Retrospective Study
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jun 6, 2022; 10(16): 5230-5240
Published online Jun 6, 2022. doi: 10.12998/wjcc.v10.i16.5230
Risk factors of mortality and severe disability in the patients with cerebrovascular diseases treated with perioperative mechanical ventilation
Jin-Zhu Zhang, Hao Chen, Xin Wang, Kan Xu
Jin-Zhu Zhang, Hao Chen, Xin Wang, Kan Xu, Department of Neurosurgery, The First Hospital of Jilin University, Changchun 130021, Jilin Province, China
Author contributions: Zhang JZ and Xu K contributed to the study conception and design; all authors collected the data and performed the data analysis; and contributed to the interpretation of the data; and complete of figures and tables; and contributed to the drafting of the article; and final approval of the submitted version.
Institutional review board statement: The study protocol was approved by the Ethics Committee of the First Hospital of Jilin University.
Conflict-of-interest statement: The authors declare that they have no conflict of interest to disclose.
Data sharing statement: The datasets generated and analyzed during the present study are available from the corresponding author on reasonable request.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Kan Xu, MD, Professor, Department of Neurosurgery, The First Hospital of Jilin University, No. 1 Xinmin Road, Changchun 130021, Jilin Province, China. xukan@mail.jlu.cn
Received: September 14, 2021
Peer-review started: September 14, 2021
First decision: October 25, 2021
Revised: January 7, 2022
Accepted: April 2, 2022
Article in press: April 2, 2022
Published online: June 6, 2022
Processing time: 261 Days and 1.7 Hours
ARTICLE HIGHLIGHTS
Research background

The dilemma is that although mechanical ventilation could sustain life in patients with acute respiratory failure, the survival rate and functional outcome for the patients of cerebrovascular diseases who treated with mechanical ventilation had a poor prognosis. Therefore, identification of risk factors affecting long-term survival and functional outcome in these patients could be useful to improve management after mechanical ventilation, to help family making decision on continuation or withdrawal of care, and to guide orientation after discharge.

Research motivation

The survival rate and prognostic outcomes of patients with cerebrovascular diseases treated with mechanical ventilation during the perioperative period were poor. The reason for mechanical ventilation was a statistically significant predictor for mortality and severe disability.

Research objectives

The average age of 111 patients was 56.46 ± 12.53 years, 59 (53.15%) were males. The mortality of in-hospital and 3-month follow-up were 36.9% and 45.0%, respectively. Of 71 discharged patients, 46.47% were seriously disabled and 12.67% died after three months follow-up. Univariate analysis showed that preoperative glasgow coma scale, operation start time and ventilation reasons had statistically significant differences in different functional outcomes. Multiple logistic regression analysis showed that the cause of ventilation was related to the death and poor prognosis of patients with cerebrovascular diseases. Compared with brainstem compression, the risk of death or severe disability of pulmonary disease, status epilepticus, impaired respiratory center function, and shock were 0.096 (95%CI: 0.028-0.328), 0.026 (95%CI: 0.004-0.163), 0.095 (95%CI: 0.013-0.709), 0.095 (95%CI: 0.020-0.444), respectively.

Research methods

A retrospective follow-up study of 111 cerebrovascular disease patients who underwent mechanical ventilation during the perioperative period in the First Hospital of Jilin University from June 2016 to June 2019 was performed. Main measurements were mortality and functional outcome in-hospital and after 3-month follow-up. The functional outcome was divided into three groups based the modified rankin scale. Univariate analysis was used to compare the differences between three functional outcomes. Multivariate logistic regression analysis was used to for risk factors of mortality and severe disability.

Research results

To analyze mortality and functional disability and to determine predictors of unfavorable outcome in the patients with cerebrovascular diseases treated with mechanical ventilation.

Research conclusions

To analyze mortality and functional disability and to determine predictors of unfavorable outcome in the patients with cerebrovascular diseases treated with mechanical ventilation.

Research perspectives

The prognosis of cerebrovascular diseases treated with mechanical ventilation during perioperative has not been clearly reported.