The frequency of poststroke infections and their impact on early stroke outcome

J Stroke Cerebrovasc Dis. 2013 May;22(4):424-9. doi: 10.1016/j.jstrokecerebrovasdis.2013.03.003. Epub 2013 Mar 27.

Abstract

Introduction: Poststroke infections are the most common medical complications of stroke and can occur in up to 65% of patients. The aim of this study was to assess the rate of infectious complications during hospitalization of stroke patients and to evaluate the impact of infection in general, including each of the urinary tract infection (UTI), pneumonia, and sepsis, on fatal and poor functional outcome at discharge.

Methods: This retrospective study enrolled patients who have been diagnosed with acute ischemic stroke treated in a 1-year period. Poor functional outcome at discharge was defined as severe invalidity and included patients with modified Rankin Scale score of 3-5. Univariate and multivariate analyses were performed.

Results: We analyzed 133 patients with acute ischemic stroke. Poststroke infection occurred in 63 (47.4%) patients. The most common infection was UTI that was present in 27 (20.3%) patients. Multivariate logistic regression analysis after adjustment for confounders demonstrated that poststroke infection was an independent predictor of poor functional outcome (odds ratio [OR] 12.82, 95% confidence interval [CI] 4.09-40.0, P < .001) and death at discharge (OR 14.92, 95% CI 2.97-76.92, P = .001). When analyzing the impact of each infectious complication, multivariate logistic regression showed that UTIs were an independent predictor of poor functional outcome (OR 14.08, 95% CI 3.06-64.84, P = .001) and death (OR 9.81, 95% CI 1.46-65.68, P = .019) at discharge.

Conclusion: Infection is a frequent poststroke complication and represents an independent predictor of poor functional and fatal early stroke outcome.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Chi-Square Distribution
  • Communicable Diseases / diagnosis
  • Communicable Diseases / etiology*
  • Communicable Diseases / mortality
  • Communicable Diseases / therapy
  • Female
  • Humans
  • Logistic Models
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Odds Ratio
  • Patient Discharge
  • Pneumonia / etiology
  • Prognosis
  • Recovery of Function
  • Retrospective Studies
  • Risk Factors
  • Sepsis / etiology
  • Severity of Illness Index
  • Stroke / complications*
  • Stroke / diagnosis
  • Stroke / mortality
  • Stroke / therapy
  • Time Factors
  • Urinary Tract Infections / etiology