In-hospital medical, neurological complications and outcome in patients with acute stroke: A prospective study

Abstract

Background: Sparse published data are available regarding the occurrence of medical and neurological complications in patients with acute stroke and their relation to outcome. Methods: In this prospective single centre study, done over one year period, 460 patients with acute stroke were studied. Stroke characteristics, severity, risk factors were documented. Predefined complications were monitored during in-hospital stay. The outcome was measured using modified Rankin scale (mRS) at the time of discharge. Results: Overall, 121 (26.3%) patients developed complications. Majority of patients (44/121,36.4%) developed complications in the first one week hospital stay. The prevalence of neurological and medical complications was 15% and 11.3% respectively. Raised intracranial pressure (ICP) [n=37 (8%)], and pneumonia [n=20 (4.3%)] were more frequently observed complications. Acute stroke patients with complications had a statistically significant poor outcome (mRS 3 to 6) than patients without complications [n=103/121 (85.1%) vs. n=219/339 (64.6%); p <0.001)]. On multivariable analysis, dyslipidaemia [odds ratio (OR) 5.128; p=0.001], hypertension (OR 2.037; p=0.002), age less than 45 years (OR 1.799; p=0.004), stroke severity with moderately severe to severe stroke (OR 4.067; p<0.001) were statistically significant predictors for the occurrence of complications. Conclusions: The mortality and morbidity were more within stroke patients with complications compared with those without complications. Efforts should be directed at preventing the occurrence of medical and surgical complications in patients with acute stroke by optimising the care of there patients.