Stroke-Associated Infection Is an Independent Risk Factor for Poor Outcome after Acute Ischemic Stroke: Data from the Netherlands Stroke Survey

Cerebrovascular Diseases - Tập 27 Số 5 - Trang 465-471 - 2009
Frédérique H Vermeij1,2, Wilma J.M. Scholte op Reimer3, Peter de Man4, Robert J. van Oostenbrugge5, Cees L. Franke6, Gosse de Jong7, Paul L.M. de Kort8, Diederik W.J. Dippel1
1Departments of Neurology and
2Neurology and,
3Cardiology, Erasmus University Medical Center, Departments of
4Microbiology, St Franciscus Gasthuis, Rotterdam,
5Department of Neurology University Hospital Maastricht, Maastricht
6Department of Neurology, Atrium Medical Center, Heerlen,
7Department of Neurology, Isala Klinieken, Zwolle, and
8Department of Neurology, St Elizabeth Ziekenhuis, Rotterdam, The Netherlands

Tóm tắt

<i>Background:</i> Infections are a common and serious threat to patients with acute ischemic stroke. The aim of this study was to assess the effect of infection on mortality and functional outcome at discharge and at 1 year. <i>Methods:</i> From a consecutive cohort study in 11 centers, the Netherlands Stroke Survey, we selected 521 patients with ischemic stroke admitted to hospital within 48 h of onset. Stroke-associated infection was defined as infection occurring within 7 days after admission. Poor outcome (modified Rankin score >2) was recorded at discharge and at 1 year. <i>Results:</i> Stroke-associated infection occurred in 78 patients (15%); 39 of these (7.5%) had pneumonia and 23 (4.4%) had urinary tract infection. Overall, 276 patients (53%) had a poor outcome at 1 year. Poor outcome was recorded in 69 patients with stroke-associated infection (88%), and 37 of the 78 patients with stroke-associated infection (47%) had died at 1 year. After adjustment for confounders, stroke-associated infection was associated with poor outcome at discharge [odds ratio (OR) 2.6, 95% confidence interval (CI) 1.0–6.7] and at 1 year (OR 3.8, 95% CI 1.8–8.9). Pneumonia had a stronger association with poor outcome at 1 year (OR 10, 95% CI 2.2–46). <i>Conclusions:</i> This study suggests that stroke-associated infection, in particular pneumonia, is independently associated with poor functional outcome after ischemic stroke.

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Cerebrovascular Diseases

Tập 27 Số 5

465-471

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