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KMID : 1201420220150020088
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Journal of Neurocritical Care
2022 Volume.15 No. 2 p.88 ~ p.95
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In-hospital mortality of atrial fibrillation-associated acute ischemic stroke in the intensive care unit
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Kim Do-Yeon
Kang Ji-Hoon
Jeong Han-Gil
Park Chan-Young
Kim Jun-Yup
Kim Beom-Joon
Han Moon-Ku
Bae Hee-Joon
Kim Baik-Kyun
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Abstract
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Background: Although atrial fibrillation (AF)-associated acute ischemic stroke (AIS) is on the rise, is devastating, and life-threatening, there is limited data on the clinical course and in-hospital mortality of patients treated in the intensive care unit (ICU). This study aimed to describe the clinical course and factors associated with in-hospital mortality in AF-associated AIS patients admitted to the ICU.
Methods: This study was a retrospective analysis of a prospective nationwide multicenter cohort including non-valvular AF-AIS patients receiving ICU care admitted to 14 stroke centers in South Korea from 2017 to 2020. In-hospital outcomes, including in-hospital mortality and neurological deterioration (ND) have been described.
Results: Amongst 2,487 AF-associated AIS patients, 259 (10.4%) were treated in the ICU. In-hospital mortality and ND occurred in 8.5% and 17.0% of the patients, respectively. Higher rates of initial National Institute for Health Stroke Scale scores, symptomatic steno-occlusive lesions, and CHA2DS2-VASc (Congestive Heart Failure, Hypertension, Age ≥75 [Doubled], Diabetes Mellitus, Prior Stroke or Transient Ischemic Attack [Doubled], Vascular Disease, Age 65?74, Female) scores were found in those with in-hospital mortality. The CHA2DS2-VASc score after admission increased the risk of in-hospital mortality (odds ratio [OR], 1.48; 95% confidence interval [CI], 1.00?2.18) were associated with in-hospital mortality. Antithrombotic use within 48 hours was related to decreased in-hospital mortality (OR, 0.26; 95% CI, 0.10?0.67).
Conclusion: ICU care in AF-associated AIS is common, and the establishment of optimal treatment strategies in the ICU may be needed.
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KEYWORD
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Stroke, Atrial fibrillation, Cerebral infarction, Critical care, Intensive care units
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