Medical complications after stroke - Multicenter study

Background and Purpose-This prospective, multicenter study was performed to determine the frequency of symptomatic complications up to 30 months after stroke using prespecified definitions of complications. Methods-We recruited 311 consecutive stroke patients admitted to hospital. Research nurses reviewed their progress on a weekly basis until hospital di scharge and again at 6, 18, and 30 months after stroke. Results-Complications during hospital admission were recorded in 265 (85%) of stroke patients. Specific complications were as follows: neurological-re current stroke (9% of patients), epileptic seizure (3%); infections-urinary tract infection (24%), chest infection (22%), others (19%); mobility relat ed-falls (25%), falls with serious injury (5%), pressure sores (21%); throm boembolism-deep venous thrombosis (2%), pulmonary embolism (1%); pain-shoul der pain (9%), other pain (34%); and psychological-depression (16%), anxiet y (14%), emotionalism (12%), and confusion (56%). During follow-up, infecti ons, falls, "blackouts," pain, and symptoms of depression and anxiety remai ned common. Complications were observed across all 3 hospital sites, and th eir frequency was related to patient dependency and duration after stroke. Conclusions-Our prospective cohort study has confirmed that poststroke comp lications, particularly infections and falls, are common. However, we have also identified complications relating to pain and cognitive or affective s ymptoms that are potentially preventable and may previously have been under estimated.