Skip to main content
Top
Published in: Neurological Sciences 4/2011

01-08-2011 | Original Article

Acute medical complications in patients admitted to a stroke unit and safe transfer to rehabilitation

Authors: Donatella Bonaiuti, Paolo Sioli, Lorenzo Fumagalli, Ettore Beghi, Elio Agostoni

Published in: Neurological Sciences | Issue 4/2011

Login to get access

Abstract

Acute medical complications often prevent patients with stroke from being transferred from stroke units to rehabilitation units, prolonging the occupation of hospital beds and delaying the start of intensive rehabilitation. This study defined incidence, timing, duration and risk factors of these complications during the acute phase of stroke. A retrospective case note review was made of hospital admissions of patients with stroke not associated with other disabling conditions, admitted to a stroke unit over 12 months and requiring rehabilitation for gait impairment. In this cohort, a search was made of hypertension, oxygen de-saturation, fever, and cardiac and pulmonary symptoms requiring medical intervention. Included were 135 patients. Hypertension was the most common complication (16.3%), followed by heart disease (14.8%), oxygen de-saturation (7.4%), fever (6.7%) and pulmonary disease (5.2%). Heart disease was the earliest and shortest complication. Most complications occurred during the first week. Except for hypertension, all complications resolved within 2 weeks.
Literature
1.
go back to reference Langhorne P, Williams BO, Gilchrist W, Howie K (1993) Do stroke units save lives? Lancet 342:395–398PubMedCrossRef Langhorne P, Williams BO, Gilchrist W, Howie K (1993) Do stroke units save lives? Lancet 342:395–398PubMedCrossRef
2.
go back to reference Stroke Unit Trialists’ Collaboration (1995) A systematic review of specialist multidisciplinary team (stroke unit) care for stroke inpatients. In: Warlow C, Van Gijn J, Sandercock P (eds) Stroke Module of the Cochrane Database of Systematic Reviews. BMJ Publishing Group, London Stroke Unit Trialists’ Collaboration (1995) A systematic review of specialist multidisciplinary team (stroke unit) care for stroke inpatients. In: Warlow C, Van Gijn J, Sandercock P (eds) Stroke Module of the Cochrane Database of Systematic Reviews. BMJ Publishing Group, London
4.
go back to reference Kalra L, Evans A, Perez I, Knapp M, Donaldson N, Swift CG (2000) Alternative strategies for stroke care: a prospective randomised controlled trial. Lancet 356:894–899PubMedCrossRef Kalra L, Evans A, Perez I, Knapp M, Donaldson N, Swift CG (2000) Alternative strategies for stroke care: a prospective randomised controlled trial. Lancet 356:894–899PubMedCrossRef
5.
go back to reference Kalra L, Evans A, Perez I, Knapp M, Swift C, Donaldson N (2005) A randomised controlled comparison of alternative strategies in stroke care. Health Technol Assess 9:1–94 Kalra L, Evans A, Perez I, Knapp M, Swift C, Donaldson N (2005) A randomised controlled comparison of alternative strategies in stroke care. Health Technol Assess 9:1–94
6.
go back to reference Langhorne P, Stott DJ, Robertson L, MacDonald J, Jones L, McAlpine C, Dick F, Taylor GS, Murray G (2000) Medical complications after stroke: a multicenter study. Stroke 31:1223–1229PubMedCrossRef Langhorne P, Stott DJ, Robertson L, MacDonald J, Jones L, McAlpine C, Dick F, Taylor GS, Murray G (2000) Medical complications after stroke: a multicenter study. Stroke 31:1223–1229PubMedCrossRef
7.
go back to reference Hung JW, Tsay TH, Chang HW, Leong CP, Lau YC (2005) Incidence and risk factors of medical complications during inpatient stroke rehabilitation. Chang Gung Med J 28:13–18 Hung JW, Tsay TH, Chang HW, Leong CP, Lau YC (2005) Incidence and risk factors of medical complications during inpatient stroke rehabilitation. Chang Gung Med J 28:13–18
