Intraventricular Bleeding and Hematoma Size as Predictors of Infection Development in Intracerebral Hemorrhage: A Prospective Cohort Study

J Stroke Cerebrovasc Dis. 2016 Nov;25(11):2708-2711. doi: 10.1016/j.jstrokecerebrovasdis.2016.07.020. Epub 2016 Aug 17.

Abstract

Background: Acute intracerebral hemorrhage (ICH) is associated with increased susceptibility to bacterial infection. The physiopathology of this phenomenon is not very clear. We conducted a prospective observational study investigating the correlation and independent predictors of infections in patients with ICH.

Patients and methods: Patients admitted between April 1997 and June 2013 with ICH diagnosis were evaluated for inclusion and exclusion criteria.

Results: Two hundred twenty-two patients were included in this study. Ninety four patients (42.6%) presented with an infection during hospitalization being more common than pneumonia (30%) and urinary tract infections (14%). Intraventricular hemorrhage (IVH) (95% confidence interval [CI], 62.7% versus 39.3%; P < .001) and higher ICH score (95% CI, 2.31% versus 1.67%; P = .0014) were more common in patients who had infections. We found the following risk factors for having an infection in patients with ICH: IVH (odds ratio [OR] 2.3; 95% IC, 1.3-4.1), each point of ICH score (OR 1.3; 95% CI, 1.1-1.6), and having a hematoma volume larger than 30 cc (OR 2.0; 95% CI, 1.1-3.5). The localization of the hematoma was not found to be relevant.

Conclusions: ICH score, size of the hematoma, and presence of IVH are independent risk factors for having an infection after ICH.

Keywords: ICH; Intracerebral hemorrhage; hemorrhagic stroke; immune response; infections; stroke inflammation.

Publication types

  • Observational Study

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Bacterial Infections / diagnosis
  • Bacterial Infections / immunology
  • Bacterial Infections / microbiology*
  • Cerebral Angiography / methods
  • Cerebral Hemorrhage / complications*
  • Cerebral Hemorrhage / diagnostic imaging
  • Cerebral Hemorrhage / immunology
  • Chi-Square Distribution
  • Computed Tomography Angiography
  • Cross Infection / diagnosis
  • Cross Infection / immunology
  • Cross Infection / microbiology*
  • Disability Evaluation
  • Female
  • Hematoma / diagnostic imaging
  • Hematoma / etiology*
  • Hematoma / immunology
  • Humans
  • Immunocompromised Host
  • Logistic Models
  • Magnetic Resonance Angiography
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Odds Ratio
  • Prospective Studies
  • Risk Assessment
  • Risk Factors
  • Time Factors
  • Young Adult