Neurological Sciences

, Volume 32, Issue 4, pp 619–623 | Cite as

Acute medical complications in patients admitted to a stroke unit and safe transfer to rehabilitation

  • Donatella Bonaiuti
  • Paolo Sioli
  • Lorenzo Fumagalli
  • Ettore Beghi
  • Elio Agostoni
Original Article


Acute medical complications often prevent patients with stroke from being transferred from stroke units to rehabilitation units, prolonging the occupation of hospital beds and delaying the start of intensive rehabilitation. This study defined incidence, timing, duration and risk factors of these complications during the acute phase of stroke. A retrospective case note review was made of hospital admissions of patients with stroke not associated with other disabling conditions, admitted to a stroke unit over 12 months and requiring rehabilitation for gait impairment. In this cohort, a search was made of hypertension, oxygen de-saturation, fever, and cardiac and pulmonary symptoms requiring medical intervention. Included were 135 patients. Hypertension was the most common complication (16.3%), followed by heart disease (14.8%), oxygen de-saturation (7.4%), fever (6.7%) and pulmonary disease (5.2%). Heart disease was the earliest and shortest complication. Most complications occurred during the first week. Except for hypertension, all complications resolved within 2 weeks.


Stroke Acute complications Stroke unit Rehabilitation 


  1. 1.
    Langhorne P, Williams BO, Gilchrist W, Howie K (1993) Do stroke units save lives? Lancet 342:395–398PubMedCrossRefGoogle Scholar
  2. 2.
    Stroke Unit Trialists’ Collaboration (1995) A systematic review of specialist multidisciplinary team (stroke unit) care for stroke inpatients. In: Warlow C, Van Gijn J, Sandercock P (eds) Stroke Module of the Cochrane Database of Systematic Reviews. BMJ Publishing Group, LondonGoogle Scholar
  3. 3.
    Donnan GA (1993) Lifesaving for stroke. Lancet 342:383–384PubMedCrossRefGoogle Scholar
  4. 4.
    Kalra L, Evans A, Perez I, Knapp M, Donaldson N, Swift CG (2000) Alternative strategies for stroke care: a prospective randomised controlled trial. Lancet 356:894–899PubMedCrossRefGoogle Scholar
  5. 5.
    Kalra L, Evans A, Perez I, Knapp M, Swift C, Donaldson N (2005) A randomised controlled comparison of alternative strategies in stroke care. Health Technol Assess 9:1–94Google Scholar
  6. 6.
    Langhorne P, Stott DJ, Robertson L, MacDonald J, Jones L, McAlpine C, Dick F, Taylor GS, Murray G (2000) Medical complications after stroke: a multicenter study. Stroke 31:1223–1229PubMedCrossRefGoogle Scholar
  7. 7.
    Hung JW, Tsay TH, Chang HW, Leong CP, Lau YC (2005) Incidence and risk factors of medical complications during inpatient stroke rehabilitation. Chang Gung Med J 28:13–18Google Scholar
  8. 8.
    Roth EJ, Lovell L, Harvey RL, Heinemann AW, Semik P, Diaz S (2001) Incidence and risk factors for medical complications during stroke rehabilitation. Stroke 32:523–529PubMedCrossRefGoogle Scholar
  9. 9.
    Doshi VS, Say JH, Young SH, Doraisamy P (2003) Complications in stroke patients: a study carried out at the rehabilitation medicine service, Changi General Hospital. Singapore Med J 44:643–652PubMedGoogle Scholar
  10. 10.
    Dromerick A, Reding M (1994) Medical and neurological complications during inpatient stroke rehabilitation. Stroke 25:358–361PubMedCrossRefGoogle Scholar
  11. 11.
    Davenport RJ, Dennis MS, Wellwood I, Warlow CP (1996) Complications after acute stroke. Stroke 27:415–420PubMedCrossRefGoogle Scholar
  12. 12.
    WHO MONICA Project Principal Investigators (1988) The World Health Organization MONICA Project (monitoring trends and determinants in cardiovascular disease): a major international collaboration. WHO MONICA Project Principal Investigators. J Clin Epidemiol 41:105–114CrossRefGoogle Scholar
  13. 13.
    Van Swieten JC, Koudstaal PJ, Visser MC, Schouten HJA, van Gijn J (1988) Interobserver agreement for the assessment of handicap in stroke patients. Stroke 19:604–607PubMedCrossRefGoogle Scholar
  14. 14.
    Domka E, Myjkowska E, Kwolek A (2005) Incidence of neuromedical complications during rehabilitation after stroke. Neurol Neurochir Pol 39:300–309PubMedGoogle Scholar
  15. 15.
    Kalra L, Yu G, Wilson K, Roots P (1995) Medical complications during stroke rehabilitation. Stroke 26:990–994PubMedCrossRefGoogle Scholar
  16. 16.
    Black-Schaffer RM, Kirsteins AE, Harvey RL (1999) Stroke rehabilitation. 2. Co-morbidities and complications. Arch Phys Med Rehabil 80:S8–S16PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2011

Authors and Affiliations

  • Donatella Bonaiuti
    • 1
  • Paolo Sioli
    • 1
  • Lorenzo Fumagalli
    • 2
  • Ettore Beghi
    • 3
  • Elio Agostoni
    • 4
  1. 1.Physical Medicine and Rehabilitation DepartmentS. Gerardo HospitalMonzaItaly
  2. 2.Department of NeurosciencesSan Gerardo HospitalMonzaItaly
  3. 3.Istituto di Ricerche Farmacologiche “Mario Negri”MilanItaly
  4. 4.Department of NeurosciencesManzoni HospitalLeccoItaly

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