Predictors of In-hospital complications in patients of osterior circulation ischemic strokes — a study from a tertiary care centre in Eastern India
Journal Title: Journal of the Indian Medical Association - Year 2017, Vol 115, Issue 12
Abstract
In-hospital complications (neurological and medical) occurring after acute stroke are important prognostic factor dictating the final outcome. So anticipating these complications at the time of admission can enhance surveillance and lead to preventive and timely therapeutic measures improving the outcome in stroke patients. So this study was done to determine the factors predicting in-hospital complications in patients of posterior circulation strokes. This study was aimed to determine the factors that could predict in-hospital complications in patients of posterior circulation strokes. This prospective study included all patients of posterior circulation ischemic strokes admitted in a tertiary care centre in Eastern India over a one year period (n=76). Neurological & medical complications (NMC) included neurological deterioration [ie, worsening by 4 points or more of the National Institute of Health Stroke Scale (NIHSS) score during the hospital stay] and all other medical complications that the patients developed during their hospital stay prior to their discharge or in-hospital mortality. In 30.3% of patients with ischemic stroke developed NMC. Patients who experienced NMC had a higher mean baseline NIHSS score at admission (6.4 versus 4.2,P <0.01).Patients having diabetes as a risk factor had significantly higher rates of complications. In hospital complications were significantly higher in patients having cardio-embolism as the stroke mechanism and in those having infarcts in the distal territory of posterior circulation (distal to and including Superior Cerebeliar Artery (SCA) territory). 30-day mortality and 6 month outcome was significantly poor in patients having complications. Higher NIHSS score (>4), diabetes as a risk factor, cardio-embolism as the stroke mechanism and distal territory infarcts (distal to and including SCA territory)were significant predictors of NMC in patients of posterior circulation strokes which ultimately dictated the 30-day mortality and 6 month outcome. The clinical significance of these findings requires further evaluation in larger prospective studies.
Authors and Affiliations
Biman Kanti Ray, Alak Pandit, Satish Lahoti, Adreesh Mukherjee, Pradip Kumar Chowdhury
Keywords
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