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on December 20, 2007

Stroke. 2007
Published online before print December 20, 2007, doi: 10.1161/STROKEAHA.107.489294
A more recent version of this article appeared on February 1, 2008
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Stroke: February 2008, Volume 39, Number 2
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Submitted on May 21, 2007
Revised on June 25, 2007
Accepted on July 4, 2007

Medical Complications in a Comprehensive Stroke Unit and an Early Supported Discharge Service

Bent Indredavik MD, PhD*; Gitta Rohweder MD; Eirik Naalsund RN; and Stian Lydersen PhD

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.

* To whom correspondence should be addressed. 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




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