Background/Aims: Post-stroke complications may influence prognosis, and may even become potentially life-threatening. The aim of this prospective study was to examine the frequency and timing of medical complications during the acute stage of critical ischemic stroke in patients treated in a neurological intensive care unit. Methods: Seventy acute ischemic stroke patients in a critical condition with morbid changes in organs other than the brain or with severe complications were admitted to a neurological intensive care unit and followed up with assessments of 15 specified complications during the first 2 weeks on days 2, 4, 7, and 14. Results: The most common complications within 2 weeks of onset were chest infection (90%), fever (64%), hypoalbuminemia (56%), arrhythmia (46%), irritable ulcer (44%), gastrointestinal dysfunction (39%), progression or recurrence of stroke (33%), and urinary tract infection (30%). The incidence of progression or recurrence of stroke and urinary tract infection peaked at day 2, and the incidence of arrhythmia, fever, chest infection, irritable ulcer, gastrointestinal dysfunction, and malnutrition peaked from 1 to 2 weeks. Conclusion: Progression or recurrence of stroke, fever, and chest infection are common complications in the acute stage of critical ischemic stroke.

1.
Roth EJ, Lovell L, Harvey RL, Heinemann AW, Semik P, Diaz S: Incidence of and risk factors for medical complications during stroke rehabilitation. Stroke 2001;32:523–529.
2.
Dromerick A, Reding M: Medical and neurological complications during inpatient stroke rehabilitation. Stroke 1994;25:358–361.
3.
Kumar S, Selim MH, Caplen LR: Medical complications after stroke. Lancet Neurol 2010;9:105–118.
4.
Davenport RJ, Dennis MS, Welwood I, Warlow CP: Complications after acute stroke. Stroke 1996;27:415–420.
5.
Langhorne P, Scott DJ, Robertson L: Medical complications after stroke. A multicenter study. Stroke 2000;31:1223–1229.
6.
Govan L, Langhorne P, Weir CJ, Stroke Unit Trialists Collaboration: Does the prevention of complications explain the survival benefit of organized inpatient (stroke unit) care? Further analysis of a systematic review. Stroke 2007;38:2536–2540.
7.
Teasdale G, Jenet B: Assessment of coma and impaired consciousness – a practical scale. Lancet 1974;2:81–84.
8.
Chinese Association of Neurology, Chinese Association of Neurological Surgeons: Key diagnostic criteria for various cerebral vascular diseases. Chin J Neurol 1996;29:379–380.
9.
Indredavik B, Rohweder G, Naalsund E, Lydersen S: Medical complications in a comprehensive stroke unit and an early supported discharge service. Stroke 2008;39;414–420.
10.
Kappelle LJ, van der Worp HB: Treatment of prevention of complications of acute ischemic stroke. Curr Neurol Neurosci Rep 2004;4:36–41.
11.
Gongora-Rivera F, Labreuche J, Jaramillo A, Steg PG, Hauw JJ, Amarenco P: Autopsy prevalence of coronary atherosclerosis in patients with fatal stroke. Stroke 2007;38:1203–1210.
12.
Jensen JK, Kristensen SR, Bak S, Atar D, Høilund-Carlsen PF, Mickley H: Frequency and significance of troponin T elevation in acute ischemic stroke. Am J Cardiol 2007;99:108–112.
13.
Kamel H, Lees KR, Lyden PD, Teal PA, Schaib A, Ali M, Johnston SC: Delayed detection of atrial fibrillation after ischemic stroke. J Stroke Cardiovasc Dis 2009;18:453–457.
14.
Prosser J, MacGregor L, Lees KR, Diener HC, Hacke W, Davis S, VISTA Investigators: Predictors of early cardiac morbidity and mortality after ischemic stroke. Stroke 2007;38:2295–2302.
15.
Heuschmann PU, Kosominsky-Rabas PL, Misselwitz B, Hermanek P, Leffmann C, Janzen RW, Rother J, Buecker-Nott HJ, Berger K, German Stroke Registers Study Group: Predictors of in-hospital mortality and attributable risk of death after ischemic stroke. Arch Intern Med 2004;164:1761–1768.
16.
Sulter G, Elting JW, Langedijk M, Maurits NM, De Keyser J: Admitting acute ischemic stroke patients to a stroke care monitoring unit versus a conventional stroke unit: a randomized pilot study. Stroke 2003;34:101–104.
17.
Suwanwela NC, Eusattasak N, Phanthumchinda K, Piravej K, Locharoenkul C: Combination of acute stroke unit and short-term stroke ward with early supported discharge decreases mortality and complications after acute ischemic stroke. J Med Assoc Thai 2007;90:1089–1096.
18.
Rocco A, Pasquini M, Cecconi E, Sirimarco G, Ricciardi MC, Vicenzini E, Altieri M, Di Piero V, Lenzi GL: Monitoring after the acute stage of stroke: a prospective study. Stroke 2007;38:1225–1228.
19.
Bae HJ, Yoon DS, Lee JY, Kim BK, Koo JS, Kwon O, Park JM: In-hospital medical complications and long-term mortality after ischemic stroke. Stroke 2005;35:2441–2445.
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