Effect of medical complications on the after-stroke rehabilitation outcome

BACKGROUND: Post-stroke rehabilitation should begin immediately and continue while improvement is seen. After stroke, patients are at risk of developing medical complications, which can hinder optimal recovery. OBJECTIVE: We aimed to determine the incidence of complications occurring during early inpatient rehabilitation and to assess their influence on patients' functionality. METHODS: For 1075 patients (585 men), we recorded neurological deficits, activities of everyday living, functionality before and after rehabilitation, and the incidence of complications. The main measure of functional outcome was the discharge Barthel Index score. RESULTS: At least one complication was reported by 76.9% of patients, and 20% experienced three or more complications. The most common problems were: urinary tract infection (23.2%), depression (18.9%), falls (17.9%), unstable hypertension (17.6%), and shoulder pain (14.9%). Patients with a severe discharge disability were 2.5-fold more likely to experience complications than subjects with a mild disability. CONCLUSIONS: Complications during the post stroke rehabilitation process had a significantly decreased chance for improvement. Knowledge of the most common type of complications, as well as their early prevention and treatment, may improve patient outcomes.