Stroke-related complications in large hemisphere infarction: incidence and influence on unfavorable outcome

Objective: Neurological and medical complications are major causes of morbidity and mortality after ischemic stroke. This study aimed to identify the incidence of stroke-related complications following large hemisphere infarction (LHI) and to explore their influence on unfavorable outcome in LHI patients. Methods: We prospectively enrolled consecutive patients with LHI. The unfavorable outcome was defined as an modified Rankin Scale (mRS) score of 4–6 at 3 months. Multivariate logistic regression analysis was employed to identify the stroke-related complications associated with unfavorable outcome. Results: Of the 256 cases with LHI included, 41 (16.0%) died during hospitalization, 94 (36.7%) died and 140 (55.3%) patients had unfavorable outcome at 3 months. A total of 194 (75.8%) had at least one complication. The three most common medical complications were pneumonia (53.5%), electrolyte disorder (30.9%), and urinary incontinence (18.4%), and the three most common neurological complications were malignant brain edema (31.2%), hemorrhagic transformation (27.7%), and poststroke seizures (7.0%). Overall, LHI patients with unfavorable outcome had more frequent stroke-related complications (91.4% versus 55.8%, p