Tachycardia as a Negative Prognostic Factor for Stroke Outcome
DOI: 10.5455/msm.2017.29.40-44 Received: 13 January 2017; Accepted: 05 March 2017 © 2017 Amina Nakicevic, Salem Alajbegovic, Lejla Alajbegovic This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/bync/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
ORIGINAL PAPER
Mater Sociomed. 2017 Mar; 29(1): 40-44
Tachycardia as a Negative Prognostic Factor for Stroke Outcome Amina Nakicevic¹, Salem Alajbegovic², Lejla Alajbegovic³ 1 Neurology Clinic, Clinical Center of Sarajevo University, Sarajevo, Bosnia and Herzegovina
Cantonal Hospital Zenica, Zenica, Bosnia and Herzegovina
2
Representative of Berlin Chemi Bosnia and Herzegovina
3
Corresponding author: Professor Salem Alajbegović, MD, PhD. Cantonal Hospital Zenica,Crkvice 67, 72000 Zenica, Bosnia and Herzegovina Phone: +387 32 406-484. ORCID ID: 0000-00027379-2489, E-mail: [email protected]
40
ABSTRACT Introduction: The outcome of stroke, especially lethal one is significant, as in the hemorrhagic as well as in ischemic stroke. Goal was to show the impact on the stroke outcome of tachycardia correlated with lesion localization. Material and methods: Material for our work was patients who were treated due to the stroke at the Neurology Clinic Sarajevo in the period from 31 March 2015 until 01 January 2016. A total of 544 stoke patients were treated in the reporting period, 221 (44.6%) died. There were 70.9% patients with ischemic and 29.1% with hemorrhagic stroke. Each patient underwent ECG, which registered tachycardia during admission and on third day of hospitalization. Results: In relation to the presence of tachycardia on admission there were statistically significant differences in the group of patients with hemorrhage and ischemia in relation to presence of tachycardia (p 0.05).
Figure Gender distribution according and of stroke Figure 1. 1. Gender distribution according to types to andtypes subtypes of subtypes stroke 80 analysis by chi-square test shows that there are no statistically significant Statistical differences in the gender representation according to the observed groups (χ2=6.563; 70 p=0.087; p>0.05). 60
2. MATERIAL AND METHODS
Years
50 80
Hemorrhagic - without coma
40 70
Hemorrhagic - coma
30 60
Ischemic - without coma
20 50
Years
Testing was conducted prospectively at the Neurology Clinic from March 31, 2015 until January 1, 2016. The sample consisted of 240 patients with different types and subtypes of cardiovascular stroke. There were 60 ischemic strokes with impaired consciousness of coma type, and 60 without disorder of consciousness of coma type. Hemorrhage strokes was registered in 60 cases with impaired consciousness of coma type, and 60 without the disorder of consciousness of
10 40 0 30
Ischemic - coma Hemorrhagic - without coma 63.33
60.83
65.58
64.73
Mean age
Hemorrhagic - coma Ischemic - without coma
20 2. Mean age according to types and subtypes of stroke Figure Ischemic - coma 10
Mater Sociomed. 2017 Mar; 29(1): 40-44 • ORIGINAL PAPER
0
63.33
60.83
65.58
Mean age
64.73
41
Lateral
Figure 2. Mean age according to types and subtypes of stroke
Medial
Statistical analysisas by a one-way analysis of variance showed wereOutcome no statistically Tachycardia Negative Prognostic Factorthat forthere Stroke significant differences between groups in relation to the mean age (F=2.514; p=0.059; p>0.05).
100
75
60
53.3 46,7 38.3
Absent
% 50
Present
40
13.3
55 Died Survived
Hemorrhagic without coma3
Hemorrhagic without coma4
Figure Tachycardia at admission to types and(χ2=35.576; Figure 3. 3. Tachycardia at admission according toaccording types and subtypes of stroke subtypes of stroke (χ2=35.576; p=0.0001) p=0.0001)
ences between groups in relation to the mean age (F=2.514; p=0.059; p>0.05).
