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Incidence and predictive factors of diaphragmatic dysfunction in acute stroke.
BMC Neurology ( IF 2.2 ) Pub Date : 2020-03-05 , DOI: 10.1186/s12883-020-01664-w
José Vicente Catalá-Ripoll 1 , José Ángel Monsalve-Naharro 1 , Francisco Hernández-Fernández 2
Affiliation  

The most characteristic clinical signs of stroke are motor and/or sensory involvement of one side of the body. Respiratory involvement has also been described, which could be related to diaphragmatic dysfunction contralateral to the brain injury. Our objective is to establish the incidence of diaphragmatic dysfunction in ischaemic stroke and analyse the relationship between this and the main prognostic markers. A prospective study of 60 patients with supratentorial ischaemic stroke in the first 48 h. Demographic and clinical factors were recorded. A diaphragmatic ultrasound was performed for the diagnosis of diaphragmatic dysfunction by means of the thickening fraction, during normal breathing and after forced inspiration. Diaphragmatic dysfunction was considered as a thickening fraction lower than 20%. The appearance of respiratory symptoms, clinical outcomes and mortality were recorded for 6 months. A bivariate and multivariate statistical analysis was designed to relate the incidence of respiratory involvement with the diagnosis of diaphragmatic dysfunction and with the main clinical determinants. An incidence of diaphragmatic dysfunction of 51.7% was observed. 70% (23 cases) of these patients developed symptoms of severe respiratory compromise during follow-up. Independent predictors were diaphragmatic dysfunction in basal respiration (p = 0.026), hemiparesis (p = 0.002) and female sex (p = 0.002). The cut-off point of the thickening fraction with greater sensitivity (75.75%) and specificity (62.9%) was 24% (p = 0.003). There is a high incidence of diaphragmatic dysfunction in patients with supratentorial ischaemic stroke which can be studied by calculating the thickening fraction on ultrasound. Among these patients we have detected a higher incidence of severe respiratory involvement.

中文翻译:

急性中风的of肌功能障碍的发生率和预测因素。

中风最典型的临床症状是身体一侧的运动和/或感觉受累。还描述了呼吸系统受累,这可能与脑损伤对侧的diaphragm肌功能障碍有关。我们的目的是确定缺血性卒中中diaphragm肌功能障碍的发生率,并分析其与主要预后指标之间的关系。前48小时60例幕上缺血性脑卒中患者的前瞻性研究。记录人口和临床因素。在正常呼吸过程中和强制吸气后,通过增厚部分进行肌超声检查以诊断diaphragm肌功能障碍。肌功能障碍被认为是增厚率低于20%。出现呼吸道症状,记录6个月的临床结果和死亡率。设计了双变量和多变量统计分析,以将呼吸道受累的发生率与of肌功能障碍的诊断以及主要的临床决定因素联系起来。of肌功能障碍的发生率为51.7%。这些患者中有70%(23例)在随访期间出现了严重的呼吸困难症状。独立的预测因素是基础呼吸的diaphragm肌功能障碍(p = 0.026),偏瘫(p = 0.002)和女性(p = 0.002)。增稠级分的临界点具有更高的灵敏度(75.75%)和特异性(62.9%),为24%(p = 0.003)。幕上缺血性卒中患者of肌功能障碍的发生率很高,可以通过计算超声的增厚率来研究。在这些患者中,我们发现严重的呼吸系统感染发生率更高。
更新日期:2020-03-06
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