{"id":{"repo_id":"varna","oai_identifier":"oai:repository.mu-varna.bg:nls/4321"},"canonical_url":"https://search.dev.ndltd.org/etd/varna/oai:repository.mu-varna.bg:nls/4321","repository":{"repo_id":"varna","name":"Medical University of Varna","base_url":"https://repository.mu-varna.bg/oai/request"},"display":{"title":"Predictive Factors for Mortality in Young and Middle-Aged Patients with Ischemic Stroke // Предиктивни фактори за смъртен изход при пациенти с исхемичен мозъчен инсулт в млада и средна възраст","abstract":"The thesis investigates the independent determinants of in-hospital mortality among patients aged 18–59 years with acute ischemic stroke. In this age group, the disease has considerable clinical and social significance, as it frequently results in long-term disability, premature death, and a substantial socioeconomic burden. A retrospective cohort, single-centre study was conducted, including 168 patients admitted to the Second Clinic of Neurology at St. Marina University Hospital – Varna between 2017 and 2022, of whom 67 died during hospitalisation, and 101 survived. Clinical, laboratory, and neuroimaging data were analysed, along with the duration of hospitalisation and the type of treatment administered. Neurological status was assessed using the NIHSS and GCS scales, while ischemic changes were evaluated by ASPECTS. Statistical analysis was performed with SPSS 20.0 and included descriptive statistics, the Mann–Whitney U test, the χ² test, and logistic regression with a significance threshold of p < 0.05. Low systolic blood pressure (≤120 mmHg), severe neurological deficit (NIHSS >15), and chronic left-sided heart failure were identified as the strongest independent predictors of fatal outcome. The study presents an original analysis of clinical, laboratory, and imaging parameters in patients aged 18–59 years, outlining a specific prognostic profile for this population.","abstract_html":"The thesis investigates the independent determinants of in-hospital mortality among patients aged 18–59 years with acute ischemic stroke. In this age group, the disease has considerable clinical and social significance, as it frequently results in long-term disability, premature death, and a substantial socioeconomic burden. A retrospective cohort, single-centre study was conducted, including 168 patients admitted to the Second Clinic of Neurology at St. Marina University Hospital – Varna between 2017 and 2022, of whom 67 died during hospitalisation, and 101 survived. Clinical, laboratory, and neuroimaging data were analysed, along with the duration of hospitalisation and the type of treatment administered. Neurological status was assessed using the NIHSS and GCS scales, while ischemic changes were evaluated by ASPECTS. Statistical analysis was performed with SPSS 20.0 and included descriptive statistics, the Mann–Whitney U test, the χ² test, and logistic regression with a significance threshold of p &lt; 0.05. Low systolic blood pressure (≤120 mmHg), severe neurological deficit (NIHSS &gt;15), and chronic left-sided heart failure were identified as the strongest independent predictors of fatal outcome. The study presents an original analysis of clinical, laboratory, and imaging parameters in patients aged 18–59 years, outlining a specific prognostic profile for this population.","abstract_has_math":false,"creators":["Kulicheva, Paola","Куличева, Паола"],"institution":"Medical University of Varna","degree_name":null,"degree_level":null,"degree_discipline":null,"degree_department":null,"school":null,"contributors":[],"advisors":[],"committee_chairs":[],"committee_members":[],"year":2026,"date_issued":"2026-02-24T13:32:05Z","date_published":"2026-02-24T13:32:05Z","updated_at":"2026-07-27T21:56:27Z","subjects":["acute ischemic stroke","neurological deficit","heart failure","Неврология / Neurology"],"languages":[],"rights":[],"rights_urls":[],"identifier_entries":[]},"links":{"outbound_url":"http://repository.mu-varna.bg/handle/nls/4321","outbound_label":"Repository record","outbound_source":"dc:identifier"},"metadata_groups":[{"id":"people","label":"People","entries":[{"key":"dc:creator","label":"Author","values":["Kulicheva, Paola","Куличева, Паола"]}]},{"id":"academic_context","label":"Academic Context","entries":[{"key":"dc:date","label":"Dc Date","values":["2026-02-24T13:32:05Z","2025"]},{"key":"dc:publisher","label":"Institution","values":["Medical University of Varna"]},{"key":"dc:type","label":"Dc Type","values":["thesis"]}]},{"id":"subjects_keywords","label":"Subjects and Keywords","entries":[{"key":"dc:subject","label":"Dc Subject","values":["acute ischemic stroke","neurological deficit","heart failure","Неврология / Neurology"]}]},{"id":"identifiers","label":"Identifiers","entries":[{"key":"dc:identifier","label":"Identifier","values":["http://repository.mu-varna.bg/handle/nls/4321"]}]},{"id":"additional","label":"Additional Metadata","entries":[{"key":"dc:description","label":"Description","values":["The thesis investigates the independent determinants of in-hospital mortality among patients aged 18–59 years with acute ischemic stroke. In this age group, the disease has considerable clinical and social significance, as it frequently results in long-term disability, premature death, and a substantial socioeconomic burden. A retrospective cohort, single-centre study was conducted, including 168 patients admitted to the Second Clinic of Neurology at St. Marina University Hospital – Varna between 2017 and 2022, of whom 67 died during hospitalisation, and 101 survived. Clinical, laboratory, and neuroimaging data were