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(Stroke. 2001;32:523.)
© 2001 American Heart Association, Inc.
Original Contributions |
Incidence of and Risk Factors for Medical Complications During Stroke Rehabilitation
From the Department of Physical Medicine and Rehabilitation, Northwestern University Medical School (E.J.R., R.L.H., A.W.H.) and the Rehabilitation Institute of Chicago (E.J.R., L.L., R.L.H., A.W.H., P.S., S.D.), Chicago, Ill.
Correspondence to Elliot J. Roth, MD, Rehabilitation Institute of Chicago, 345 E Superior St, Chicago, IL 60611-3015. E-mail ejr{at}northwestern.edu
Background and Purpose—The aims of this study were to examine the frequency, types, and clinical factors associated with medical complications that occur during inpatient rehabilitation and to identify risk factors for complications that require a transfer to an acute care facility.
Methods—A cohort of 1029 patients consecutively admitted for inpatient stroke rehabilitation was studied. Demographic and stroke information, impairment, preexisting medical conditions, and admission laboratory abnormalities were recorded. Medical complications, defined as new or exacerbated medical problems, were documented for each patient. Complications that required transfer off rehabilitation were noted. Univariate and multiple logistic regression analyses were used to determine factors that were associated with risk of medical complications and risk of transfer off rehabilitation.
Results—Seventy-five
percent of patients experienced 
1 medical complication during
rehabilitation. Significant factors for the development of any medical
complication included greater neurological deficit (odds ratio [OR],
4.10; confidence interval [CI], 1.88 to 8.91),
hypoalbuminemia (OR, 1.71; 95% CI, 1.15 to 2.52), and history
of hypertension (OR, 1.81; 95% CI, 1.27 to 2.59). Nineteen percent of
patients had a medical complication that required transfer to an acute
care facility. Significant factors for transfers were elevated
admission white blood cell counts (OR, 1.92; 95% CI, 1.32 to 2.79),
low admission hemoglobin levels (OR, 1.89; 95% CI, 1.32 to 2.68),
greater neurological deficit (OR, 2.46; 95% CI, 1.37 to 4.39), and a
history of cardiac arrhythmia (OR, 1.79; 95% CI, 1.18 to
2.67).
Conclusions—Medical complications are common among patients undergoing stroke rehabilitation. A significant number of these medical complications may require a transfer to an acute facility.
Key Words: cerebrovascular disorders • complications • rehabilitation • stroke outcome
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