[EngO7-6] Predictive factors of abnormal finding detected by computerized tomography scan of brain among medical critically ill patients
Background
Computerized tomography (CT) scan is an investigation of choice for diagnosis causes of acute neurological deterioration among medical critically ill patients; however, transferring patient to perform CT scan associate with complications. Transferring only high suspicious case could avoid unnecessary transferring associate complications.
Objective
To identify predictive factors for abnormal finding detection from CT scan of brain among medical critically ill patients who developed acute neurological deterioration.
Methods
A retrospective chart review, enrolled patient in medical intensive care unit (ICU), who developed acute alteration of consciousness or neurological deficit and was underwent CT scan of brain during 2007 to 2017. The primary outcome was radiological confirmed acute onset hemorrhagic or ischemic stroke. Patient’s demographics data, neurological examination and laboratory findings were recorded. To identify predictive factors of abnormal finding detected by CT scan, uni-variated and multi-variated analysis was performed.
Results
A total of 113 ICU patients were included. CT scan showed hemorrhagic stroke in 17 patients (15.0%) and ischemic stroke in 35 patients (30.9%). Comparing with no abnormal neurological finding detected by CT scan, patients with hemorrhagic stroke associated with significant higher blood pressure, lower Glasgow coma scale and alkalosis. While, patients with ischemic stroke associated with older age and alkalosis. Multi-variated analysis identify abnormal pupil examination is an independent predictor of hemorrhagic stroke (relative risk, 26.86; 95% CI, 3.68-196.29; P= 0.001) and abnormal Babinski’s sign is an independent predictor of ischemic stroke (relative risk, 4.58; 95% CI, 1.14-18.49; P= 0.032).
Conclusions
Critically ill patient who developed acute neurological deterioration, abnormal pupil examination is a predictive factor of hemorrhagic stroke while abnormal Babinski’s sign is a predictive factor of ischemic stroke.
Computerized tomography (CT) scan is an investigation of choice for diagnosis causes of acute neurological deterioration among medical critically ill patients; however, transferring patient to perform CT scan associate with complications. Transferring only high suspicious case could avoid unnecessary transferring associate complications.
Objective
To identify predictive factors for abnormal finding detection from CT scan of brain among medical critically ill patients who developed acute neurological deterioration.
Methods
A retrospective chart review, enrolled patient in medical intensive care unit (ICU), who developed acute alteration of consciousness or neurological deficit and was underwent CT scan of brain during 2007 to 2017. The primary outcome was radiological confirmed acute onset hemorrhagic or ischemic stroke. Patient’s demographics data, neurological examination and laboratory findings were recorded. To identify predictive factors of abnormal finding detected by CT scan, uni-variated and multi-variated analysis was performed.
Results
A total of 113 ICU patients were included. CT scan showed hemorrhagic stroke in 17 patients (15.0%) and ischemic stroke in 35 patients (30.9%). Comparing with no abnormal neurological finding detected by CT scan, patients with hemorrhagic stroke associated with significant higher blood pressure, lower Glasgow coma scale and alkalosis. While, patients with ischemic stroke associated with older age and alkalosis. Multi-variated analysis identify abnormal pupil examination is an independent predictor of hemorrhagic stroke (relative risk, 26.86; 95% CI, 3.68-196.29; P= 0.001) and abnormal Babinski’s sign is an independent predictor of ischemic stroke (relative risk, 4.58; 95% CI, 1.14-18.49; P= 0.032).
Conclusions
Critically ill patient who developed acute neurological deterioration, abnormal pupil examination is a predictive factor of hemorrhagic stroke while abnormal Babinski’s sign is a predictive factor of ischemic stroke.