Detection of symptoms of late complications after stroke in young survivors with active surveillance versus usual care

Purpose Stroke survivors develop late complications after stroke (LCAS) that impair return to pre-stroke responsibilities. Optimal strategies for detection have not been developed. We assessed differences in LCAS symptom detection among young stroke survivors undergoing active surveillance versus usual care. Methods This was a retrospective cohort study including patients age 18-50 with ischemic stroke, transient ischemic attack, or intracerebral hemorrhage evaluated in a Stroke Clinic between 1/1/2016-12/31/2017 with at least one outpatient evaluation during the first year after stroke. "Active surveillance" involved a semi-structured interview to elicit LCAS symptoms including headache, seizures, lethargy, mood disorders, cognitive impairment, central pain, insomnia, spasticity, dystonia, and orthostasis. "Usual care" did not involve the interview. Rates of LCAS symptom detection were assessed at 0-3 months and 3-12 months. Results One hundred twenty-one stroke survivors were included, of which 37% (45) underwent active surveillance. There were no differences in baseline characteristics except hospitalization location. Patients undergoing active surveillance were more likely to have at least one LCAS symptom detected (77% vs 49% at 0-3 months, p = 0.02; 81% vs. 54% at 3-12 months, p = 0.008). Active surveillance was more likely to detect symptoms of non-motor LCAS. There were no differences for motor LCAS. Conclusions Active surveillance leads to higher rates of early symptom detection of non-motor LCAS in young stroke survivors.