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The 1-year survival rate was 33.1%(n=41).Sixty-five patients(52%)died in the neurological intensive care unit.Among 17 variables analyzed,seven were found to significantly influence 2-month fatality in the univariate analysis;age greater than 65 years,atrial fibrillation,bilateral absence of pupillary light reflex,bilateral absence of corneal reflex,bilateral Babinski's sign,infratentorial stroke,and Glasgow Coma Scale(GCS score less than 10.Independent predictors of death at 2 months were age greater than 65 years(P=.03),GCS score less than 10(P=.01)and intubation performed because of coma or acute respiratory failure(P=.04).Overall prognosis of ventilated patients with severe stroke is better than previously reported. Older patients comatose on admission who need to be intubated because of neurological or respiratory deterioration have the poorest prognosis.We conclude that intubation and mechanical ventilation of severe stroke patients should be performed in a timely manner,before irreversible damage occurs. |
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