analysed, along with the duration of hospitalisation and the type of treatment administered. Neurological status was assessed using the NIHSS and GCS scales, while ischemic changes were evaluated by ASPECTS. Statistical analysis was performed with SPSS 20.0 and included descriptive statistics, the Mann–Whitney U test, the χ² test, and logistic regression with a significance threshold of p < 0.05. Low systolic blood pressure (≤120 mmHg), severe neurological deficit (NIHSS >15), and chronic left-sided heart failure were identified as the strongest independent predictors of fatal outcome. The study presents an original analysis of clinical, laboratory, and imaging parameters in patients aged 18–59 years, outlining a specific prognostic profile for this population.","Дисертационният труд изследва независимите детерминанти на вътреболничната смъртност при пациенти на 18–59 години с остър исхемичен инсулт. Заболяването в тази група има висока социална и клинична значимост, тъй като често води до инвалидизация, преждевременна смърт и сериозна обществено-икономическа тежест. Проведено е ретроспективно кохортно едноцентрово проучване с 168 пациенти, хоспитализирани във Втора клиника по нервни болести на УМБАЛ „Св. Марина“ – Варна (2017–2022), от които 67 са с летален изход, а 101 – преживели инсулта. Анализирани са клинични, лабораторни и образни данни, продължителността на хоспитализацията и видът на лечението. Неврологичният статус е оценен по NIHSS и GCS, а исхемичните промени – по ASPECTS. Статистическата обработка със SPSS 20.0 включва дескриптивен анализ, тестовете Mann–Whitney U, χ² и логистична регресия при p < 0.05. Ниското систолно налягане (≤120 mmHg), тежкият неврологичен дефицит (NIHSS >15) и хроничната левостранна сърдечна недостатъчност се установиха като най-силни независими предиктори за летален изход. Трудът представя оригинален анализ на клинични, лабораторни и образни фактори при пациенти на възраст 18–59 години, очертавайки специфичен прогностичен профил за тази популация."]},{"key":"dc:format","label":"Dc Format","values":["application/pdf"]},{"key":"dc:title","label":"Title","values":["Predictive Factors for Mortality in Young and Middle-Aged Patients with Ischemic Stroke // Предиктивни фактори за смъртен изход при пациенти с исхемичен мозъчен инсулт в млада и средна възраст"]}]}],"canonical_facts":{"dc:creator":["Kulicheva, Paola","Куличева, Паола"],"dc:date":["2026-02-24T13:32:05Z","2025"],"dc:description":["The thesis investigates the independent determinants of in-hospital mortality among patients aged 18–59 years with acute ischemic stroke. In this age group, the disease has considerable clinical and social significance, as it frequently results in long-term disability, premature death, and a substantial socioeconomic burden. A retrospective cohort, single-centre study was conducted, including 168 patients admitted to the Second Clinic of Neurology at St. Marina University Hospital – Varna between 2017 and 2022, of whom 67 died during hospitalisation, and 101 survived. Clinical, laboratory, and neuroimaging data were analysed, along with the duration of hospitalisation and the type of treatment administered. Neurological status was assessed using the NIHSS and GCS scales, while ischemic changes were evaluated by ASPECTS. Statistical analysis was performed with SPSS 20.0 and included descriptive statistics, the Mann–Whitney U test, the χ² test, and logistic regression with a significance threshold of p < 0.05. Low systolic blood pressure (≤120 mmHg), severe neurological deficit (NIHSS >15), and chronic left-sided heart failure were identified as the strongest independent predictors of fatal outcome. The study presents an original analysis of clinical, laboratory, and imaging parameters in patients aged 18–59 years, outlining a specific prognostic profile for this population.","Дисертационният труд изследва независимите детерминанти на вътреболничната смъртност при пациенти на 18–59 години с остър исхемичен инсулт. Заболяването в тази група има висока социална и клинична значимост, тъй като често води до инвалидизация, преждевременна смърт и сериозна обществено-икономическа тежест. Проведено е ретроспективно кохортно едноцентрово проучване с 168 пациенти, хоспитализирани във Втора клиника по нервни болести на УМБАЛ „Св. Марина“ – Варна (2017–2022), от които 67 са с летален изход, а 101 – преживели инсулта. Анализирани са клинични, лабораторни и образни данни, продължителността на хоспитализацията и видът на лечението. Неврологичният статус е оценен по NIHSS и GCS, а исхемичните промени – по ASPECTS. Статистическата обработка със SPSS 20.0 включва дескриптивен анализ, тестовете Mann–Whitney U, χ² и логистична регресия при p < 0.05. Ниското систолно налягане (≤120 mmHg), тежкият неврологичен дефицит (NIHSS >15) и хроничната левостранна сърдечна недостатъчност се установиха като най-силни независими предиктори за летален изход. Трудът представя оригинален анализ на клинични, лабораторни и образни фактори при пациенти на възраст 18–59 години, очертавайки специфичен прогностичен профил за тази популация."],"dc:format":["application/pdf"],"dc:identifier":["http://repository.mu-varna.bg/handle/nls/4321"],"dc:publisher":["Medical University of Varna"],"dc:subject":["acute ischemic stroke","neurological deficit","heart failure","Неврология / Neurology"],"dc:title":["Predictive Factors for Mortality in Young and Middle-Aged Patients with Ischemic Stroke // Предиктивни фактори за смъртен изход при пациенти с исхемичен мозъчен инсулт в млада и средна възраст"],"dc:type":["thesis"]},"updated_at":"2026-07-27T21:56:27Z"}