BACKGROUND AND PURPOSE

Infection is a frequent complication after an acute stroke and may affect stroke outcome. We identified predictors of early infection, type of infection, their relation to initial disability, and the eventual outcome during the inpatient period.

METHODS

This was a study of patients with acute ischaemic stroke admitted to Universiti Kebangsaan Malaysia Hospital from June 2000 to January 2001. A single observer, using pre-defined diagnostic criteria recorded information on demography, the type, time of onset, and frequency of infections that occurred during the inpatient period.

RESULTS

One hundred and sixty three patients with acute ischaemic stroke were enrolled in the study. Early infection was observed in 26 (16%) patients. The infections observed were pneumonia (12.3%), and urinary tract infection (3.7%). Using multivariate analysis, the independent predictors of early infection were Barthel index (BI) less than 5 (OR 4.23; 95% CI 1.70 to 5.11), middle cerebral artery (MCA) territory infarcts (OR 4.91; 95%CI 1.57 to 8.82), and a Glasgow coma score (GCS) less than 9 (OR 5.12; 95% CI 2.98 to 15.52). The presence of early infection increased mortality (OR 14.83; 95% CI 4.31 to 51.07).

CONCLUSIONS

Severe disability, large MCA infarct and poor GCS independently predict the development of early infection.