In-hospital medical complications associated with stroke recurrence after initial ischemic stroke

Wang, Penglian; Wang, Yilong; Zhao, Xingquan; Du, Wanliang; Wang, Anxin; Liu, Gaifen; Liu, Liping; Ji, Ruijun; Wang, Chunxue; Dong, Kun; Wang, Yongjun

doi:10.1097/md.0000000000004929

Cited by 35 publications

(22 citation statements)

References 48 publications

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“…Previous studies demonstrated that pneumonia and urinary tract infection were the most common clinical complications after an ischemic stroke, increasing morbidity and mortality 21-23 . The frequency of these complications in the study population was very similar to previous published studies; pneumonia between 10.6% and 21.2% 6,24-25 , and urinary tract infection between 3.2% and 5.0% 6,24 . There is a reciprocal interaction between complications and hospital stay; the infection retards the discharge, and the length of stay increases the risk of infection 26 .…”

Section: Discussionsupporting

confidence: 89%

Preditores de internação prolongada em Unidade de Acidente Vascular Cerebral (AVC)

Gaspari

Cruz

Batista³

et al. 2019

Rev. Latino-Am. Enfermagem

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Objective to analyze the in-hospital complications of prolonged hospital stay in patients with ischemic stroke or transient ischemic attack, admitted to the stroke unit of a tertiary hospital.Method this is an evaluative correlational study. All first-ever ischemic stroke or transient ischemic attack patients admitted were retrospectively analyzed. During hospital stay, the predictors of long-term hospitalization considered were: 1) clinical complications (pneumonia, urinary tract infection, pressure damage and deep vein thrombosis), and 2) neurological complications (malignant ischemic stroke and symptomatic hemorrhagic transformation).Results 353 patients were discharged in the study period. Mean age was 64.1±13.7 years old and 186 (52.6%) were men. The mean time of hospital stay was 13.7±14.3 days. Pneumonia (25.3±28.8 days, p<0.001), urinary tract infection (32.9±45.2 days, p<0.001) and malignant stroke (29.1±21.4 days, p<0.001) increased significantly the length of hospital stay compared to patients without any complications (11.2±7.1 days).Conclusion this study showed that three complications delayed hospital discharge in patients admitted in a stroke unit, two preventable ones: pneumonia and urinary tract infection. More intense measures to avoid them should be included in the performance indicators to reduce the length of hospital stay in stroke units.

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Section: Discussionsupporting

confidence: 89%

Preditores de internação prolongada em Unidade de Acidente Vascular Cerebral (AVC)

Gaspari

Cruz

Batista³

et al. 2019

Rev. Latino-Am. Enfermagem

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“…These complications included pneumonia, urinary tract infection, HT, gastrointestinal bleeding (GIB), deep vein thrombosis, pulmonary embolism, seizures and brain herniation. The definition of each complication was consistent with that in previous studies (Table 1) [4,18].…”

Section: Methodssupporting

confidence: 64%

“…Medical complications impede optimal recovery after ischemic stroke and are potentially life‐threatening. Accumulating evidence indicates that complications are common in stroke patients and strongly associated with mortality, disability and stroke recurrence after ischemic stroke . For example, hemorrhagic transformation (HT), the most feared complication after intravenous thrombolysis in acute ischemic stroke, limits the widespread use of reperfusion therapies such as anticoagulation and thrombolysis, resulting in the particularly poor outcomes associated with ischemic stroke, especially cardioembolic infarction .…”

