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Risk Factors for Multiple Organ Dysfunction Syndrome in Severe Stroke Patients
BACKGROUND: Severe stroke patients have poor clinical outcome which may be associated with development of multiple organ dysfunction syndrome (MODS). Therefore, the aim of our study was to investigate independent risk factors for development of MODS in severe stroke patients. METHODS: Ninety seven s...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Public Library of Science
2016
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5125686/ https://www.ncbi.nlm.nih.gov/pubmed/27893797 http://dx.doi.org/10.1371/journal.pone.0167189 |
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author | Qin, Wei Zhang, Xiaoyu Yang, Shuna Li, Yue Yuan, Junliang Yang, Lei Li, Shujuan Hu, Wenli |
author_facet | Qin, Wei Zhang, Xiaoyu Yang, Shuna Li, Yue Yuan, Junliang Yang, Lei Li, Shujuan Hu, Wenli |
author_sort | Qin, Wei |
collection | PubMed |
description | BACKGROUND: Severe stroke patients have poor clinical outcome which may be associated with development of multiple organ dysfunction syndrome (MODS). Therefore, the aim of our study was to investigate independent risk factors for development of MODS in severe stroke patients. METHODS: Ninety seven severe stroke patients were prospective recruited from Jan 2011 to Jun 2015. The development of MODS was identified by Sequential Organ Failure Assessment (SOFA) score (score ≥ 3, at least two organs), which was assessed on day 1, 4, 7, 10 and 14 after admission. Baseline characteristics, Acute Physiology and Chronic Health Evaluation (APACHE) II score, Glasgow coma score (GCS) and cerebral imaging parameters were collected at admission. Cox regression was performed to determine predictors for the development of MODS. Medical complications after admission and in-hospital mortality were also investigated. RESULTS: 33 (34%) patients were in MODS group and 64 (66%) were in non-MODS group within 14 days after admission. Patients in MODS group had more smoker (51.5% vs 28.1%, p = 0.023), higher NIHSS score (23.48 ± 6.12 vs 19.81 ± 4.83, p = 0.004), higher APACHE II score (18.70 ± 5.18 vs 15.64 ± 4.36, p = 0.003) and lower GCS score (6.33 ± 2.48 vs 8.14 ± 2.73, p = 0.002). They also had higher rate of infarction in multi vascular territories (36.4% vs 10.9%, p = 0.003). The most common complication in all patients was pulmonary infection, while complication scores were comparable between two groups. Patients with MODS had higher in-hospital mortality (69.7% vs 9.4%, p = 0.000). In Cox regression, NIHSS score (RR = 1.084, 95% CI 1.019–1.153) and infarction in multi vascular territories (RR = 2.345 95% CI 1.105–4.978) were independent risk factors for development of MODS. CONCLUSIONS: In acute phase of stroke, NIHSS score and infarction in multi vascular territories predicted MODS in severe stroke patients. Moreover, patients with MODS had higher in-hospital mortality, suggesting that early identification of MODS is critical important. |
format | Online Article Text |
id | pubmed-5125686 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2016 |
publisher | Public Library of Science |
record_format | MEDLINE/PubMed |
spelling | pubmed-51256862016-12-15 Risk Factors for Multiple Organ Dysfunction Syndrome in Severe Stroke Patients Qin, Wei Zhang, Xiaoyu Yang, Shuna Li, Yue Yuan, Junliang Yang, Lei Li, Shujuan Hu, Wenli PLoS One Research Article BACKGROUND: Severe stroke patients have poor clinical outcome which may be associated with development of multiple organ dysfunction syndrome (MODS). Therefore, the aim of our study was to investigate independent risk factors for development of MODS in severe stroke patients. METHODS: Ninety seven severe stroke patients were prospective recruited from Jan 2011 to Jun 2015. The development of MODS was identified by Sequential Organ Failure Assessment (SOFA) score (score ≥ 3, at least two organs), which was assessed on day 1, 4, 7, 10 and 14 after admission. Baseline characteristics, Acute Physiology and Chronic Health Evaluation (APACHE) II score, Glasgow coma score (GCS) and cerebral imaging parameters were collected at admission. Cox regression was performed to determine predictors for the development of MODS. Medical complications after admission and in-hospital mortality were also investigated. RESULTS: 33 (34%) patients were in MODS group and 64 (66%) were in non-MODS group within 14 days after admission. Patients in MODS group had more smoker (51.5% vs 28.1%, p = 0.023), higher NIHSS score (23.48 ± 6.12 vs 19.81 ± 4.83, p = 0.004), higher APACHE II score (18.70 ± 5.18 vs 15.64 ± 4.36, p = 0.003) and lower GCS score (6.33 ± 2.48 vs 8.14 ± 2.73, p = 0.002). They also had higher rate of infarction in multi vascular territories (36.4% vs 10.9%, p = 0.003). The most common complication in all patients was pulmonary infection, while complication scores were comparable between two groups. Patients with MODS had higher in-hospital mortality (69.7% vs 9.4%, p = 0.000). In Cox regression, NIHSS score (RR = 1.084, 95% CI 1.019–1.153) and infarction in multi vascular territories (RR = 2.345 95% CI 1.105–4.978) were independent risk factors for development of MODS. CONCLUSIONS: In acute phase of stroke, NIHSS score and infarction in multi vascular territories predicted MODS in severe stroke patients. Moreover, patients with MODS had higher in-hospital mortality, suggesting that early identification of MODS is critical important. Public Library of Science 2016-11-28 /pmc/articles/PMC5125686/ /pubmed/27893797 http://dx.doi.org/10.1371/journal.pone.0167189 Text en © 2016 Qin et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
spellingShingle | Research Article Qin, Wei Zhang, Xiaoyu Yang, Shuna Li, Yue Yuan, Junliang Yang, Lei Li, Shujuan Hu, Wenli Risk Factors for Multiple Organ Dysfunction Syndrome in Severe Stroke Patients |
title | Risk Factors for Multiple Organ Dysfunction Syndrome in Severe Stroke Patients |
title_full | Risk Factors for Multiple Organ Dysfunction Syndrome in Severe Stroke Patients |
title_fullStr | Risk Factors for Multiple Organ Dysfunction Syndrome in Severe Stroke Patients |
title_full_unstemmed | Risk Factors for Multiple Organ Dysfunction Syndrome in Severe Stroke Patients |
title_short | Risk Factors for Multiple Organ Dysfunction Syndrome in Severe Stroke Patients |
title_sort | risk factors for multiple organ dysfunction syndrome in severe stroke patients |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5125686/ https://www.ncbi.nlm.nih.gov/pubmed/27893797 http://dx.doi.org/10.1371/journal.pone.0167189 |
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