Stroke and breathing

Barnett, Heather; Davis, Arielle; Khot, Sandeep P.

doi:10.1016/b978-0-323-91532-8.00016-1

Cited by 4 publications

(3 citation statements)

References 128 publications

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“…Respiratory failure was not common in patients with large infarcts, but once it occurred, almost all patients had unfavorable outcomes, and respiratory failure was related to futile recanalization. Respiratory failure may be related to stroke-associated pneumonia (SAP) and a large infarct core 40 . SAP is one of most common post-stroke infections, occurring with an overall incidence ranging from 5% to 26% 41,42 .…”

Section: Discussionmentioning

confidence: 99%

“…Respiratory failure may be related to stroke-associated pneumonia (SAP) and a large infarct core 40 .…”

Section: Discussionmentioning

confidence: 99%

“…Second, aspiration is related to impaired consciousness and dysphagia 44 . Third, additional risk factors for pneumonia include severe stroke, immobility, weak cough, and placement of a nasogastric feeding tube 40 . Pneumonia is associated with prolonged hospital stay, early and long-term mortality and functional outcome 41 .…”

Section: Discussionmentioning

confidence: 99%

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Predictors of futile recanalization in patients with large infarct: a post hoc analysis of the ANGEL-ASPECT trial

Yi,

Huo,

Lin

et al. 2023

Preprint

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Background: Few studies have focused on factors associated with futile recanalization in acute anterior circulation stroke patients with large infarct cores who were treated with modern endovascular therapy (EVT). The aim of this study was to explore the factors associated with futile recanalization in patients with large ischemic strokes. Methods: This is a post hoc analysis of the ANGEL-ASPECT trial. Demographic and clinical characteristics, acute stroke workflow interval times, and imaging characteristics were compared between the futile and meaningful recanalization groups. A favorable outcome was defined as a 90-day mRS score 0-3, successful reperfusion was defined as eTICI 2b, 2c and 3 on final angiogram, and futile recanalization was defined as failure to achieve a favorable outcome despite successful reperfusion. Multivariate analysis was performed to identify the predictors of futile recanalization. Results: One hundred eighty-three patients were included in the final analysis; 91 (49.7%) patients had futile recanalization, and 92 (51.3%) patients had meaningful recanalization. In multivariable logistic regression analysis, older age (age ≥68, OR=3.29, P=0.004), higher NIHSS score (NIHSS ≥16, OR=3.33, P=0.003), diabetes (OR=3.23, P=0.017), larger final volume (FIV ≥174.7, OR=6.79, P<0.001), postoperative respiratory failure (OR=14.56, P=0.01), and female sex (OR=2.78, P=0.01) were independent predictors of futile recanalization. Conclusions: Futile recanalization occurred in approximately half of acute stroke patients with a large infarct core following endovascular treatment. Old age, high baseline NIHSS score, diabetes mellitus, large FIV and respiratory failure were independent predictors of futile recanalization after endovascular therapy for large ischemic strokes. Stroke-related pneumonia control may improve prognosis.

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Section: Discussionmentioning

confidence: 99%

“…Respiratory failure may be related to stroke-associated pneumonia (SAP) and a large infarct core 40 .…”

Section: Discussionmentioning

confidence: 99%