Section: Introductionmentioning

confidence: 99%

Impact of anemia on in‐hospital complications after ischemic stroke

Wei

Zhang

Tan

et al. 2018

Euro J of Neurology

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Background and purpose In‐hospital complications after stroke represent barriers to optimal recovery and are even potentially life‐threatening. Anemia is common in stroke patients and is related to poor outcome after stroke. Less is known, however, of the association of anemia with complications. We aimed to investigate the impact of anemia on a series of in‐hospital complications after ischemic stroke. Methods Consecutive patients with ischemic stroke within 7 days were included. Anemia on admission and its severity were defined according to World Health Organization criteria. Eight pre‐specified complications, such as pneumonia, gastrointestinal bleeding (GIB) and hemorrhagic transformation, were recorded during hospitalization. Results A total of 2647 patients were included. Anemia was present in 648 patients (24.5%), and 883 patients (33.4%) experienced at least one complication. Patients with anemia were more likely to experience one or more complications, pneumonia, GIB and thromboembolism (all P < 0.001) than patients without anemia. After adjustment for the confounders, patients with anemia had an adjusted odds ratio for at least one complication of 1.539 [95% confidence interval (CI), 1.232–1.923], for pneumonia of 1.707 (95% CI, 1.345–2.167), for GIB of 2.245 (95% CI, 1.215–4.148) and for thromboembolism of 3.443 (95% CI, 1.668–7.108). The risk of at least one complication, pneumonia, GIB and thromboembolism increased with anemia severity (all P < 0.05). There was no significant association between anemia and urinary tract infection, hemorrhagic transformation, seizures and brain herniation. Conclusion Anemia is an independent predictor of in‐hospital complications following stroke, especially for pneumonia, GIB and thromboembolism. It remains to be studied whether prophylaxis and treatment of anemia would prevent in‐hospital complications.

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“…A prospective cohort study conducted at the Belgrade stroke institutions revealed that the most frequent infections among the AIS patients were urinary tract, intections (UTI) (17.7%) and chest infections (9.7%) 22 . It is well known that complications are associated with worse outcome in those patients 23 . Further, in Korea, the nurses are included in the Stroke Alerts Teams (SAT) organized with the aim to accelerate time to thrombolysis in the patients with AIS 24 .…”

Section: Discussionmentioning

confidence: 99%

Assessment of nursing care-associated predictors of in-hospital mortality in the patients with acute ischemic stroke

Skodric

Marić²,

Jovanović

et al. 2019

VOJNOSANIT PREGL

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Background/Aim. Stroke remains one of the leading causes of death and disability worldwide. The aim of the study was to determine the nursing care-associated predictors of in-hospital mortality in the patients with acute ischemic stroke (AIS) who were hospitalized at the Department of Emergency Neurology. Methods. Prospective cohort study included 59 consecutive patients with AIS admitted to the Department of Emergency Neurology, Neurology Clinic, Clinical Center of Serbia, Belgrade. The patients were followed until discharge or death. For exploring a relationship between the outcome of patients with AIS and different groups of factors, the univariate and multivariate Cox proportionate hazard regression models were used. Results. There were 32 male and 27 female patients with AIS. The mean age was 62.5 ? 15.2 years. The average duration of hospitalization was 11.1 ? 9.6 days (median 8 days; range 1?54 days). Almost 80% of patients (47/59; 79.7%) were admitted to the stroke unit, while 12 (20.3%) patients were admitted to the intensive care unit. In the univariate Cox regression analysis the significant variables (p < 0.05) were the Morse score (p = 0.030) and the type of admission unit (p = 0.029). The multivariate predictive model revealed that the type of admission unit (stroke unit vs conventional unit) [hazard ratio (HR) = 0.16; p = 0.032] was the independent predictor of in-hospital mortality in the patients with AIS. Conclusion. The results of this study showed an important role of nursing staff in the recovery of the AIS patients, as well as that admission to the stroke units versus the conventional units is the independent predictor of decreased in-hospital mortality. [Project of the Serbian Ministry of Education, Science and Technological Development, Grant no. 175087]

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In-hospital medical complications associated with stroke recurrence after initial ischemic stroke

Abstract: Supplemental Digital Content is available in the text

Cited by 35 publications

References 48 publications

Preditores de internação prolongada em Unidade de Acidente Vascular Cerebral (AVC)

Preditores de internação prolongada em Unidade de Acidente Vascular Cerebral (AVC)

Impact of anemia on in‐hospital complications after ischemic stroke

Assessment of nursing care-associated predictors of in-hospital mortality in the patients with acute ischemic stroke

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