4. DISCUSSION
20
10
10 0
Hemorrhagic without coma2
25
20
11.7
10 Hemorrhagic without coma
17 104 28.3 43.3 43 133 71.7 55.4 60 240 25.0 100.0
80
45
30
30 20
32 53.3 27 45.0 60 25.0
70
61.7
40
0
24 40.0 34 56.7 60 25.0
80
70
% 50
31 51.7 29 48.3 60 25.0
90
90
80
60
χ2=13.876; p=0.031
100
88.3
86.7
90
Total
N % N % N %
Hemorrhagic without coma
Hemorrhagic without coma2
Hemorrhagic without coma3
Hemorrhagic without coma4
Figure4. side according to types andto subtypes strokesubtypes (χ2=72.467;ofp=0.0001) Figure Lesion 4. Lesion side according typesofand stroke
(χ2=72.467; p=0.0001)
istered 675 patients with a first stroke, of which 53% female and 47% male (mean age 72.2 years) (10). In our material, the average age was from 60.83 to 65.8 years as the comparative results of the above studies for the entire sample. We analyze the sample in relation to age by groups and according to a statistical analysis by one-way analysis of variance it is shown
Lesion side
Lesion localization
Statistical analysis by one-way analysis of variance showed that there were no statistically significant differences between groups in relation to the average Group age (p>0.05). Statistical analysis shows that Hemorrhagic Hemorrhagic there are significant differences between the Hemorrhagic - Hemorrhagic - Total - without - without without coma without coma observed group in relation to the presence of coma coma N 3 3 2 3 11 tachycardia on admission at the level of p
DOI: 10.5455/msm.2017.29.40-44 Received: 13 January 2017; Accepted: 05 March 2017 © 2017 Amina Nakicevic, Salem Alajbegovic, Lejla Alajbegovic This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/bync/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
ORIGINAL PAPER
Mater Sociomed. 2017 Mar; 29(1): 40-44
Tachycardia as a Negative Prognostic Factor for Stroke Outcome Amina Nakicevic¹, Salem Alajbegovic², Lejla Alajbegovic³ 1 Neurology Clinic, Clinical Center of Sarajevo University, Sarajevo, Bosnia and Herzegovina
Cantonal Hospital Zenica, Zenica, Bosnia and Herzegovina
2
Representative of Berlin Chemi Bosnia and Herzegovina
3
Corresponding author: Professor Salem Alajbegović, MD, PhD. Cantonal Hospital Zenica,Crkvice 67, 72000 Zenica, Bosnia and Herzegovina Phone: +387 32 406-484. ORCID ID: 0000-00027379-2489, E-mail: [email protected]
40
ABSTRACT Introduction: The outcome of stroke, especially lethal one is significant, as in the hemorrhagic as well as in ischemic stroke. Goal was to show the impact on the stroke outcome of tachycardia correlated with lesion localization. Material and methods: Material for our work was patients who were treated due to the stroke at the Neurology Clinic Sarajevo in the period from 31 March 2015 until 01 January 2016. A total of 544 stoke patients were treated in the reporting period, 221 (44.6%) died. There were 70.9% patients with ischemic and 29.1% with hemorrhagic stroke. Each patient underwent ECG, which registered tachycardia during admission and on third day of hospitalization. Results: In relation to the presence of tachycardia on admission there were statistically significant differences in the group of patients with hemorrhage and ischemia in relation to presence of tachycardia (p 0.05).
Figure Gender distribution according and of stroke Figure 1. 1. Gender distribution according to types to andtypes subtypes of subtypes stroke 80 analysis by chi-square test shows that there are no statistically significant Statistical differences in the gender representation according to the observed groups (χ2=6.563; 70 p=0.087; p>0.05). 60
2. MATERIAL AND METHODS
Years
50 80
Hemorrhagic - without coma
40 70
Hemorrhagic - coma
30 60
Ischemic - without coma
20 50
Years
Testing was conducted prospectively at the Neurology Clinic from March 31, 2015 until January 1, 2016. The sample consisted of 240 patients with different types and subtypes of cardiovascular stroke. There were 60 ischemic strokes with impaired consciousness of coma type, and 60 without disorder of consciousness of coma type. Hemorrhage strokes was registered in 60 cases with impaired consciousness of coma type, and 60 without the disorder of consciousness of
10 40 0 30
Ischemic - coma Hemorrhagic - without coma 63.33
60.83
65.58
64.73
Mean age
Hemorrhagic - coma Ischemic - without coma
20 2. Mean age according to types and subtypes of stroke Figure Ischemic - coma 10
Mater Sociomed. 2017 Mar; 29(1): 40-44 • ORIGINAL PAPER
0
63.33
60.83
65.58
Mean age
64.73
41
Lateral
Figure 2. Mean age according to types and subtypes of stroke
Medial
Statistical analysisas by a one-way analysis of variance showed wereOutcome no statistically Tachycardia Negative Prognostic Factorthat forthere Stroke significant differences between groups in relation to the mean age (F=2.514; p=0.059; p>0.05).
100
75
60
53.3 46,7 38.3
Absent
% 50
Present
40
13.3
55 Died Survived
Hemorrhagic without coma3
Hemorrhagic without coma4
Figure Tachycardia at admission to types and(χ2=35.576; Figure 3. 3. Tachycardia at admission according toaccording types and subtypes of stroke subtypes of stroke (χ2=35.576; p=0.0001) p=0.0001)
ences between groups in relation to the mean age (F=2.514; p=0.059; p>0.05).
4. DISCUSSION
20
10
10 0
Hemorrhagic without coma2
25
20
11.7
10 Hemorrhagic without coma
17 104 28.3 43.3 43 133 71.7 55.4 60 240 25.0 100.0
80
45
30
30 20
32 53.3 27 45.0 60 25.0
70
61.7
40
0
24 40.0 34 56.7 60 25.0
80
70
% 50
31 51.7 29 48.3 60 25.0
90
90
80
60
χ2=13.876; p=0.031
100
88.3
86.7
90
Total
N % N % N %
Hemorrhagic without coma
Hemorrhagic without coma2
Hemorrhagic without coma3
Hemorrhagic without coma4
Figure4. side according to types andto subtypes strokesubtypes (χ2=72.467;ofp=0.0001) Figure Lesion 4. Lesion side according typesofand stroke
(χ2=72.467; p=0.0001)
istered 675 patients with a first stroke, of which 53% female and 47% male (mean age 72.2 years) (10). In our material, the average age was from 60.83 to 65.8 years as the comparative results of the above studies for the entire sample. We analyze the sample in relation to age by groups and according to a statistical analysis by one-way analysis of variance it is shown
Lesion side
Lesion localization
Statistical analysis by one-way analysis of variance showed that there were no statistically significant differences between groups in relation to the average Group age (p>0.05). Statistical analysis shows that Hemorrhagic Hemorrhagic there are significant differences between the Hemorrhagic - Hemorrhagic - Total - without - without without coma without coma observed group in relation to the presence of coma coma N 3 3 2 3 11 tachycardia on admission at the level of p
