Published online before print December 20, 2007, doi: 10.1161/STROKEAHA.107.489294
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
(Stroke. 2008;39:414.)
© 2008 American Heart Association, Inc.
Original Contributions |
Medical Complications in a Comprehensive Stroke Unit and an Early Supported Discharge Service
From the Stroke Unit, Department of Medicine, University Hospital of Trondheim (B.I., G.R., E.N.), and the Department of Neuroscience (B.I., G.R.) and Unit for Applied Clinical Research (S.L.), Faculty of Medicine, University of Trondheim, Trondheim, Norway.
Correspondence to Bent Indredavik, Stroke Unit, Department of Medicine, University Hospital of Trondheim, Olav Kyrres gt 17, N-7006 Trondheim, Norway. E-mail Bent.Indredavik{at}ntnu.no
Background and Purpose— The aims of the study were to examine the frequency and timing of predefined medical complications in unselected acute stroke patients treated in an acute comprehensive stroke unit and an early supported discharge service.
Methods— Four hundred eighty-nine acute stroke patients were included and followed up with assessments of 16 prespecified complications during the first week. Two hundred forty-four of the patients were randomly allocated to a 3-month follow-up.
Results— During the first week, 312 of 489 patients (63.8%) experienced 1 or more complications. The most common complications were pain in 117 patients (23.9%), temperature 
38°C in 116 (23.7%), progressing stroke in 90 (18.4%), urinary tract infection in 78 (16.0%), troponin T elevation without criteria of myocardial infarction in 57 (11.7%), chest infections in 55 (11.2%), nonserious falls in 36 (7.4%), and myocardial infarction in 22 (4.5%), whereas stroke recurrence, seizure, deep venous thrombosis, pulmonary embolism, shoulder pain, serious falls, other infections, and pressure sores were each present in 
2.5% of patients. During the 3-month follow-up, 201 of 244 patients (82.4%) experienced at least 1 complication, the most common of which was pain, which occurred in 134 patients (53.3%), followed by urinary tract infection in 68 (27.9%) and nonserious falls in 61 (25.0%). The severity of stroke on admission was the most important risk factor for developing complications.
Conclusions— This is the first study of complications in unselected acute stroke patients treated in a comprehensive stroke unit and early supported discharge service and shows that pain, progressing stroke, infections, myocardial infarction, and falls are common complications, whereas others occur infrequently. Most complications occur during the first 4 days, and stroke severity is the most important risk factor.
Key Words: complications • stroke service • stroke unit
This article has been cited by other articles:
 |
|
 |
|
  A. Hug, A. Dalpke, N. Wieczorek, T. Giese, A. Lorenz, G. Auffarth, A. Liesz, and R. Veltkamp Infarct Volume is a Major Determiner of Post-Stroke Immune Cell Function and Susceptibility to Infection Stroke, October 1, 2009; 40(10): 3226 - 3232. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. Summers, A. Leonard, D. Wentworth, J. L. Saver, J. Simpson, J. A. Spilker, N. Hock, E. Miller, P. H. Mitchell, and on behalf of the American Heart Association Counci Comprehensive Overview of Nursing and Interdisciplinary Care of the Acute Ischemic Stroke Patient: A Scientific Statement From the American Heart Association Stroke, August 1, 2009; 40(8): 2911 - 2944. [Full Text] [PDF]
|
|
|
|
 |
|
 D.J. Stott, A. Falconer, H. Miller, J.C. Tilston, and P. Langhorne Urinary tract infection after stroke QJM, April 1, 2009; 102(4): 243 - 249. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Eriksson, E.-L. Glader, B. Norrving, A. Terent, and B. Stegmayr Sex Differences in Stroke Care and Outcome in the Swedish National Quality Register for Stroke Care Stroke, March 1, 2009; 40(3): 909 - 914. [Abstract] [Full Text] [PDF]
|
|