Mathematical modeling of severe ischemic stroke with multiple organ failure: a retrospective observational study

Abstract

INTRODUCTION: The development of organ dysfunctions and multiple organ failure (MOF) in patients with severe ischemic stroke (IS) is a factor in aggravating the clinical course and outcome. OBJECTIVE: To study the prognostic aspects of the clinical course and outcomes of severe IS with the development of MOF. MATERIALS AND METHODS: The study included 110 patients with severe IS (National Institutes of Health Stroke Scale ≥ 16 points). To assess the severity of MOF on days 1 and 5 of hospitalization, standard scales SAPS II, SOFA were used. The predictor significance of the indicators was determined by a comparative regression analysis using the least squares method. RESULTS: In patients with a fatal outcome compared to survivors, a higher severity of MOF on the SAPS II was observed both on the first (31 (25; 39) and 24 (21; 29) respectively, p < 0.0001) and fifth days of the disease (40 (33; 49.5) and 29 (25; 35) respectively, p < 0.0001). In the development of severe IS with MOF, an unfavorable outcome is significantly more often observed in the cardioembolic subtype compared to the atherothrombotic subtype of IS (50.75 and 29.85 % respectively, p = 0.0469). The probable mortality according to comparative regression analysis was significantly higher in cardioembolic stroke for patients with MOF severity from 29 to 49 points on the SAPS II (p = 0.0021). CONCLUSIONS: MOF is the most important predictor of death in severe IS. At the same time, the cardioembolic subtype of IS differ by a higher probable mortality in comparison with the atherothrombotic subtype with the MOF severity in the range of 29–49 points according to the SAPS II scale.