Monitoring after the acute stage of stroke: a prospective study.

Abstract:

BACKGROUND AND PURPOSE:In the early stage of stroke, the occurrence of neurologic and medical complications is associated with clinical deterioration. Previous studies were focused on the first week after stroke onset. The aim of this study was to evaluate the impact of complications on clinical outcome in patients with stroke in the early subacute stage. METHODS:We prospectively evaluated the influence on the outcome of complications feasible (MC) and not feasible for monitoring (NMC) in all patients with stroke admitted consecutively in our subacute stroke unit. Patients were divided into three classes according to stroke severity evaluated by the National Institutes of Health Stroke Scale score. A change in the National Institutes of Health Stroke Scale score group from admission to discharge was considered clinically significant. RESULTS:We included 261 patients. Sixty percent of patients had complications (105 MC, 118 NMC). Hyperthermia (OR=14.12; 95% CI: 6.01 to 33.20), urinary infections (OR=4.92; 95% CI: 2.19 to 11.04), hypertension (OR=2.86; 95% CI: 1.21 to 6.76), hypoxia (OR=15.75; 95% CI: 6.73 to 36.84), and neuroradiologic damage progression (OR=58.31; 95% CI, 19.48 to 174.55) were associated with a change to a more severe class at discharge and with a higher risk of mortality. CONCLUSIONS:A high percentage of patients can develop both MC and NMC during this subacute stage of stroke. The occurrence of complications influences outcome and raises the question about the need for a prolonged stay in a dedicated ward for patients with stroke.

journal_name

Stroke

journal_title

Stroke

authors

Rocco A,Pasquini M,Cecconi E,Sirimarco G,Ricciardi MC,Vicenzini E,Altieri M,Di Piero V,Lenzi GL

doi

10.1161/01.STR.0000259659.91505.40

subject

Has Abstract

pub_date

2007-04-01 00:00:00

pages

1225-8

issue

4

eissn

0039-2499

issn

1524-4628

pii

01.STR.0000259659.91505.40

journal_volume

38

pub_type

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