Factors Affecting Prognosis in Hypoxic Encephalopathy Patients Followed-up in Intensive Care Unit

Objectives:Hypoxic encephalopathy (HE) after cardiac arrest is a clinical condition that can cause severe neurological sequelae and death. It is important to determine the prognosis in patients with HE for follow up and developing future treatments in the long term. Our aim was to investigate the ef...

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Main Authors: Nesrin Helvacı Yılmaz, Cem Erdoğan, Deniz Kızılaslan, Özge Arıcı Düz, Eren Toplutaş, Lütfü Hanoğlu
Format: Article
Language:English
Published: Galenos Publishing House 2019-08-01
Series:Ankara Üniversitesi Tıp Fakültesi Mecmuas
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Online Access: http://ankaratipfakultesimecmuasi.net/archives/archive-detail/article-preview/factors-affecting-prognosis-in-hypoxic-encephalopa/30436
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author Nesrin Helvacı Yılmaz
Cem Erdoğan
Deniz Kızılaslan
Özge Arıcı Düz
Eren Toplutaş
Lütfü Hanoğlu
author_facet Nesrin Helvacı Yılmaz
Cem Erdoğan
Deniz Kızılaslan
Özge Arıcı Düz
Eren Toplutaş
Lütfü Hanoğlu
author_sort Nesrin Helvacı Yılmaz
collection DOAJ
description Objectives:Hypoxic encephalopathy (HE) after cardiac arrest is a clinical condition that can cause severe neurological sequelae and death. It is important to determine the prognosis in patients with HE for follow up and developing future treatments in the long term. Our aim was to investigate the effects of age, gender, hypothermia, lesion site in brain magnetic resonance imaging (MRI), seizure and electroencephalography (EEG) findings on prognosis in patients with the diagnosis of HE.Materials and Methods:The data of the adult intensive care unit was evaluated retrospectively. A total of 194 patients with HE were included into the study. One hundred and eighteen (60.8%) of the patients were male and 76 (39.2%) were female. The survivors and those who died were identified. Hypothermia therapy, brain MRI findings (cortical and/or subcortical lesion), presence of seizures (myoclonic, generalized, focal) and EEG findings (epileptic activity, status, generalized slowing) were recorded.Results:The mean age was 59.46±1.71 (18-89). Seventy-six (39.2%) patients underwent hypothermia. One hundred and seven (55.2%) patients died. The rate of exitus in elderly patients was significantly higher (p<0.01). The brain MRI of 88 patients showed hypoxic lesions (cortical in 8 patients, subcortical in 21 patients, cortical + subcortical lesion in 59 patients). The survival rate of the patients with cortical or subcortical pathology is significantly higher than patients with both pathology (p<0.01). As a result of multiple regression analysis, a 1-year increase in age, increased the risk of death by 4%, while the presence of pathological findings in both areas in brain MRI increased the risk of death by 2.62 times. There was no significant difference of gender, hypothermia, seizures and pathological EEG findings on survival (p>0.05).Conclusion:Approximately half of the patients included in our study died. The survival rate of the elderly patients and the patients with multiple lesions in brain MRI was low.
