Stroke, Vol 25, 358-361, Copyright © 1994 by American Heart Association
A Dromerick and M Reding
BACKGROUND AND PURPOSE: We sought to assess the type, frequency, and
clinical predictors of neuromedical complications occurring during
inpatient rehabilitation after stroke. METHODS: One hundred consecutive
patient records were reviewed. All medical and neurological complications
requiring a physician's order for further evaluation or treatment were
recorded. RESULTS: Complications were urinary tract infection (44 cases),
depression (33), musculoskeletal pain (31), urinary retention (25), falls
(25), fungal dermatitis (24), hypotension (19), diabetes mellitus (16),
hypertension (15), and other neuromedical problem (194). The mean +/- SD
numbers of medical and neurological complications per patient were 3.6 +/-
2 and 0.6 +/- 0.8, respectively. Complications were independently related
to both the severity of functional disability as judged by Barthel score (r
= -.42, P < .001) and length of rehabilitation hospital stay (r = .54, P
< .001). Cardiac complications were predicted by New York Heart
Association class 3 or 4 symptomatology on admission (P < .05). The age,
sex, interval from stroke to rehabilitation hospital admission, and
ischemic versus hemorrhagic etiology of the stroke were unrelated to the
number of complications observed. Thirteen patients required transfer back
to an acute-care hospital, one of whom died within 24 hours of transfer.
There were no deaths on the rehabilitation unit. CONCLUSIONS: We have
defined the type and frequency of neuromedical complications during
inpatient rehabilitation after stroke. Their frequency varies with the
severity of stroke, cardiovascular comorbidity, and length of stay.
ARTICLES
Medical and neurological complications during inpatient stroke rehabilitation
Cornell University Medical College, Burke Rehabilitation Hospital, White Plains, NY.
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