BACKGROUND AND PURPOSE: The relationship between in-hospital stroke-related medical complications and clinical outcome remains unclear. We examined whether medical complications were associated with length of stay (LOS) and mortality among stroke unit patients. METHODS: Using population-based Danish medical registries, we performed a follow-up study among all patients with acute stroke admitted to stroke units in 2 counties between 2003 and 2009 (n=13 721). Data regarding in-hospital medical complications, including pneumonia, urinary tract infection, pressure ulcer, falls, deep venous thrombosis, pulmonary embolism, and severe constipation together with LOS and mortality were prospectively registered. RESULTS: Overall, 25.2% of patients (n=3453) experienced 1 or more medical complications during hospitalization. The most common complications were urinary tract infection (15.4%), pneumonia (9.0%), and constipation (6.8%). Median LOS was 13 days (25th and 75th quartiles, 5 and 33). All medical complications were associated with longer LOS. The adjusted relative LOS extension ranged from 1.80 (95% CI, 1.54-2.11) for pneumonia to 3.06 (95% CI, 2.67-3.52) for falls. Patients with 1 or more complications had an increased 1-year mortality rate (adjusted mortality rate ratio [MRR], 1.20; 95% CI, 1.04-1.39). The association was mainly because of pneumonia, which was associated with higher mortality both after 30 days (adjusted MRR, 1.59; 95% CI, 1.31-1.93) and 1 year (adjusted MRR, 1.76; 95% CI, 1.45-2.14). CONCLUSIONS: In-hospital medical complications were associated with longer LOS and some, in particular pneumonia, also with an increased mortality among patients with acute stroke.
BACKGROUND AND PURPOSE: The relationship between in-hospital stroke-related medical complications and clinical outcome remains unclear. We examined whether medical complications were associated with length of stay (LOS) and mortality among stroke unit patients. METHODS: Using population-based Danish medical registries, we performed a follow-up study among all patients with acute stroke admitted to stroke units in 2 counties between 2003 and 2009 (n=13 721). Data regarding in-hospital medical complications, including pneumonia, urinary tract infection, pressure ulcer, falls, deep venous thrombosis, pulmonary embolism, and severe constipation together with LOS and mortality were prospectively registered. RESULTS: Overall, 25.2% of patients (n=3453) experienced 1 or more medical complications during hospitalization. The most common complications were urinary tract infection (15.4%), pneumonia (9.0%), and constipation (6.8%). Median LOS was 13 days (25th and 75th quartiles, 5 and 33). All medical complications were associated with longer LOS. The adjusted relative LOS extension ranged from 1.80 (95% CI, 1.54-2.11) for pneumonia to 3.06 (95% CI, 2.67-3.52) for falls. Patients with 1 or more complications had an increased 1-year mortality rate (adjusted mortality rate ratio [MRR], 1.20; 95% CI, 1.04-1.39). The association was mainly because of pneumonia, which was associated with higher mortality both after 30 days (adjusted MRR, 1.59; 95% CI, 1.31-1.93) and 1 year (adjusted MRR, 1.76; 95% CI, 1.45-2.14). CONCLUSIONS: In-hospital medical complications were associated with longer LOS and some, in particular pneumonia, also with an increased mortality among patients with acute stroke.
Authors: Amelia K Boehme; Andre D Kumar; Adrianne M Dorsey; James E Siegler; Monica S Aswani; Michael J Lyerly; Dominique J Monlezun; Alexander J George; Karen C Albright; Timothy M Beasley; Sheryl Martin-Schild Journal: J Stroke Cerebrovasc Dis Date: 2013-08-15 Impact factor: 2.136
Authors: Phil Wells; W Frank Peacock; Gregory J Fermann; Craig I Coleman; Li Wang; Onur Baser; Jeff Schein; Concetta Crivera Journal: J Thromb Thrombolysis Date: 2019-07 Impact factor: 2.300
Authors: Adam J Friedant; Brittany M Gouse; Amelia K Boehme; James E Siegler; Karen C Albright; Dominique J Monlezun; Alexander J George; Timothy Mark Beasley; Sheryl Martin-Schild Journal: J Stroke Cerebrovasc Dis Date: 2015-01-16 Impact factor: 2.136
Authors: Jason-Flor V Sisante; Michael G Abraham; Milind A Phadnis; Sandra A Billinger; Manoj K Mittal Journal: J Stroke Cerebrovasc Dis Date: 2016-07-14 Impact factor: 2.136