Kwan J, Hand P
Department of Medicine for the Elderly, Royal Bournemouth Hospital, Bournemouth, UK.
Acta Neurol Scand. 2007 May;115(5):331-8. doi: 10.1111/j.1600-0404.2006.00783.x.
We sought to explore the frequency, risk factors, and clinical consequences of post-stroke infections (PSI).
We assessed consecutive patients admitted with suspected stroke. On day 1, we recorded the patients' baseline characteristics, stroke subtype and severity, physiological parameters, and laboratory results. On day 5, we recorded the occurrence of complications including infections, and functional outcome.
We recruited 439 patients [398 with stroke and 41 with transient ischaemic attack (TIA)], of whom 73 (17%) had PSI (67 with stroke and 6 with TIA) by day 5. Compared to patients without PSI, those with PSI were significantly more likely to: (i) be older (mean age 78 vs 73 years, P=0.001); (ii) be dependent before admission (47% vs 24%, P<0.001); (iii) have total anterior circulation strokes (40% vs 20%, P<0.001); (iv) be hypoxic on arrival (35% vs 17%, P=0.001); (v) have urinary catheters (43% vs 16%, P<0.001), and (vi) develop pressure sores (7% vs 2%, P=0.022) and seizures (12% vs 2%, P<0.001). After adjusting for case mix, PSI was significantly associated with in-hospital death (OR 2.50, 95% CI 1.27-4.90, P=0.008) and institutionalization on discharge (OR 1.86, 95% CI 1.00-3.43, P=0.049).
Post-stroke infection can affect patients admitted with TIA as well as acute stroke, and it may be associated with poor short-term outcomes.
我们试图探究卒中后感染（PSI）的发生率、危险因素及临床后果。
我们评估了连续收治的疑似卒中患者。在第1天，我们记录了患者的基线特征、卒中亚型及严重程度、生理参数和实验室检查结果。在第5天，我们记录了包括感染在内的并发症的发生情况及功能转归。
我们纳入了439例患者[398例卒中患者和41例短暂性脑缺血发作（TIA）患者]，其中73例（17%）在第5天时发生了PSI（67例卒中患者和6例TIA患者）。与未发生PSI的患者相比，发生PSI的患者更有可能：（i）年龄更大（平均年龄78岁对73岁，P=0.001）；（ii）入院前依赖他人（47%对24%，P<0.001）；（iii）发生完全性前循环卒中（40%对20%，P<0.001）；（iv）入院时缺氧（35%对17%，P=0.001）；（v）留置导尿管（43%对16%，P<0.001），以及（vi）发生压疮（7%对2%，P=0.022）和癫痫发作（12%对2%，P<0.001）。在对病例组合进行调整后，PSI与住院期间死亡（比值比2.50，95%可信区间1.27 - 4.90，P=0.008）及出院时入住机构（比值比1.
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