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. 2013 Sep 24;8(9):e75719.
doi: 10.1371/journal.pone.0075719. eCollection 2013.

Influence of acute complications on outcome 3 months after ischemic stroke

Maike Miriam Grube  1 , Hans-Christian Koennecke, Georg Walter, Andreas Meisel, Jan Sobesky, Christian Hans Nolte, Ian Wellwood, Peter Ulrich Heuschmann; Berlin Stroke Register (BSR)
Affiliations

Influence of acute complications on outcome 3 months after ischemic stroke

Maike Miriam Grube et al. PLoS One. .

Abstract

Background: Early medical complications are potentially modifiable factors influencing in-hospital outcome. We investigated the influence of acute complications on mortality and poor outcome 3 months after ischemic stroke.

Methods: Data were obtained from patients admitted to one of 13 stroke units of the Berlin Stroke Registry (BSR) who participated in a 3-months-follow up between June 2010 and September 2012. We examined the influence of the cumulative number of early in-hospital complications on mortality and poor outcome (death, disability or institutionalization) 3 months after stroke using multivariable logistic regression analyses and calculated attributable fractions to determine the impact of early complications on mortality and poor outcome.

Results: A total of 2349 ischemic stroke patients alive at discharge from acute care were included in the analysis. Older age, stroke severity, pre-stroke dependency and early complications were independent predictors of mortality 3 months after stroke. Poor outcome was independently associated with older age, stroke severity, pre-stroke dependency, previous stroke and early complications. More than 60% of deaths and poor outcomes were attributed to age, pre-stroke dependency and stroke severity and in-hospital complications contributed to 12.3% of deaths and 9.1% of poor outcomes 3 months after stroke.

Conclusion: The majority of deaths and poor outcomes after stroke were attributed to non-modifiable factors. However, early in-hospital complications significantly affect outcome in patients who survived the acute phase after stroke, underlining the need to improve prevention and treatment of complications in hospital.

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Conflict of interest statement

Competing Interests: MMG reports no disclosures. HCK eceived honoraria for serving as a speaker for ev3 medical, Medtronic, UCB, Bristol-Myers Squibb, and Boehringer Ingelheim. GW reports no disclosures. AM served as a consultant of Atheneum Partners and Mitsubishi Chemical Europe, received honoraria from serving on the scientific advisory board of Biomarin Europe, served on the speakers’ bureau of Siemens Health Care, Biomarin Europe and Temmler GmbH and is funded by the European Union’s Seventh Framework Programme (FP7/2008-2013) under Grant Agreements 201024 and 202213 (European Stroke Network); the Deutsche Forschungsgemeinschaft (NeuroCure Cluster of Excellence, Exc 257, Collaborative Research Centres SFB-TRR 43 and SFB-TRR 84); the Bundesministerium für Bildung und Forschung (Center for Stroke Research Berlin, 01 EO 08 01); the Helmholtz Gemeinschaft (SO-022NG). JS received honorary and travel support from Boehringer Ingelheim, Pfizer and Sanofi. CHN receives/received travel grants and honoraria from Boehringer Ingelheim and Pfizer, honoraria for performing expert witness in court and research support from the Federal Ministry of Education and Research (BMBF) in Germany and the Investitionsbank Berlin. IW reports no disclosures. PUH receives/ received research support from the European Union, the Federal Ministry of Education and Research (BMBF) in Germany, the German Stroke Foundation, and the Charité – Universitätsmedizin Berlin. AM has served as an editor for PLOS ONE. This also does not alter the authors' adherence to all the PLOS ONE policies on sharing data and materials.

Figures

Figure 1
Figure 1. Flow chart of the study population.
See this image and copyright information in PMC

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