Stroke complications may subtract additional 2 years of healthy life

July 01, 2010

Complications shortly after a stroke deprive patients of about two years of healthy life -- in addition to the toll of stroke, according to research reported in Stroke: Journal of the American Heart Association.

Findings from the Complication in Acute Stroke Study (COMPASS) are based on data from more than 1,200 patients (average age 66) treated at four South Korean university hospitals in 2004-05. All patients had an acute ischemic stroke, which results when a blood vessel supplying the brain is blocked.

Researchers gauged the impact of stroke and its complications using disability-adjusted life years (DALY) measures of age, gender and disability level. DALY combines years of life lost with years of healthy life lost due to disability. They calculated DALY lost due to stroke and additional DALY lost due to stroke complications.

The average DALY lost for stroke survivors was 3.82 years. When researchers assessed the effect of complications after stroke, they found that average DALY for those without¬ complications was 3.10 years. However, patients suffering any of a range of complications -- about a third of all subjects -- lost an average of 5.21 DALY, a difference of 2.1 healthy life years.

Other research gauging stroke's burden has focused either on loss of potential life or loss of function. "This study delineates the burden of post-stroke complications with a more comparable and more understandable scale -- healthy life years lost," said Keun-Sik Hong, M.D., Ph.D., lead author of the study and associate professor at Inje University in South Korea.

DALY, a measure of global disease burden devised by the World Health Organization, can yield consistent comparisons between the impact of stroke and other medical conditions and provide insights on treatments' benefits. "Accordingly, this scale helps public health policy decision-makers to allocate limited resources based on a more scientific judgment," Hong said.

Almost 34 percent of patients experience some complication within four weeks of their stroke, including stroke progression, pneumonia, urinary tract infection, additional stroke, seizure, or heart attack.

Patients with one complication lost 1.52 additional DALY on average, while patients with two or more complications lost 2.69 DALY.

Almost half the complications developed within two days of the stroke, including half the cases of pneumonia and 65 percent of the instances of ischemic stroke progression, Hong said.

Among limitations of the study:Having a simple measure to convey the burden of post-stroke complications and the importance of best-practice care can greatly impact hospital and public health decision-making, the researchers said. Formal screening for dysphagia, a swallowing disorder that often results from stroke, can cut risk of developing pneumonia in half. Patients who are spared pneumonia avoid a potential average loss of 2.14 disability-adjusted life years.

Other components of organized stroke care include early rehabilitation and prevention of deep vein thrombosis, clotting in the deep veins such as in the legs, which has potentially fatal complications. "All of these efforts can lead to better stroke outcome," Hong said.
Co-authors are: Jeffrey L. Saver, M.D.; Dong-Wha Kang, M.D., Ph.D.; Hee-Joon Bae, M.D., Ph.D.; Kyung-Ho Yu, M.D., Ph.D.; Jaseong Koo, M.D., Ph.D.; Moon-Ku Han, M.D., Ph.D.; Yong-Jin Cho, M.D., Ph.D.; Jong-Moo Park, M.D., Ph.D.; and Byung-Chul Lee, M.D., Ph.D. Author disclosures are on the manuscript.

The U.S. National Institutes of Health and the American Heart Association funded the study.

Statements and conclusions of study authors published in American Heart Association scientific journals are solely those of the study authors and do not necessarily reflect the association's policy or position. The association makes no representation or guarantee as to their accuracy or reliability. The association receives funding primarily from individuals; foundations and corporations (including pharmaceutical, device manufacturers and other companies) also make donations and fund specific association programs and events. The association has strict policies to prevent these relationships from influencing the science content. Revenues from pharmaceutical and device corporations are available at

Contact information: Dr. Hong can be reached at (011) 82-31-910-7680; (Please do not publish contact information.)

Additional resources

Life after stroke -

Downloadable stock footage and animation are available; click on "Multimedia Resources"

American Heart Association

Related Stroke Articles from Brightsurf:

Stroke alarm clock may streamline and accelerate time-sensitive acute stroke care
An interactive, digital alarm clock may speed emergency stroke care, starting at hospital arrival and through each step of the time-sensitive treatment process.

Stroke patients with COVID-19 have increased inflammation, stroke severity and death
Stroke patients who also have COVID-19 showed increased systemic inflammation, a more serious stroke severity and a much higher rate of death, compared to stroke patients who did not have COVID-19, according a retrospective, observational, cross-sectional study of 60 ischemic stroke patients admitted to UAB Hospital between late March and early May 2020.

'Time is vision' after a stroke
University of Rochester researchers studied stroke patients who experienced vision loss and found that the patients retained some visual abilities immediately after the stroke but these abilities diminished gradually and eventually disappeared permanently after approximately six months.

More stroke awareness, better eating habits may help reduce stroke risk for young adult African-Americans
Young African-Americans are experiencing higher rates of stroke because of health conditions such as high blood pressure, diabetes and obesity, yet their perception of their stroke risk is low.

How to help patients recover after a stroke
The existing approach to brain stimulation for rehabilitation after a stroke does not take into account the diversity of lesions and the individual characteristics of patients' brains.

Kids with headache after stroke might be at risk for another stroke
A new study has found a high incidence of headaches in pediatric stroke survivors and identified a possible association between post-stroke headache and stroke recurrence.

High stroke impact in low- and middle-income countries examined at 11th World Stroke Congress
Less wealthy countries struggle to meet greater need with far fewer resources.

Marijuana use might lead to higher risk of stroke, World Stroke Congress to be told
A five-year study of hospital statistics from the United States shows that the incidence of stroke has risen steadily among marijuana users even though the overall rate of stroke remained constant over the same period.

We need to talk about sexuality after stroke
Stroke survivors and their partners are not adequately supported to deal with changes to their relationships, self-identity, gender roles and intimacy following stroke, according to new research from the University of Sydney.

Standardized stroke protocol can ensure ELVO stroke patients are treated within 60 minutes
A new study shows that developing a standardized stroke protocol of having neurointerventional teams meet suspected emergent large vessel occlusion (ELVO) stroke patients upon their arrival at the hospital achieves a median door-to-recanalization time of less than 60 minutes.

Read More: Stroke News and Stroke Current Events is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to