Publication: Long-term morbidities in stroke survivors: a prospective multicenter study of Thai stroke rehabilitation registry
Issued Date
2013
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Language
eng
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Mahidol University
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BioMed Central
Bibliographic Citation
BMC Geriatrics. Vol. 13, (2013), 33
Suggested Citation
Vilai Kuptniratsaikul, Apichana Kovindha, Sumalee Suethanapornkul, Nuttaset Manimmanakorn, Yingsumal Archongka Long-term morbidities in stroke survivors: a prospective multicenter study of Thai stroke rehabilitation registry. BMC Geriatrics. Vol. 13, (2013), 33. doi:10.1186/1471-2318-13-33 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/2650
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Thesis
Title
Long-term morbidities in stroke survivors: a prospective multicenter study of Thai stroke rehabilitation registry
Abstract
Background: Stroke-related complications are barriers to patients’ recovery leading to increasing morbidity, mortality,
and health care costs, decreasing patient’s quality of life. The purpose of this study was to quantify incidence and risk
factors of stroke-related complications during the first year after discharge from rehabilitation ward.
Methods: A prospective observational study was conducted in nine tertiary-care rehabilitation centers. We evaluated
the incidence of morbidities during the first year after stroke, including musculoskeletal pain, neuropathic pain,
pneumonia, deep vein thrombosis (DVT), pressure ulcer, spasticity, shoulder subluxation, joint contracture, dysphagia,
urinary incontinence, anxiety and depression. The complications at discharge and at month-12 were compared using
the McNemar test. Univariate analysis and multiple logistic regression analysis by forward stepwise method were used
to determine factors predicting the complications at month-12.
Results: Two hundred and fourteen from 327 patients (65.4%) were included. The age was 62.1 ± 12.5 years, and 57.9%
were male. In 76.8% of the patients at least one complication was found during the first year after stroke. Those
complications were musculoskeletal pain (50.7%), shoulder subluxation (29.3%), depression (21.2%), spasticity (18.3%),
joint contracture (15.7%) and urinary incontinence (14.4%). Other complications less than 5% were dysphagia (3.5%),
pressure ulcer (2.6%), infection (1.5%), and neuropathic pain (3.0%). Nearly 60% of patients with complications at
discharge still had the same complaints after one year. Only 7.6% were without any complication. Morbidity was
significantly associated with age and type of stroke. Using multiple logistic regression analysis, age and physical
complications at discharge were significant risk factors for physical and psychological morbidities after stroke
respectively (OR = 2.1, 95% CI 1.2, 3.7; OR = 3.1, 95% CI 1.3, 7.1).
Conclusion: Long-term complications are common in stroke survivors. More than three-fourths of the patients
developed at least one during the first year after rehabilitation. Strategies to prevent complications should be
concerned especially on musculoskeletal pain which was the most common complaint. Physical complications at
discharge period associated with psychological complications at 1 year followed up. More attention should be
emphasized on patients age older than 60 years who were the major risk group for developing such complications.