Factors Affecting Prognosis in Hypoxic Encephalopathy Patients Followed-up in Intensive Care Unit
Journal Title: Journal of Ankara University Faculty of Medicine - Year 2019, Vol 72, Issue 2
Abstract
Objectives: Hypoxic encephalopathy (HE) after cardiac arrest is a clinical condition that can cause severe neurological sequelae and death. It is important to determine the prognosis in patients with HE for follow up and developing future treatments in the long term. Our aim was to investigate the effects of age, gender, hypothermia, lesion site in brain magnetic resonance imaging (MRI), seizure and electroencephalography (EEG) findings on prognosis in patients with the diagnosis of HE. Materials and Methods: The data of the adult intensive care unit was evaluated retrospectively. A total of 194 patients with HE were included into the study. One hundred and eighteen (60.8%) of the patients were male and 76 (39.2%) were female. The survivors and those who died were identified. Hypothermia therapy, brain MRI findings (cortical and/or subcortical lesion), presence of seizures (myoclonic, generalized, focal) and EEG findings (epileptic activity, status, generalized slowing) were recorded. Results: The mean age was 59.46±1.71 (18-89). Seventy-six (39.2%) patients underwent hypothermia. One hundred and seven (55.2%) patients died. The rate of exitus in elderly patients was significantly higher (p<0.01). The brain MRI of 88 patients showed hypoxic lesions (cortical in 8 patients, subcortical in 21 patients, cortical + subcortical lesion in 59 patients). The survival rate of the patients with cortical or subcortical pathology is significantly higher than patients with both pathology (p<0.01). As a result of multiple regression analysis, a 1-year increase in age, increased the risk of death by 4%, while the presence of pathological findings in both areas in brain MRI increased the risk of death by 2.62 times. There was no significant difference of gender, hypothermia, seizures and pathological EEG findings on survival (p>0.05). Conclusion: Approximately half of the patients included in our study died. The survival rate of the elderly patients and the patients with multiple lesions in brain MRI was low.
Authors and Affiliations
Nesrin Helvacı Yılmaz, Cem Erdoğan, Deniz Kızılaslan, Özge Arıcı Düz, Eren Toplutaş, Lütfü Hanoğlu
Comparison of Mean Platelet Volume at Admission in Subtypes of Acute Myocardial Infarction
Objectives: Thrombus by the activated platelets and reduced blood flow of myocardium as a result of the thrombus lies under the pathophysiology of acute myocardial infarction (MI). Mean platelet volume (MPV) is known to...
The Place and Outcomes of Surgical Thrombectomy in Acute Arteriovenous Fistula Thrombosis
Objectives: The rate of arteriovenous fistula (AVF) thrombosis has been increasing in the population and there was yet no consensus on the salvage operation to be performed. Our aim is to demonstrate the success of the c...
The Effects of Body Mass Index on Efficacy of Intermittent Pneumatic Compression
Objectives: The aim of our study was to compare the efficacy of intermittent pneumatic compression on venous hemodynamics in individuals with different body mass indexes (BMIs). Materials and Methods: The study included...
Clinicopathological Corrrelation of Skin Biopsies in Pediatric Patients
Objectives: The incidences of dermatological diseases in the pediatric group differ from those in adults. Skin biopsies are frequently employed by dermatologists at differential diagnosis, and clinicopathological correla...
Our Treatment Approach to Hairy Cell Leukemia
Objectives: Hairy cell leukemia (HCL) is a rare chronic lymphoid malignancy which develops from mature B cells. The frequency is 2% of all leukemias and diagnosed mostly in middle ages. Patients respond to treatment with...