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急性脑梗死早期感染的危险因素。

Risk factors for early infection after an acute cerebral infarction.

作者信息

Hanchaiphiboolkul Suchat

机构信息

Prasat Neurological Institute, Department of Medical Services, Ministry of Public Health, Rajthevee, Bangkok 10400, Thailand.

出版信息

J Med Assoc Thai. 2005 Feb;88(2):150-5.

Abstract

BACKGROUND AND OBJECTIVE

Infection is a common complication after an acute stroke. This is important because it may cause death or delayed successful rehabilitation. Investigation of the risk factors for infection after an acute stroke is limited The objective of this study was to determine the risk factors for early infection after an acute cerebral infarction.

DESIGN

Retrospective analystical study.

MATERIAL AND METHOD

The medical records of patients admitted within 48 hours of onset of symptoms to Prasat Neurological Institute from 1 January 2002 to 31 December 2003, with a diagnosis of cerebral infarction, confirmed with CT or MRI of the brain were retrospectively studied. Collected data included clinical features, risk factors for stroke, comorbid conditions, infection, and results of diagnosis tests. Univariate and multiple logistic regression analyses were used to determine factors that were associated with the risk of early infection.

RESULTS

During the 24-month study period, 332 cerebral infarct patients were identified. Early infection occurred in 7.6%. The most common infection was pneumonia (4.3%). In the final multiple logistic model, independent risk factors for early infections were atrial fibrillation (OR, 9.31; 95% CI, 2.18-39.75), thromboembolic infarction (large vessel disease) (OR, 6.04; 95% CI, 1.97-18.54), admission conscious level (subconscious or unconscious/coma) (OR, 4.82; 95% CI, 1.60-14.55) and previous stroke (OR, 3.20; 95% CI, 1.21-8.47) respectively.

CONCLUSION

Atrial fibrillation, thromboembolic infarction (large vessel disease), admission conscious level (subconscious or unconscious/coma), and previous stroke were independent risk factors for development of early infection.

摘要

背景与目的

感染是急性卒中后的常见并发症。这一点很重要,因为它可能导致死亡或延迟康复。对急性卒中后感染的危险因素的研究有限。本研究的目的是确定急性脑梗死早期感染的危险因素。

设计

回顾性分析研究。

材料与方法

回顾性研究2002年1月1日至2003年12月31日在Prasat神经研究所症状发作48小时内入院、诊断为脑梗死且经头颅CT或MRI证实的患者的病历。收集的数据包括临床特征、卒中危险因素、合并症、感染情况以及诊断检查结果。采用单因素和多因素逻辑回归分析来确定与早期感染风险相关的因素。

结果

在为期24个月的研究期间,共确定了332例脑梗死患者。早期感染发生率为7.6%。最常见的感染是肺炎(4.3%)。在最终的多因素逻辑模型中,早期感染的独立危险因素分别是房颤(比值比[OR],9.31;95%可信区间[CI],2.18 - 39.75)、血栓栓塞性梗死(大血管疾病)(OR,6.04;95% CI,1.97 - 18.54)、入院时意识水平(意识模糊或昏迷)(OR,4.82;95% CI,1.60 - 14.55)和既往卒中(OR,3.20;95% CI,1.21 - 8.47)。

结论

房颤、血栓栓塞性梗死(大血管疾病)、入院时意识水平(意识模糊或昏迷)和既往卒中是早期感染发生的独立危险因素。

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