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. 2019 Aug 30:12:1756286419873264.
doi: 10.1177/1756286419873264. eCollection 2019.

Stroke-related complications in large hemisphere infarction: incidence and influence on unfavorable outcome

Jie Li  1 , Ping Zhang  1 , Simiao Wu  2 , Yanfen Wang  1 , Ju Zhou  1 , Xingyang Yi  1 , Chun Wang  3
Affiliations

Stroke-related complications in large hemisphere infarction: incidence and influence on unfavorable outcome

Jie Li et al. Ther Adv Neurol Disord. .

Abstract

Objective: Neurological and medical complications are major causes of morbidity and mortality after ischemic stroke. This study aimed to identify the incidence of stroke-related complications following large hemisphere infarction (LHI) and to explore their influence on unfavorable outcome in LHI patients.

Methods: We prospectively enrolled consecutive patients with LHI. The unfavorable outcome was defined as an modified Rankin Scale (mRS) score of 4-6 at 3 months. Multivariate logistic regression analysis was employed to identify the stroke-related complications associated with unfavorable outcome.

Results: Of the 256 cases with LHI included, 41 (16.0%) died during hospitalization, 94 (36.7%) died and 140 (55.3%) patients had unfavorable outcome at 3 months. A total of 194 (75.8%) had at least one complication. The three most common medical complications were pneumonia (53.5%), electrolyte disorder (30.9%), and urinary incontinence (18.4%), and the three most common neurological complications were malignant brain edema (31.2%), hemorrhagic transformation (27.7%), and poststroke seizures (7.0%). Overall, LHI patients with unfavorable outcome had more frequent stroke-related complications (91.4% versus 55.8%, p < 0.001) than patients with favorable outcome. After adjusting for age, baseline National Institutes of Health Stroke Scale score, and other confounders, only malignant brain edema [odds ratios (OR) 19.76, 95% confidence interval (CI) 4.73-82.45] and pneumonia (OR 2.45, 95% CI 1.11-5.40) were independently associated with 3-month unfavorable outcome in patients with LHI.

Conclusions: More than three-quarters of LHI patients have at least one stroke-related complication. LHI patients with the unfavorable outcome had stroke-related complications more frequently, whereas only malignant brain edema and pneumonia are independently associated with 3-month unfavorable outcome.

Keywords: complications; large hemispheric infarction; outcome.

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Conflict of interest statement

Conflict of interest statement: The authors declare that there is no conflict of interest.

Figures

Figure 1.
Figure 1.
The incidence of stroke-related complications in the entire cohort of LHI patients. LHI, large hemisphere infarction.
See this image and copyright information in PMC

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