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Original Paper
Received: December 10, 2001
Accepted: May 7, 2002
Key Words
Stroke Complications * Recurrence
Abstract
The objective of this study was to assess typical earlyonset complications following ischemic stroke in a large, hospital-based cohort to provide clinical data for future randomized trials and quality standards in clinical routine. 3,866 patients with acute ischemic stroke were prospectively documented in 14 Neurology Departments with an acute stroke unit. Within the first week after admission, increased intracranial pressure (7.6%) and recurrent cerebral ischemia (5.1%) were the most fre
quent neurological complications. Fever >38 deg C (13.2%), severe arterial hypertension (7.5%) and pneumonia RAW were the most frequent medical complications. Multivariate regression analysis yielded brain stem infarction and large-artery atherosclerosis as independent predictors for early recurrent ischemic stroke. This study provides representative data on onset and severity of early neurological and medical complications as well as possible predictors for early recurrent cerebral ischemia following acute ischemic stroke.
Introduction
Despite the recent decline in mortality rates, ischemic stroke remains the third leading cause of death and the leading cause of handicap and disability in industrialized countries [1]. In addition to the initial neuronal damage, neurological and medical complications following acute ischemic stroke could be independent predictors for adverse functional outcome and death after 3 months [2]. One issue of optimized care in stroke units therefore is the prevention and treatment of early complications in order to minimize adverse outcome effects and prolongation of hospital stay. Apart from the individual clinical experience, knowledge on onset and course of typical complications following acute ischemic stroke is therefore mandatory to determine the duration of close monitoring and acute care. Several analyses on adverse events in randomized trials have been published, but can be generalized only with caution because these patients were selected according to specific study criteria and had to consent to participate in a clinical trial [3, 4]. On the other hand, hospital-based cohort studies in patients with acute ischemic stroke in the past have only been retrospective or too small to provide representative data on less frequent complications [5, 6].
This study had been planned as part of the German Stroke Databank in order to identify frequency, delay of onset, and severity of...