ISSN (print) 1726-9806     ISSN (online) 1818-474X
No. 2 (2025), INTENSIVE CARE IN NEUROLOGY
No. 2 (2025)
INTENSIVE CARE IN NEUROLOGY

Predictive significance of multiple organ dysfunction severity in patients with severe ischemic stroke: a prospective observational study

Published 30.04.2025
V.V. Silkin
Orenburg State Medical University, Orenburg, Russia
https://orcid.org/0000-0003-0280-5278
Vadim I. Ershov
Orenburg State Medical University, Orenburg, Russia
https://orcid.org/0000-0001-9150-0382
T.Yu. Lozinskaya
Orenburg State Medical University, Orenburg, Russia
https://orcid.org/0000-0002-1508-5727
A.M. Nazarov
Orenburg State Medical University, Orenburg, Russia
https://orcid.org/0000-0003-4975-9336
N.V. Gumalatova
Orenburg State Medical University, Orenburg, Russia
https://orcid.org/0000-0002-0854-0314
S.N. Liashchenko
Orenburg State Medical University, Orenburg, Russia
https://orcid.org/0000-0001-6467-2242
PDF_2025-2-113-124 (Russian)

Keywords

ischemic stroke
multiple organ dysfunction
prognosis

How to Cite

Silkin V.V., Ershov V.I., Lozinskaya T.Y., Nazarov A.M., Gumalatova N.V., Liashchenko S.N. Predictive significance of multiple organ dysfunction severity in patients with severe ischemic stroke: a prospective observational study. Annals of Critical Care. 2025;(2):113–124. doi:10.21320/1818-474X-2025-2-113-124.
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Abstract

INTRODUCTION: Severe acute ischemic stroke (AIS) remains a pressing problem in modern medicine. The multiple organ dysfunction (MOD) in this category of patients is a common complication, and early assessment its severity is important in determining intensive care tactics. OBJECTIVES: to assess the predictive significance of the severity of MOD in patients with severe AIS.  MATERIALS AND METHODS: The observational two-center prospective study included 140 patients with severe AIS. Neurological status was assessed according to the National Institutes of Health Stroke Scale (NIHSS), severity of the patient's condition and organ disorders using the New Simplified Acute Physiology Score (SAPS II), Sequential Organ Failure Assessment (SOFA) scales. The outcome of the disease was assessed upon discharge from the hospital or upon the fatal outcome. The predictive value of the SAPS II, SOFA, and NIHSS was assessed using ROC analysis and the area under the ROC curve (AUC). RESULTS: The study group included 25 patients with AIS in vertebrobasilar region and 115 with hemispheric localization. The mortality rate was 60 %. Only the SAPS II score was independent predictor for hospital outcome. The SAPS II has the greatest predictive significance (AUC = 0.719). Also, SOFA has a satisfactory predictor value for the 1st day (AUC = 0.706). SAPS II predictor significance was higher in the cardioembolic subtype in the comparison with the atherothrombotic AIS (AUC = 0.808 and AUC = 0.667, respectively). A three-dimensional regression model was obtained for the probable hospital mortality dependence on the NIHSS on the first day and the dynamics of severity by SOFA from day 1 to day 5. CONCLUSIONS: Assessment of the severity of the condition and MOD using specialized scales in patients with severe AIS has prognostic value in relation to the hospital outcomes, including in patients with various pathogenetic subtypes of AIS.

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