Document Detail


In-hospital medical complications and long-term mortality after ischemic stroke.
MedLine Citation:
PMID:  16224097     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND AND PURPOSE: Inhospital medical complications account for a considerable portion of deaths during the early stage of stroke. However, relatively few studies have examined their long-term effects on mortality in stroke patients. METHODS: We prospectively and consecutively collected data on 579 patients with acute ischemic stroke from November 1998 to February 2001. Mortality was confirmed using national death certificate data from 1999 to 2003. RESULTS: During admission, one or more medical complications requiring intervention developed in 160 of these 579 patients (27.6%). For these 160 subjects, the 30-day, 90-day, 1-year, 2-year, 3-year, and 4-year mortalities were 16.3, 29.4, 46.9, 55.6, 61.3, and 70.7%, whereas the mortality figures for those without such complications (n=419) were 1.4, 3.8, 8.8, 15.0, 19.1, and 22.4 (P<0.001 with log-rank test). To eliminate the short-term effects of these complications and thus reveal their long-term effects, we investigated differences in mortality versus the presence of inhospital complications at more than 30 days, 90 days, 1 year, 2 years, and 3 years after stroke, respectively. Cox's proportional hazard regression analysis was applied at these times after stroke and showed that all hazard ratios of medical complications in terms of mortality were statistically larger than one, regardless of adjusting for effects of potential predictors on mortality. CONCLUSIONS: Our study shows that stroke patient mortality is influenced by inhospital medical complications significantly up to the chronic stage. This finding suggests that the appropriate prevention and management of inhospital complications could improve short-term and long-term prognoses after stroke.
Authors:
Hee-Joon Bae; Doo-Sang Yoon; Juneyoung Lee; Byung-Kun Kim; Ja-Seong Koo; Ohyun Kwon; Jong-Moo Park
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2005-10-13
Journal Detail:
Title:  Stroke; a journal of cerebral circulation     Volume:  36     ISSN:  1524-4628     ISO Abbreviation:  Stroke     Publication Date:  2005 Nov 
Date Detail:
Created Date:  2005-10-27     Completed Date:  2006-02-22     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0235266     Medline TA:  Stroke     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2441-5     Citation Subset:  IM    
Affiliation:
Department of Neurology, Eulji General Hospital, Eulji University School of Medicine, Seoul, Korea.
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MeSH Terms
Descriptor/Qualifier:
Aged
Brain Ischemia / pathology
Disease Progression
Female
Hospitals*
Humans
Ischemia / complications*,  mortality*
Male
Middle Aged
Models, Statistical
Multivariate Analysis
Prognosis
Proportional Hazards Models
Prospective Studies
Regression Analysis
Severity of Illness Index
Stroke / complications*,  mortality*
Time Factors
Treatment Outcome
Vascular Diseases / pathology

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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