ArticleCritical care medicine2009
Long-term survival in older critically ill patients with acute ischemic stroke.
Article in Critical care medicine, 2009. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
20 citing papers in PubMed, 1 synthesis or guideline pooled it, 64 citations in OpenAlex.
- Guidelines for Neuroprognostication in Critically ill Adults with Acute Ischemic Stroke.Neurocritical care · 2026Guideline
- Long-Term Outcomes After Severe Acute Brain Injury Requiring Mechanical Ventilation: Recovery Trajectories Among Patients and Mental Health Symptoms of Their Surrogate Decision Makers.Neurocritical care · 2025Observational
- Epidemiological Study of Stroke Presenting to the Emergency Department of a Tertiary Hospital: An Observational Study.JNMA; journal of the Nepal Medical Association · 2025Observational
- Outcome of Cerebral Venous Thrombosis Requiring Mechanical Ventilation.Journal of clinical medicine · 2025Article
- Comprehensive assessment and progression of health status during neurorehabilitation in survivors of critical illness: a prospective cohort study.Annals of intensive care · 2024Article
- Outcomes of patients admitted to the ICU for acute stroke: a retrospective cohort.BMC anesthesiology · 2022Article
- Acute ischemic stroke in a university hospital intensive care unit: 1-year costs and outcome.Acta anaesthesiologica Scandinavica · 2022Article
- Related Factors and a Threshold of the Maximum Neuron-Specific Enolase Value Affecting the Prognosis of Patients with Aneurysmal Subarachnoid Hemorrhage.Applied bionics and biomechanics · 2022Article
- Age-Specific and Sex-Specific Trends in Life-Sustaining Care After Acute Stroke.Journal of the American Heart Association · 2021Article
- One-year survival in acute stroke patients requiring mechanical ventilation: a multicenter cohort study.Annals of intensive care · 2020Article
- Early Prediction of Prognosis in Elderly Acute Stroke Patients.Critical care explorations · 2019Article
- Roles of blood-brain barrier integrins and extracellular matrix in stroke.American journal of physiology. Cell physiology · 2019Review
- Predictors of intensive care unit admission and mortality in patients with ischemic stroke: investigating the effects of a pulmonary rehabilitation program.BMC neurology · 2017Article
- Hypernatremia at Hospital Discharge and Out of Hospital Mortality Following Primary Intracerebral Hemorrhage.Neurocritical care · 2016Observational
- Effect of end-stage renal disease on long-term survival after a first-ever mechanical ventilation: a population-based study.Critical care (London, England) · 2015Article
- [Dysphagia management of acute and long-term critically ill intensive care patients].Medizinische Klinik, Intensivmedizin und Notfallmedizin · 2014Review
- Exploratory analysis of glyburide as a novel therapy for preventing brain swelling.Neurocritical care · 2014Article
- Artery of Percheron infarction as an unusual cause of coma: three cases and literature review.Neurocritical care · 2014Review
- Acute ischemic stroke in the ICU: to admit or not to admit?Intensive care medicine · 2014Article
- A population-based analysis of ethnic differences in admission to the intensive care unit after stroke.Neurocritical care · 2012Article
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Authors and funding
3 authors at 1 institution in 1 country.
Funding
Abstract
objectivesTo compare survival in older patients with acute ischemic stroke admitted to intensive care units (ICUs) with those not requiring ICU care and to assess the impact of mechanical ventilation (MV) and percutaneous gastrostomy tubes (PEG) on long-term mortality.
designMulticentered retrospective cohort study.
settingAdministrative data from the Centers for Medicare and Medicaid Services covering 93 metropolitan counties primarily in the eastern half of the United States. PATIENTS: 31,301 patients discharged with acute ischemic stroke in 2000.
interventionsNone. MEASUREMENTS AND MAIN
resultsMortality from the time of index hospitalization up to the end of the follow-up period of 12 months. Information was also gathered on use of mechanical ventilation, percutaneous gastrostomy, sociodemographic variables and a host of comorbid conditions. Of all patients with acute ischemic stroke, 26% required ICU admission. The crude death rate for ICU stroke patients was 21% at 30 days and 40% at 1-yr follow-up. At 30 days, after adjustment of sociodemographic variables and comorbidities, ICU patients had a 29% higher mortality hazard compared with non-ICU patients. MV was associated with a five-fold higher mortality hazard (hazard ratio 5.59, confidence interval [CI] 4.93-6.34). The use of PEG was not associated with mortality at 30 days. By contrast, at 1-yr follow up in 30-day survivors, ICU admission was not associated with mortality hazard (hazard ratio 1.01, 95% CI 0.93-1.09). MV still had a higher risk of death (hazard ratio 1.88, 95% CI 1.57-2.25), and PEG patients had a 2.59-fold greater mortality hazard (95% CI 2.38-2.82).
conclusionsBoth short-term and long-term mortality in older patients with acute ischemic stroke admitted to ICUs is lower than previously reported. The need for MV and PEG are markers for poor long-term outcome. Future research should focus on the identification of clinical factors that lead to increased mortality in long-term survivors and efforts to reduce those risks.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.