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series Ankara Üniversitesi Tıp Fakültesi Mecmuas
spelling doaj-art-b27323f2e96f4718a28bd8906fa7c1ac2025-08-20T03:39:25ZengGalenos Publishing HouseAnkara Üniversitesi Tıp Fakültesi Mecmuas1307-56081307-56082019-08-0172219920410.4274/atfm.galenos.2018.2019.1687813049054Factors Affecting Prognosis in Hypoxic Encephalopathy Patients Followed-up in Intensive Care UnitNesrin Helvacı Yılmaz0Cem Erdoğan1Deniz Kızılaslan2Özge Arıcı Düz3Eren Toplutaş4Lütfü Hanoğlu5 İstanbul Medipol Üniversitesi Tıp Fakültesi, Nöroloji Anabilim Dalı, İstanbul, Türkiye İstanbul Medipol Üniversitesi Tıp Fakültesi, Anestezi ve Reanimasyon Anabilim Dalı, İstanbul, Türkiye İstanbul Medipol Üniversitesi Tıp Fakültesi, Anestezi ve Reanimasyon Anabilim Dalı, İstanbul, Türkiye İstanbul Medipol Üniversitesi Tıp Fakültesi, Nöroloji Anabilim Dalı, İstanbul, Türkiye İstanbul Medipol Üniversitesi Tıp Fakültesi, Nöroloji Anabilim Dalı, İstanbul, Türkiye İstanbul Medipol Üniversitesi Tıp Fakültesi, Nöroloji Anabilim Dalı, İstanbul, Türkiye Objectives:Hypoxic encephalopathy (HE) after cardiac arrest is a clinical condition that can cause severe neurological sequelae and death. It is important to determine the prognosis in patients with HE for follow up and developing future treatments in the long term. Our aim was to investigate the effects of age, gender, hypothermia, lesion site in brain magnetic resonance imaging (MRI), seizure and electroencephalography (EEG) findings on prognosis in patients with the diagnosis of HE.Materials and Methods:The data of the adult intensive care unit was evaluated retrospectively. A total of 194 patients with HE were included into the study. One hundred and eighteen (60.8%) of the patients were male and 76 (39.2%) were female. The survivors and those who died were identified. Hypothermia therapy, brain MRI findings (cortical and/or subcortical lesion), presence of seizures (myoclonic, generalized, focal) and EEG findings (epileptic activity, status, generalized slowing) were recorded.Results:The mean age was 59.46±1.71 (18-89). Seventy-six (39.2%) patients underwent hypothermia. One hundred and seven (55.2%) patients died. The rate of exitus in elderly patients was significantly higher (p<0.01). The brain MRI of 88 patients showed hypoxic lesions (cortical in 8 patients, subcortical in 21 patients, cortical + subcortical lesion in 59 patients). The survival rate of the patients with cortical or subcortical pathology is significantly higher than patients with both pathology (p<0.01). As a result of multiple regression analysis, a 1-year increase in age, increased the risk of death by 4%, while the presence of pathological findings in both areas in brain MRI increased the risk of death by 2.62 times. There was no significant difference of gender, hypothermia, seizures and pathological EEG findings on survival (p>0.05).Conclusion:Approximately half of the patients included in our study died. The survival rate of the elderly patients and the patients with multiple lesions in brain MRI was low. http://ankaratipfakultesimecmuasi.net/archives/archive-detail/article-preview/factors-affecting-prognosis-in-hypoxic-encephalopa/30436 Hypoxic EncephalopathyPrognosisIntensive Care Unit
spellingShingle Nesrin Helvacı Yılmaz
Cem Erdoğan
Deniz Kızılaslan
Özge Arıcı Düz
Eren Toplutaş
Lütfü Hanoğlu
Factors Affecting Prognosis in Hypoxic Encephalopathy Patients Followed-up in Intensive Care Unit
Ankara Üniversitesi Tıp Fakültesi Mecmuas
Hypoxic Encephalopathy
Prognosis
Intensive Care Unit
title Factors Affecting Prognosis in Hypoxic Encephalopathy Patients Followed-up in Intensive Care Unit
title_full Factors Affecting Prognosis in Hypoxic Encephalopathy Patients Followed-up in Intensive Care Unit
title_fullStr Factors Affecting Prognosis in Hypoxic Encephalopathy Patients Followed-up in Intensive Care Unit
title_full_unstemmed Factors Affecting Prognosis in Hypoxic Encephalopathy Patients Followed-up in Intensive Care Unit
title_short Factors Affecting Prognosis in Hypoxic Encephalopathy Patients Followed-up in Intensive Care Unit
title_sort factors affecting prognosis in hypoxic encephalopathy patients followed up in intensive care unit
topic Hypoxic Encephalopathy
Prognosis
Intensive Care Unit
url http://ankaratipfakultesimecmuasi.net/archives/archive-detail/article-preview/factors-affecting-prognosis-in-hypoxic-encephalopa/30436
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