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中风住院期间肺炎和尿路感染的发生率及决定因素。

Frequency and determinants of pneumonia and urinary tract infection during stroke hospitalization.

作者信息

Ovbiagele Bruce, Hills Nancy K, Saver Jeffrey L, Johnston S Claiborne

机构信息

Stroke Center and Department of Neurology, University of California at Los Angeles Medical Center, Los Angeles, California, USA.

出版信息

J Stroke Cerebrovasc Dis. 2006 Sep-Oct;15(5):209-13. doi: 10.1016/j.jstrokecerebrovasdis.2006.05.004.

Abstract

BACKGROUND

Patients with acute stroke are at risk for pneumonia and urinary tract infection (UTI). Identifying patients with stroke at high risk for common infections could enhance timely treatment and improve clinical outcomes. We aimed to identify risk factors associated with the occurrence of pneumonia and UTI during stroke hospitalization.

METHODS

We analyzed the frequency of pneumonia and UTI and their influence on outcomes during hospitalization in patients diagnosed with ischemic stroke in the California Acute Stroke Prototype Registry. Generalized estimating equations were used to identify factors and outcomes independently associated with pneumonia and UTI.

RESULTS

Overall, 663 patients were admitted with acute ischemic stroke at 11 hospitals. Pneumonia occurred in 66 (10%) and UTI in 84 (13%). Older age, atrial fibrillation, and congestive heart failure were independently associated with greater risk for developing pneumonia, whereas a history of dementia was associated with lesser risk. Women and patients with a history of cerebrovascular events were significantly more likely to experience a UTI. Both pneumonia and UTI were associated with significantly greater length of stay, but only pneumonia was independently associated with higher inpatient mortality and poorer discharge ambulatory status.

CONCLUSIONS

Several factors are associated with an increased risk of developing pneumonia and UTI during ischemic stroke hospitalization. Early identification and treatment of these patients may improve clinical outcomes.

摘要

背景

急性中风患者有发生肺炎和尿路感染(UTI)的风险。识别中风后有常见感染高风险的患者可加强及时治疗并改善临床结局。我们旨在确定与中风住院期间肺炎和UTI发生相关的危险因素。

方法

我们分析了加利福尼亚急性中风原型登记处确诊为缺血性中风的患者住院期间肺炎和UTI的发生频率及其对结局的影响。使用广义估计方程来确定与肺炎和UTI独立相关的因素和结局。

结果

总体而言,11家医院共收治了663例急性缺血性中风患者。66例(10%)发生肺炎,84例(13%)发生UTI。年龄较大、心房颤动和充血性心力衰竭与发生肺炎的风险增加独立相关,而痴呆病史与较低风险相关。女性和有脑血管事件病史的患者发生UTI的可能性显著更高。肺炎和UTI均与住院时间显著延长相关,但只有肺炎与较高的住院死亡率和较差的出院步行状态独立相关。

结论

缺血性中风住院期间,有几个因素与发生肺炎和UTI的风险增加相关。对这些患者进行早期识别和治疗可能会改善临床结局。

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