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Impact of neurological and medical complications on 3-month outcomes in acute ischaemic stroke

Cited 98 time in Web of Science Cited 108 time in Scopus
Authors
Hong, K-S; Kang, D-W; Koo, J-S; Yu, K-H; Han, M-K; Cho, Y-J; Park, J-M; Bae, H-J; Lee, B-C
Issue Date
2008-12-04
Publisher
Wiley-Blackwell
Citation
Eur J Neurol. 2008; 15(12): 1324-1331
Keywords
Acute DiseaseAgedBrain Ischemia/*complications/mortalityCerebral Hemorrhage/etiology/mortalityDiabetes Complications/mortalityFemaleHemorrhage/etiology/mortalityHumansHyperlipidemias/complications/mortalityHypertension/complications/mortalityIncidenceKorea/epidemiologyMaleMiddle AgedMortality/trendsPneumonia/etiology/mortalityPrognosisProspective StudiesRisk FactorsSmoking/adverse effectsStroke/*complications/mortalityTime FactorsUrinary Tract Infections/etiology/mortality
Abstract
OBJECTIVE: To evaluate the impact of neurological and medical complications on 3-month outcomes in acute ischaemic stroke patients. METHODS: We prospectively investigated complications for all the consecutive acute ischaemic stroke patients admitted within 7 days from onset in four university hospitals during a 1-year period. Baseline data and 3-month outcomes were collected. Poor outcome was defined as a modified Rankin Scale score 3-6. RESULTS: A total of 1 254 patients were recruited: 264 (21.1%) and 303 (24.2%) patients experienced one or more neurological and medical complications, respectively. The most common complications were ischaemic stroke progression (17.1%) and pneumonia (12.0%). Of 1 233 patients with available 3-month outcomes, 34.9% had a poor outcome. Multivariate analysis revealed that neurological (odds ratio, 95% confidence interval; 5.47, 3.63-8.24) and medical (3.47, 2.30-5.23) complications were independent predictors of the poor outcome. For the individual complications, ischaemic stroke progression (7.48, 4.73-11.84), symptomatic hemorrhagic transformation (3.57, 1.33-9.54), pneumonia (4.44, 2.20-8.99), extracranial bleeding (4.45, 1.88-10.53), and urinary tract infection (2.72, 1.32-5.60) were independently associated with the poor outcome. CONCLUSION: Outcome after ischaemic stroke is adversely influenced by complications, especially ischaemic stroke progression, symptomatic hemorrhagic transformation, pneumonia, extracranial bleeding, and urinary tract infection. Interventions to prevent those complications might improve ischaemic stroke outcome.
ISSN
1468-1331 (Electronic)
Language
English
URI
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=19049549

http://hdl.handle.net/10371/68390
DOI
https://doi.org/10.1111/j.1468-1331.2008.02310.x
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College of Medicine/School of Medicine (의과대학/대학원)Dept. of Neurology (신경과학교실)Journal Papers (저널논문_신경과학교실)
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