Post-stroke complications and its association with mortality of patients with stroke: a five-year experience at a tertiary care centre in Nepal

Abstract

Introduction: Post–stroke complications increase the mortality, delay the recovery, prolong the hospitalization and increase the health care costs. Data regarding the post–stroke complications in Nepal are limited. We aimed to determine post–stroke medical complications and their association with mortality among patients admitted with stroke.

Materials and methods: This study was a five–year retrospective analysis among patients aged 18 years and above, diagnosed with stroke and admitted to the Department of Internal medicine between 2012 and 2016 at B.P. Koirala Institute of Health Sciences (BPKIHS) in Eastern Nepal. Data on patient characteristics and post stroke medical complications were extracted from medical records and expressed as descriptive statistics. Mortality was considered as a poor outcome and its association with post–stroke medication complications was determined using bivariate analysis.

Results: There were 278 patients with stroke in the five year period, with the mean±SD age of 65±15 years. Ischemic stroke was most prevalent (82.9%) stroke type. The most common post–stroke complication was aspiration pneumonia (25.9%) followed by raised intracranial pressure (13.3%), pressure sores (8.3%), and urinary tract infections (5.4%). The mortality rate was 18.7%. There was a statistically significant association of aspiration pneumonia and raised intracranial pressure with mortality at P<0.001.

Conclusion: Aspiration pneumonia and raised intracranial pressure were the common post–stroke complications among patients with stroke admitted in BPKIHS and mortality was significantly associated with these complications.