• Perrine Bouvet, Martin Murgier, Bertrand Pons, and Michael Darmon.
• Perrine Bouvet is a physician, medical-surgical intensive care unit, Saint-Etienne University Hospital, Saint-Etienne, France, and Department of Anesthesiology, Montelimar Hospital, Montelimar, France. Martin Murgier is a physician, medical-surgical intensive care unit, Saint-Etienne University Hospital. Bertrand Pons is a physician, medical-surgical intensive care unit, Pointe à Pitre University Hospital, Guadeloupe, France. Michael Darmon is a physician, medical intensive care unit, Saint-Louis University Hospital, AP-HP, Paris, France; a professor of intensive care medicine, Faculty of Medicine, Paris Diderot University, Sorbonne Paris Cité, Paris, France; and a researcher on the ECSTRA Team, Biostatistics and Clinical Epidemiology, UMR 1153, Center of Research in Epidemiology and Statistics Sorbonne Paris Cité (CRESS), INSERM, Paris, France.
• Am. J. Crit. Care. 2019 Nov 1; 28 (6): 477-480.

BackgroundData on outcomes of critically ill patients requiring mechanical ventilation at the onset of stroke are limited.ObjectiveTo assess the hospital and long-term functional outcomes of patients with stroke who require mechanical ventilation.MethodsThis retrospective single-center cohort study performed from 1994 to 2008 involved adult patients within 7 days of stroke onset and who required intensive care unit admission and mechanical ventilation.ResultsA total of 274 patients requiring mechanical ventilation at the onset of stroke were analyzed. Indications for intubation included coma in 195 patients (71%). The median (interquartile range) score on the Glasgow Coma Scale at admission to the intensive care unit was 6 (3-9). Forty-four patients (16%) had sepsis at intensive care unit admission. The overall hospital mortality rate was 53%. After adjustment for confounders, severity of illness at admission as assessed by the Simplified Acute Physiology Score II (odds ratio, 1.07; 95% CI, 1.05-1.10), anisocoria (odds ratio, 5.26; 95% CI, 1.76-15.80), and sepsis at intensive care unit admission (odds ratio, 0.40; 95% CI, 0.19-0.85) were associated with outcome. At 1 year, median (interquartile range) modified Rankin Scale score was 6 (2-6). Only 89 patients (32%) exhibited mild to moderate neurologic impairment.ConclusionIn this study, adult patients requiring mechanical ventilation at the onset of stroke experienced high 1-year mortality, with survivors having poor functional status.©2019 American Association of Critical-Care Nurses.

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