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Background: Post-stroke complications influence mortality, but the assessment of complications is often restricted to the index hospitalization. Information on complications that occur after discharge is limited and the association of such events with mortality is not well described. We assessed the impact of complications occurring after hospital discharge for stroke on mortality within 1 year. Methods: We identified fee-for-service Medicare beneficiaries aged ≥65 years who were discharged with a primary diagnosis of ischemic stroke in 2011-2012. We evaluated four potential complications within the first year after discharge (urinary tract infection, acute myocardial infarction, pulmonary embolism, and decubitus ulcer; chosen via stepwise modeling of 11 complications). We fit a Cox extension model for 1-year all-cause mortality, with the first occurrence of a post-discharge complication as a time-varying variable and adjustment for age, race, sex, and 27 baseline clinical characteristics (e.g., hypertension, diabetes, renal failure, congestive heart failure). Results: There were 437,961 patients discharged with ischemic stroke in 2011-2012 (mean age 78.9y, 55.2% female, 85.4% white). Common baseline comorbidities included hypertension (79.3%), chronic atherosclerosis (34.4%), diabetes (32.8%), anemia (18.6%), and chronic obstructive pulmonary disease (15.7%). The mean index hospital stay was 4.3 days, and 53.1% of patients were discharged home or with home care. The 1-year mortality rate among discharged stroke patients was 23.7%. Post-discharge urinary tract infection (hazard ratio [HR] 1.19, 95% confidence interval [CI] 1.17-1.21), myocardial infarction (HR 1.27, 95% CI 1.22-1.32), pulmonary embolism (HR 1.42, 95% CI 1.34-1.49), and decubitus ulcer (HR 1.65, 95% CI 1.60-1.69) were associated with increased risk of death within 1 year. Conclusion: Post-discharge complications were associated with 1-year mortality after ischemic stroke. Complications related to stroke events reflect aspects of quality of care throughout recovery, not just the index hospitalization. Future analyses of 1-year mortality should consider dynamic changes in post-discharge events that modify risk profiles during the recovery period.