(165) Clinical Outcomes of ICU Visits due to Cerebrovascular Accident

Introduction: According to the CDC 7.8 million Americans have had a Cerebrovascular accident (CVA) in their lifetime. They are the fifth cause of death in the United States. This analysis aims to pinpoint the risk factors that lead to deathly outcomes in ICU admissions related to CVAs.

Methods: A retrospective analysis was done collecting clinical outcomes from admissions to the Intensive Care Unit (ICU) from the database Medical Information Mart for Intensive Care (MIMIC-III), from 2001 to 2012 in the Beth Israel Deaconess Medical Center. We included all ICU visits with a diagnosis of Ischemic or Hemorrhagic CVA based on 8 ICD9 codes (430, 431, 436, 432.1, 432.9, 437.0, 437.9). Patients’ demographics like gender, age, and ethnicity were included, along with ICD9 codes for risk factors like obesity, hypertension, alcoholism, tobacco use, coagulopathies and administration of anticoagulants based on drug prescriptions. Data was assessed using IBM SPSS version 24.0 and employing descriptives statistics, mean values, and Chi Square for significance.

Results: Out of 3006 ICU visits with a CVA diagnosis, 1394 (46.4%) were female, and 1612 (53.6%) were male. On average, their length of stay was 294.97 hours, and 801 (26.64%) died. The significant risk factors were being male (p= < 0.001), being Caucasian (p = < 0.004), having hypertension as a comorbidity (p = < 0.001), alcoholism (p = < 0.001). tobacco use (p = < 0.001), coagulopathies (p = < 0.001) and use of anticoagulants (p = <.001). On the other hand, no significant correlation was found with obesity (p = 0.876) and dyslipidemia (p = 0.454). However, a correlation between obesity and mortality (p=0.040) exists, whereas gender(p=0.646) and a hypertension (p=0.657) diagnosis are irrelevant to the outcome.

Conclusions: According to our data, Caucasian hypertensive men of middle age are more likely to suffer from an CVA. However, lifestyle factors like alcoholism and smoking habits are also determinant in the outcome of the patient. While obesity is not a significant risk factor for a CVA occurrence, it is a determinant for clinical outcomes, meaning an obese patient is more likely to die after an event than a patient with a healthy body weight. Recognizing mortality risk factors might help provide more adequate care in the ICU.