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Ershov V.I.
Orenburg State Medical University;
University Research and Clinical Center of Neurology, Neuro-Resuscitation and Neurosurgery
Lozinskaya T.Yu.
Orenburg State Medical University;
University Scientific and Clinical Center of Neurology, Neuroreanimatology and Neurosurgery
Gumalatova N.V.
Orenburg State Medical University;
University Scientific and Clinical Center of Neurology, Neuroreanimatology and Neurosurgery
Golubkina A.A.
Orenburg State Medical University;
University Scientific and Clinical Center of Neurology and Neurosurgery
Silkin V.V.
Orenburg State Medical University;
University Scientific and Clinical Center of Neurology and Neurosurgery
Mathematical modeling of outcomes in patients with clinical combination of ischemic stroke and COVID-19 complicated by multiple organ failure
Journal: Russian Journal of Anesthesiology and Reanimatology. 2025;(3): 42‑49
Read: 249 times
To cite this article:
Ershov VI, Lozinskaya TYu, Gonchar-Zaikin AP, Gumalatova NV, Lutsay ED, Golubkina AA, Silkin VV. Mathematical modeling of outcomes in patients with clinical combination of ischemic stroke and COVID-19 complicated by multiple organ failure. Russian Journal of Anesthesiology and Reanimatology.
2025;(3):42‑49. (In Russ.)
https://doi.org/10.17116/anaesthesiology202503142
Multiple organ failure in patients with severe ischemic stroke is a predictor of unfavorable clinical course and prognosis. In turn, COVID-19 increases the risk of ischemic stroke. Identification of prognostic patterns of multiple organ failure in patients with severe ischemic stroke and COVID-19 may be important for decision support in the management of these patients.
To determine predictive value of multiple organ failure regarding the course and outcomes of severe ischemic stroke following COVID-19.
A retrospective study included 110 COVID-19 patients with severe ischemic stroke NIHSS score ≥16. Severity of multiple organ failure in 1 and 5 days after admission was assessed using standard SAPS II and SOFA scales. Regression analysis using the least squares method was performed to determine significance of indicators.
Dead patients were characterized by more severe multiple organ failure according to SAPS II scale on day 1 (33 (27—39) and 23 (20—27) points, respectively, p=0.038). In case of severe ischemic stroke and COVID-19 complicated by multiple organ failure, unfavorable outcomes were significantly more common in cardioembolic subtype compared to atherothrombotic subtype (87% and 63%, respectively, p=0.004). According to regression analysis, probable mortality was significantly higher in cardioembolic stroke for patients with SAPS II score 30—41 (p=0.043). Serum C-reactive protein was significantly higher in dead patients compared to survivors (p=0.024).
Early multiple organ failure is the most important predictor of death in clinical combination of COVID-19 and severe ischemic stroke. Mortality was significantly higher in patients with cardioembolic subtype, severe acute respiratory failure and increased serum markers of systemic inflammation.
Authors:
Ershov V.I.
Orenburg State Medical University;
University Research and Clinical Center of Neurology, Neuro-Resuscitation and Neurosurgery
Lozinskaya T.Yu.
Orenburg State Medical University;
University Scientific and Clinical Center of Neurology, Neuroreanimatology and Neurosurgery
Gumalatova N.V.
Orenburg State Medical University;
University Scientific and Clinical Center of Neurology, Neuroreanimatology and Neurosurgery
Golubkina A.A.
Orenburg State Medical University;
University Scientific and Clinical Center of Neurology and Neurosurgery
Silkin V.V.
Orenburg State Medical University;
University Scientific and Clinical Center of Neurology and Neurosurgery
Received:
20.11.2024
Accepted:
03.12.2024
List of references:
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