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A new marker identification of high risk stroke patients: Jugular saturation - 13/12/19

Doi : 10.1016/j.ajem.2019.03.040 
Mevlut Guven, MD a, , Nazire Belgin Akilli, MD a, Ramazan Koylu, MD a, Vefa Oner, MD b, Merve Guven, MD c, Muhammed Rasit Ozer, MD a
a Department of Emergency Medicine, University of Health Sciences, Konya Education and Research Hospital, Konya, Turkey 
b Department of Radiology, University of Health Sciences, Konya Education and Research Hospital, Konya, Turkey 
c Department of Emergency Medicine, Necmettin Erbakan University, Meram Medical School, Konya, Turkey 

Corresponding author at: Department of Emergency Medicine, University of Health Sciences, Konya Education and Research Hospital, Konya 42090, Turkey.Department of Emergency MedicineUniversity of Health SciencesKonya Education and Research HospitalKonya42090Turkey

Abstract

Objectives

The aim of this prospective study; to investigate in emergency patients with stroke the relationship between jugular saturation and National Institutes of Health Stroke Scale (NIHSS), lesion volume and mortality score.

Materials and methods

In this prospective study, 82 patients who fulfilling the criteria for inclusion in diagnosed with were enrolled in the study. Patients' demographic data, comorbid conditions and stroke type were recorded. The arterial blood pressure, heart rate, and consciousness were recorded at the emergency department. Glasgow Coma Score (GCS) and National Health Institutions Stroke Scale (NIHSS) scores were calculated. Complete Blood Count (CBC) and biochemical values were obtained at the time of admission to the emergency department. Arterial blood gas and jugular venous blood gas were taken and pO2, SpO2 and lactate values were recorded. Patients were grouped according to jugular desaturation (<50%). After imaging, the lesion was located by a specialist radiologist and the lesion volume was calculated. Afterwards, it was followed up by means of the hospital registry system where the patients were followed up (service, intensive care), hospitalization time and whether in-hospital mortality occurred.

Results

82 patients were included in the study. Of the 82 patients, 36 (43.9%) were male and 46 (56.1%) were female. The mean age was 69.8 ± 13.3. Patients were divided into two groups, jugular venous saturation <50% and ≥50%. 16 patients with J.SpO2 <50% were detected. There was no difference between the two groups in terms of age, sex, Glasgow Coma Scale (GCS), National Health Institutions Stroke Scale (NIHSS) score, laboratory data other than hemoglobin and lesion volume (p > 0,05). In-hospital mortality occurred in 9 (13.6%) of patients with J.SpO2 ≥% 50; In the group with J.SpO2 < % 50, 6 patients (37.5%) died within the hospital and this difference was statistically significant (p < 0,05).

Conclusion

SjVO2 measurement can be used to identify high-risk stroke patients and to direct critical interventions. However, no correlation was found between this value and lesion volume and NIHSS scale.

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Keywords : Stroke, Jugular saturation, Mortality


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 The authors have no disclosures or conflicts of interest.


© 2019  Publié par Elsevier Masson SAS.
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Vol 38 - N° 1

P. 7-11 - janvier 2020 Retour au numéro
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