Influence of acute complications on outcome 3 months after ischemic stroke

• Published in: PloS one 2013-09, Vol.8 (9), p.e75719-e75719
• Main Authors: Grube, Maike Miriam, Koennecke, Hans-Christian, Walter, Georg, Meisel, Andreas, Sobesky, Jan, Nolte, Christian Hans, Wellwood, Ian, Heuschmann, Peter Ulrich
• Format: Article
• Language: English
• Subjects: Activities of daily living; Age; Aged; Aged, 80 and over; Berlin; Brain Ischemia - complications; Complications; Diabetes; Education; Fatalities; Female; Health aspects; Hospitalization; Humans; Institutionalization; Ischemia; Male; Mortality; Patients; Regression analysis; Stroke; Stroke - complications; Stroke patients; Studies; Urinary tract infections
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0075719

Early medical complications are potentially modifiable factors influencing in-hospital outcome. We investigated the influence of acute complications on mortality and poor outcome 3 months after ischemic stroke. Data were obtained from patients admitted to one of 13 stroke units of the Berlin Stroke Registry (BSR) who participated in a 3-months-follow up between June 2010 and September 2012. We examined the influence of the cumulative number of early in-hospital complications on mortality and poor outcome (death, disability or institutionalization) 3 months after stroke using multivariable logistic regression analyses and calculated attributable fractions to determine the impact of early complications on mortality and poor outcome. A total of 2349 ischemic stroke patients alive at discharge from acute care were included in the analysis. Older age, stroke severity, pre-stroke dependency and early complications were independent predictors of mortality 3 months after stroke. Poor outcome was independently associated with older age, stroke severity, pre-stroke dependency, previous stroke and early complications. More than 60% of deaths and poor outcomes were attributed to age, pre-stroke dependency and stroke severity and in-hospital complications contributed to 12.3% of deaths and 9.1% of poor outcomes 3 months after stroke. The majority of deaths and poor outcomes after stroke were attributed to non-modifiable factors. However, early in-hospital complications significantly affect outcome in patients who survived the acute phase after stroke, underlining the need to improve prevention and treatment of complications in hospital.