{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,21]],"date-time":"2026-04-21T15:18:44Z","timestamp":1776784724131,"version":"3.51.2"},"reference-count":42,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2026,1,2]],"date-time":"2026-01-02T00:00:00Z","timestamp":1767312000000},"content-version":"vor","delay-in-days":1,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"\u00f6sterreichische Forschungsf\u00f6rderungsgesellschaft","award":["898252"],"award-info":[{"award-number":["898252"]}]},{"DOI":"10.13039\/100031306","name":"Bundesministerium f\u00fcr Arbeit und Wirtschaft","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100031306","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100018774","name":"Bundesministerium f\u00fcr Klimaschutz, Umwelt, Energie, Mobilit\u00e4t, Innovation und Technologie","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100018774","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Federal states of Tyrol, Salzburg, and Vienna"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,1,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Complications may secondarily impair functional outcome after stroke and transient ischemic attack (TIA). Here, we estimated the population-level impact of complications on long-term functional outcome to describe their combined impact and identify the most impactful complications.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patients and methods<\/jats:title>\n                    <jats:p>Patients admitted for acute ischemic stroke or TIA (ABCD2 score\u2009\u2a7e\u20093) and discharged without severe disability were followed-up for occurence of 12 in-hospital and 26 post-discharge complications. Population-level impact of complications on the primary endpoint of non-excellent functional outcome (modified Rankin Scale (mRS)\u2009&amp;gt;\u20091) at end of follow-up 12\u2009months after stroke was assessed by population attributable fraction (PAF). This cohort study was performed at a single European comprehensive stroke center and nested within a randomized controlled trial of intensified post-stroke care, STROKE-CARD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 1705 patients aged 69.4\u2009\u00b1\u200913.6\u2009years (59.8% male), 36.8% (95% confidence interval: 34.5, 39.2) had non-excellent outcome at 12\u2009months, 21.3% (19.4, 23.3) had unfavorable outcome (mRS\u2009&amp;gt;\u20092), and functional worsening occurred in-hospital in 2.6% (2.0, 3.6) and post-discharge in 20.3% (18.4, 22.3). Non-excellent 1-year functional outcome was predicted in-hospital by occurrence of recurrent stroke, neurological worsening, and infections (PAF: 0.6%\u20133.2%). Post-discharge, 12 complications significantly predicted outcome, and pain, severe fatigue, falls, and depression were most impactful (PAF: 5.4%\u201313.0%). Together, in-hospital complications accounted for 7.6% and post-discharge complications for 31.8% of non-excellent outcome, whereas acute therapy (thrombolysis and\/or thrombectomy) and STROKE-CARD care accounted for 8.0% and 14.5% of excellent outcomes. In moderate and severe stroke (NIHSS\u2009&amp;gt;\u20095), acute therapy was the strongest predictor of excellent outcome (PAF: 29.1%). Results were consistent or stronger in patients with TIA, without prestroke disability, or in the regional catchment area, and when focusing on unfavorable outcome or worsening in mRS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>Complications were responsible for more than one third of non-excellent 1-year functional outcome with pain, severe fatigue, depression, and falls most impactful. Complications rivaled the impact of acute therapy and determined functional outcome after TIA as well as after stroke.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Effective prevention and treatment of complications may substantially improve long-term functional outcomes after stroke and TIA.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/esj\/23969873251383315","type":"journal-article","created":{"date-parts":[[2026,1,20]],"date-time":"2026-01-20T11:01:16Z","timestamp":1768906876000},"source":"Crossref","is-referenced-by-count":3,"title":["Effect of in-hospital and post-discharge complications on 1-year functional outcome after stroke and transient ischemic 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,","place":["Austria"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-3075-5437","authenticated-orcid":false,"given":"Anel","family":"Karisik","sequence":"additional","affiliation":[{"name":"Department of Neurology , Medical University of Innsbruck, Innsbruck ,","place":["Austria"]},{"name":"VASCage - Research Centre on Vascular Ageing and Stroke , Innsbruck ,","place":["Austria"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-3508-3923","authenticated-orcid":false,"given":"Kurt","family":"M\u00f6lgg","sequence":"additional","affiliation":[{"name":"Department of Neurology , Medical University of Innsbruck, Innsbruck ,","place":["Austria"]},{"name":"VASCage - Research Centre on Vascular Ageing and Stroke , Innsbruck 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Innsbruck ,","place":["Austria"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karin","family":"Willeit","sequence":"additional","affiliation":[{"name":"Department of Neurology , Medical University of Innsbruck, Innsbruck ,","place":["Austria"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-9172-493X","authenticated-orcid":false,"given":"Wilfried","family":"Lang","sequence":"additional","affiliation":[{"name":"VASCage - Research Centre on Vascular Ageing and Stroke , Innsbruck ,","place":["Austria"]},{"name":"Medical Faculty , Sigmund Freud Private University, Vienna ,","place":["Austria"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Johann","family":"Willeit","sequence":"additional","affiliation":[{"name":"Department of Neurology , Medical University of Innsbruck, Innsbruck 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