Background / Aim
Airway support is recommended for patients with acute stroke who have decreased consciousness or who have bulbar dysfunction, and not to further injure the penumbra.
In trauma, a GCS score of 8 or less automatically necessitates endotracheal intubation. This is not the case for acute stroke. Unfortunately, the prognosis of patients who require endotracheal intubation generally is poor. Families also refuse intubation due to misinformation that intubated patients are more likely to die.
This study aims to determine the demographic profile and functional outcomes of intubated acute stroke patients during the pandemic, with GCS above 8.
Methods
Chart reviews of patients from 2020-2022 are confirmed by imaging. Descriptive statistics and univariate and multivariate logistic regression were used.
Results
A total of 49 cases of intubated acute stroke patients were recorded during the two-year study period where 69.4% were male. Bulk of patients are 60 years old and above (49%). 63.2% of the intubated patients have hemorrhagic strokes commonly located in the cortical regions. Most patients have multiple medical comorbidities. NIHSS, age, type of stroke, location, and volume of intracranial hemorrhage have no direct correlation with endotracheal intubation. COVID-19 infection during acute stroke has no significant correlation to mortality (p-value 0.5018). 59.2% of the intubated patients were extubated but 20.4% of them underwent tracheostomy tube insertion.
Conclusion
Endotracheal intubation is observed in the elderly population with multiple comorbidities, predominantly in males, and commonly presents as unresponsiveness. Most importantly, COVID infection and endotracheal intubation have no impact on mortality.