8.
go back to reference Roth EJ, Lovell L, Harvey RL, Heinemann AW, Semik P, Diaz S (2001) Incidence and risk factors for medical complications during stroke rehabilitation. Stroke 32:523–529PubMedCrossRef Roth EJ, Lovell L, Harvey RL, Heinemann AW, Semik P, Diaz S (2001) Incidence and risk factors for medical complications during stroke rehabilitation. Stroke 32:523–529PubMedCrossRef
9.
go back to reference Doshi VS, Say JH, Young SH, Doraisamy P (2003) Complications in stroke patients: a study carried out at the rehabilitation medicine service, Changi General Hospital. Singapore Med J 44:643–652PubMed Doshi VS, Say JH, Young SH, Doraisamy P (2003) Complications in stroke patients: a study carried out at the rehabilitation medicine service, Changi General Hospital. Singapore Med J 44:643–652PubMed
10.
go back to reference Dromerick A, Reding M (1994) Medical and neurological complications during inpatient stroke rehabilitation. Stroke 25:358–361PubMedCrossRef Dromerick A, Reding M (1994) Medical and neurological complications during inpatient stroke rehabilitation. Stroke 25:358–361PubMedCrossRef
11.
go back to reference Davenport RJ, Dennis MS, Wellwood I, Warlow CP (1996) Complications after acute stroke. Stroke 27:415–420PubMedCrossRef Davenport RJ, Dennis MS, Wellwood I, Warlow CP (1996) Complications after acute stroke. Stroke 27:415–420PubMedCrossRef
12.
go back to reference WHO MONICA Project Principal Investigators (1988) The World Health Organization MONICA Project (monitoring trends and determinants in cardiovascular disease): a major international collaboration. WHO MONICA Project Principal Investigators. J Clin Epidemiol 41:105–114CrossRef WHO MONICA Project Principal Investigators (1988) The World Health Organization MONICA Project (monitoring trends and determinants in cardiovascular disease): a major international collaboration. WHO MONICA Project Principal Investigators. J Clin Epidemiol 41:105–114CrossRef
13.
go back to reference Van Swieten JC, Koudstaal PJ, Visser MC, Schouten HJA, van Gijn J (1988) Interobserver agreement for the assessment of handicap in stroke patients. Stroke 19:604–607PubMedCrossRef Van Swieten JC, Koudstaal PJ, Visser MC, Schouten HJA, van Gijn J (1988) Interobserver agreement for the assessment of handicap in stroke patients. Stroke 19:604–607PubMedCrossRef
14.
go back to reference Domka E, Myjkowska E, Kwolek A (2005) Incidence of neuromedical complications during rehabilitation after stroke. Neurol Neurochir Pol 39:300–309PubMed Domka E, Myjkowska E, Kwolek A (2005) Incidence of neuromedical complications during rehabilitation after stroke. Neurol Neurochir Pol 39:300–309PubMed
15.
go back to reference Kalra L, Yu G, Wilson K, Roots P (1995) Medical complications during stroke rehabilitation. Stroke 26:990–994PubMedCrossRef Kalra L, Yu G, Wilson K, Roots P (1995) Medical complications during stroke rehabilitation. Stroke 26:990–994PubMedCrossRef
16.
go back to reference Black-Schaffer RM, Kirsteins AE, Harvey RL (1999) Stroke rehabilitation. 2. Co-morbidities and complications. Arch Phys Med Rehabil 80:S8–S16PubMedCrossRef Black-Schaffer RM, Kirsteins AE, Harvey RL (1999) Stroke rehabilitation. 2. Co-morbidities and complications. Arch Phys Med Rehabil 80:S8–S16PubMedCrossRef
Metadata
Title
Acute medical complications in patients admitted to a stroke unit and safe transfer to rehabilitation
Authors
Donatella Bonaiuti
Paolo Sioli
Lorenzo Fumagalli
Ettore Beghi
Elio Agostoni
Publication date
01-08-2011
Publisher
Springer Milan
Published in
Neurological Sciences / Issue 4/2011
Print ISSN: 1590-1874
Electronic ISSN: 1590-3478
DOI
https://doi.org/10.1007/s10072-011-0588-2

Other articles of this Issue 4/2011

Neurological Sciences 4/2011 Go to the issue