title: Effect of in-hospital medical complications on case fatality post-acute ischemic stroke: data from the China National Stroke Registry.
abstract: BACKGROUND
  In-hospital medical complications are associated with poorer clinical outcomes for stroke patients after disease onset. However, few studies from China have reported the effect of these complications on the mortality of patients with acute ischemic stroke. In this prospective work, the China National Stroke Registry Study, we investigated the effect of medical complications on the case fatality of patients with acute ischemic stroke.
  
  
  METHODS
  From September 2007 to August 2008, we prospectively obtained the data of patients with acute stroke from 132 clinical centers in China. Medical complications, case fatality and other information recorded at baseline, during hospitalisation, and at 3, 6, and 12 months after stroke onset. Multivariable Logistic regression was performed to analyze the effect of medical complications on the case fatality of patients with acute ischemic stroke.
  
  
  RESULTS
  There were 39 741 patients screened, 14 526 patients with acute ischemic stroke recruited, and 11 560 ischemic stroke patients without missing data identified during the 12-month follow-up. Of the 11 560 ischemic patients, 15.8% (1826) had in-hospital medical complications. The most common complication was pneumonia (1373; 11.9% of patients), followed by urinary tract infection and gastrointestinal bleeding. In comparison with patients without complications, stroke patients with complications had a significantly higher risk of death during their hospitalization, and at 3, 6 and 12 months post-stroke. Having any one in-hospital medical complication was an independent risk factor for death in patients with acute ischemic stroke during hospital period (adjusted OR = 6.946; 95%CI 5.181 to 9.314), at 3 months (adjusted OR = 3.843; 95%CI 3.221 to 4.584), 6 months (adjusted OR = 3.492; 95%CI 2.970 to 4.106), and 12 months (adjusted OR = 3.511; 95%CI 3.021 to 4.080). Having multiple complications strongly increased the death risk of patients.
  
  
  CONCLUSIONS
  Short-term and long-term outcomes of acute stroke patients are affected by in-hospital medical complications.
authors.affiliation: Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing 100050, China.
authors.forename: Peng-Lian
authors.initials: PL
authors.lastname: Wang
authors.forename: Xing-Quan
authors.initials: XQ
authors.lastname: Zhao
authors.forename: Zhong-Hua
authors.initials: ZH
authors.lastname: Yang
authors.forename: An-Xin
authors.initials: AX
authors.lastname: Wang
authors.forename: Chun-Xue
authors.initials: CX
authors.lastname: Wang
authors.forename: Li-Ping
authors.initials: LP
authors.lastname: Liu
authors.forename: Yi-Long
authors.initials: YL
authors.lastname: Wang
authors.forename: Xin-Gao
authors.initials: XG
authors.lastname: Wang
authors.forename: Yi
authors.initials: Y
authors.lastname: Ju
authors.forename: Sheng-Yun
authors.initials: SY
authors.lastname: Chen
authors.forename: Qi-Dong
authors.initials: QD
authors.lastname: Chen
authors.forename: Hui
authors.initials: H
authors.lastname: Qu
authors.forename: Jing-Jing
authors.initials: JJ
authors.lastname: Lu
authors.forename: Jing
authors.initials: J
authors.lastname: Zhang
authors.forename: Rui-Hua
authors.initials: RH
authors.lastname: Ma
authors.forename: Yu-Mei
authors.initials: YM
authors.lastname: Zhang
authors.forename: Yong-Jun
authors.initials: YJ
authors.lastname: Wang
mesh_terms: D000368:Aged; D002681:China; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000150:complications; D017052:Hospital Mortality; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D011014:Pneumonia / Q000150:complications; D011446:Prospective Studies; D012042:Registries / Q000706:statistics & numerical data; D020521:Stroke / Q000401:mortality*; D014552:Urinary Tract Infections / Q000150:complications