Medical complications in a comprehensive stroke unit and an early supported discharge service.

BACKGROUND AND PURPOSE: The aims of the study were to examine the frequency and timing of predefined medical complications in unselected acute stroke patients treated in an acute comprehensive stroke unit and an early supported discharge service.

METHODS: Four hundred eighty-nine acute stroke patients were included and followed up with assessments of 16 prespecified complications during the first week. Two hundred forty-four of the patients were randomly allocated to a 3-month follow-up.

RESULTS: During the first week, 312 of 489 patients (63.8%) experienced 1 or more complications. The most common complications were pain in 117 patients (23.9%), temperature >or=38 degrees C in 116 (23.7%), progressing stroke in 90 (18.4%), urinary tract infection in 78 (16.0%), troponin T elevation without criteria of myocardial infarction in 57 (11.7%), chest infections in 55 (11.2%), nonserious falls in 36 (7.4%), and myocardial infarction in 22 (4.5%), whereas stroke recurrence, seizure, deep venous thrombosis, pulmonary embolism, shoulder pain, serious falls, other infections, and pressure sores were each present in
CONCLUSIONS: This is the first study of complications in unselected acute stroke patients treated in a comprehensive stroke unit and early supported discharge service and shows that pain, progressing stroke, infections, myocardial infarction, and falls are common complications, whereas others occur infrequently. Most complications occur during the first 4 days, and stroke severity is the most important risk factor.