title: In-hospital medical complications, length of stay, and mortality among stroke unit patients.
abstract: OBJECTIVE
  The relationship between in-hospital stroke-related medical complications and clinical outcome remains unclear. We examined whether medical complications were associated with length of stay (LOS) and mortality among stroke unit patients.
  
  
  METHODS
  Using population-based Danish medical registries, we performed a follow-up study among all patients with acute stroke admitted to stroke units in 2 counties between 2003 and 2009 (n=13 721). Data regarding in-hospital medical complications, including pneumonia, urinary tract infection, pressure ulcer, falls, deep venous thrombosis, pulmonary embolism, and severe constipation together with LOS and mortality were prospectively registered.
  
  
  RESULTS
  Overall, 25.2% of patients (n=3453) experienced 1 or more medical complications during hospitalization. The most common complications were urinary tract infection (15.4%), pneumonia (9.0%), and constipation (6.8%). Median LOS was 13 days (25th and 75th quartiles, 5 and 33). All medical complications were associated with longer LOS. The adjusted relative LOS extension ranged from 1.80 (95% CI, 1.54-2.11) for pneumonia to 3.06 (95% CI, 2.67-3.52) for falls. Patients with 1 or more complications had an increased 1-year mortality rate (adjusted mortality rate ratio [MRR], 1.20; 95% CI, 1.04-1.39). The association was mainly because of pneumonia, which was associated with higher mortality both after 30 days (adjusted MRR, 1.59; 95% CI, 1.31-1.93) and 1 year (adjusted MRR, 1.76; 95% CI, 1.45-2.14).
  
  
  CONCLUSIONS
  In-hospital medical complications were associated with longer LOS and some, in particular pneumonia, also with an increased mortality among patients with acute stroke.
authors.affiliation: Department of Clinical Epidemiology, Aarhus, University Hospital, Olof Palmes Allé 43-45, 8200 Aarhus N, Denmark. ai@dce.au.dk
authors.forename: Annette
authors.initials: A
authors.lastname: Ingeman
authors.forename: Grethe
authors.initials: G
authors.lastname: Andersen
authors.forename: Heidi H
authors.initials: HH
authors.lastname: Hundborg
authors.forename: Marie L
authors.initials: ML
authors.lastname: Svendsen
authors.forename: Søren P
authors.initials: SP
authors.lastname: Johnsen
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005500:Follow-Up Studies; D017052:Hospital Mortality / Q000639:trends*; D006801:Humans; D007902:Length of Stay / Q000639:trends*; D012042:Registries; D020521:Stroke / Q000175:diagnosis / Q000401:mortality*; D055815:Young Adult