Stroke-related complications in large hemisphere infarction: incidence and influence on unfavorable outcome
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 pat...
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doaj-9327dae6db674570b04e98ef468eccfc2020-11-25T03:16:27ZengSAGE PublishingTherapeutic Advances in Neurological Disorders1756-28642019-08-011210.1177/1756286419873264Stroke-related complications in large hemisphere infarction: incidence and influence on unfavorable outcomeJie LiPing ZhangSimiao WuYanfen WangJu ZhouXingyang YiChun WangObjective: 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.https://doi.org/10.1177/1756286419873264 |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Jie Li Ping Zhang Simiao Wu Yanfen Wang Ju Zhou Xingyang Yi Chun Wang |
spellingShingle |
Jie Li Ping Zhang Simiao Wu Yanfen Wang Ju Zhou Xingyang Yi Chun Wang Stroke-related complications in large hemisphere infarction: incidence and influence on unfavorable outcome Therapeutic Advances in Neurological Disorders |
author_facet |
Jie Li Ping Zhang Simiao Wu Yanfen Wang Ju Zhou Xingyang Yi Chun Wang |
author_sort |
Jie Li |
title |
Stroke-related complications in large hemisphere infarction: incidence and influence on unfavorable outcome |
title_short |
Stroke-related complications in large hemisphere infarction: incidence and influence on unfavorable outcome |
title_full |
Stroke-related complications in large hemisphere infarction: incidence and influence on unfavorable outcome |
title_fullStr |
Stroke-related complications in large hemisphere infarction: incidence and influence on unfavorable outcome |
title_full_unstemmed |
Stroke-related complications in large hemisphere infarction: incidence and influence on unfavorable outcome |
title_sort |
stroke-related complications in large hemisphere infarction: incidence and influence on unfavorable outcome |
publisher |
SAGE Publishing |
series |
Therapeutic Advances in Neurological Disorders |
issn |
1756-2864 |
publishDate |
2019-08-01 |
description |
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. |
url |
https://doi.org/10.1177/1756286419873264 |
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