF group,35(62.5%)affected On the left side of the medulla,21 cases(37.5%)involved the right side of the medulla.There was no significant difference in the lesion side between the two groups(P = 0.360).7.Hospitalization daysHospitalization days were 12.3±8.3 days in the RF group and 11.8±1.4 days in the non-RF group.There was no significant difference in length of stay between the two groups(P=0.244).Conclusions:1.The anatomic location of the medullary infarction and the degree of vertical expansion are important factors in the occurrence of respiratory failure.2.Patients with respiratory failure due to medullary infarction are more likely to have swallowing dysfunction.