Hypoxaemia in acute stroke is frequent and worsens outcome.

Rowat, Anne M, Dennis, Martin S and Wardlaw, Joanna M (2006) Hypoxaemia in acute stroke is frequent and worsens outcome. Cerebrovascular Diseases, 21 (3). pp. 166-172. ISSN 1015-9770

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Background: Hypoxaemia in the acute phase of stroke might damage the ischaemic penumbra and worsen clinical outcome. We determined the frequency of hypoxaemia on admission with stroke and assessed whether it was related to outcome. Methods: We measured arterial oxygen saturation (SaO2) and breathing effort with portable monitoring equipment in a large cohort of acute stroke patients, continually from arrival at hospital, during interdepartment transfer, in imaging and on the ward. Patients received best medical care according to current guidelines. Baseline neurological examination and 3-month outcome (Modified Rankin Scale) were assessed blind to other data. Hypoxaemia was defined as SaO2 <90% for 10% of each assessment stage. Results: Mean SaO2 was lowest during transfers (p < 0.01), but hypoxaemia was common in all assessment stages. Patients with hypoxaemia (30/153, 20%) were more likely to have a pre-existing respiratory disease on admission than those without hypoxaemia (p < 0.04). More patients with hypoxaemia (40%) died than those without hypoxaemia (20%) (hazard ratio, 2.0; 95% CI, 1.0-4.1), though after adjusting for National Institute of Health Stroke Scale and age this association was not statistically significant (hazard ratio, 1.5; 95% CI, 0.7-3.1). There were similar numbers of dependent survivors in both groups. Conclusion: Hypoxaemia during acute stroke assessment was associated with increased risk of death. Although SaO2 is lower during transfers, hypoxaemia occurs in all stages of the admission process. Further research is necessary to determine whether strategies to avoid hypoxaemia during acute assessment improve stroke survival.

Item Type: Article
Print ISSN: 1015-9770
Electronic ISSN: 1421-9786
Uncontrolled Keywords: Acute stroke; Cheyne-Stokes respiration; Hypoxaemia
University Divisions/Research Centres: Faculty of Health, Life & Social Sciences > School of Nursing, Midwifery and Social Care
Dewey Decimal Subjects: 600 Technology > 610 Medicine & health > 610 Medicine & health
600 Technology > 610 Medicine & health > 616 Diseases
Library of Congress Subjects: R Medicine > R Medicine (General)
R Medicine > RC Internal medicine
Item ID: 1591
Depositing User: RAE Import
Date Deposited: 06 Mar 2008 10:06
Last Modified: 09 Mar 2012 16:24

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