Burden and System-wise Distribution of Multisystem Post- Stroke Complications in an Ambispective Cohort

Chadarajupalli  Srilakshmi; V V Siva Krishna  Pushadapu; Puttagunta Srinivasa  Babu; S.  Kumaravelu; Satheesh S  Gottipati; Pamidipati  Kowshik

doi:10.5530/ctbp.2026.2s.2

Authors

Chadarajupalli Srilakshmi Department of Pharmacy practice, Vignan Pharmacy College, Vadlamudi, Guntur-522213, Andhra Pradesh
V V Siva Krishna Pushadapu Department of Pharmaceutics, Vignan Pharmacy College, Vadlamudi, Guntur-522213, Andhra Pradesh
Puttagunta Srinivasa Babu Department of Pharmaceutics, Vignan Pharmacy College, Vadlamudi, Guntur-522213, Andhra Pradesh
S. Kumaravelu Department of Neurology, Ramesh Hospitals, Guntur-522003, Andhra Pradesh
Satheesh S Gottipati Department of Pharmacy practice, Vignan Pharmacy College, Vadlamudi, Guntur-522213, Andhra Pradesh
Pamidipati Kowshik Department of Pharmacy practice, Vignan Pharmacy College, Vadlamudi, Guntur-522213, Andhra Pradesh

DOI:

https://doi.org/10.5530/ctbp.2026.2s.2

Keywords:

Stroke complications, Barthel Index, Multisystem morbidity, Functional recovery, Neurorehabilitation

Abstract

Background: Post-stroke complications are common and contribute to delayed recovery and long-term disability. However, the cumulative burden of multisystem complications and their relationship with functional outcomes remain insufficiently characterized. Objective: To evaluate the prevalence, system-wise distribution, and functional impact of multisystem post-stroke complications in an ambispective cohort. Methods: An ambispective observational study was conducted in a tertiary care center, integrating six years of retrospective data with six months of prospective follow-up. A total of 350 stroke patients were included. Complications (n = 1,676) were classified across twelve organ systems. Functional outcomes were assessed using changes in the Barthel Index (BI). Multivariable regression, correlation, and subgroup analyses were performed. Results: CNSrelated complications were most frequent (40.0%), followed by pain-related (14.9%) and gastrointestinal (11.6%) complications. Mean BI scores improved significantly (67.5 to 73.5; p < 0.001), with 82.9% of patients showing functional improvement. Multivariable analysis did not identify independent predictors of recovery, and no correlation was observed between complication burden and BI change. Subgroup analyses showed consistent improvement across patient categories. Conclusion: Multisystem complications are highly prevalent after stroke but were not independently associated with functional recovery. Recovery appears to be influenced by multifactorial determinants, highlighting the importance of sustained multidisciplinary management.