Complications of Cerebrovascular Accident in Two Tertiary Care Hospitals of Peshawar, Pakistan

Stroke is considered as a lethal condition associated with significant mortality and morbidity. After stroke, complications are common and cause devastating effects on rehabilitation. The present study was designed to study the frequency of complications in acute stroke patients in Peshavar, Pakistan. This prospective observational study was conducted from March 2006 to February 2007 in the General Surgery and Neurosurgery Postgraduate Medical Institute, Lady Reading Hospital and Department of General Medicine of Hayatabad Medical Complex in Peshawar, Pakistan in a tertiary health care facility. The study was conducted on 100 consecutive patients of acute stroke, presenting within 7 days of the onset of stroke. All patients fulfilling WHO definition of acute stroke were admitted. The patients with subarachnoid hemorrhage were excluded from study. After initial assessment for the degree of neurological defect and functional disabilities, the patients were investigated for stroke types and cause. Daily assessment of all patients for occurrence of complications was done till discharge from hospital or death of the patient. Fift-eight (58%) patients were male and 42 (42%) were female with a mean age of 59.98 (±11.95) years. The patients with intra-cerebral bleeding were 32 while those with cerebral infarction were 64 and cases with lacunar infarction, were 4. The median hospital stay was 6 days. The main complications were aspiration pneumonia in 28 (28%), constipation in 28 (28%), chest infection in 27 (27%), dehydration in 21 (21%) and urinary tract infection (UTI) in 12 (12%). 16 patients (16%) had no complications and seven patients died. Aspiration pneumonia was the cause of death in four patients (57%) during their hospital stay. Post-stroke complications are very common and these can alter the outcome of stroke patients. Multidisciplinary stroke management is needed to decrease the complications of acute stroke.