Diedler Jennifer, Sykora Marek, Hahn Philipp, Rupp André, Rocco Andrea, Herweh Christian, Steiner Thorsten
Department of Neurology, University of Heidelberg, Heidelberg, Germany.
Cerebrovasc Dis. 2009;27(3):272-9. doi: 10.1159/000199465. Epub 2009 Feb 6.
The aim of the current study was to assess the occurrence of infection and its impact on the short- and long-term outcome of patients with supratentorial intracerebral hemorrhage (ICH).
247 patients suffering from supratentorial ICH were extracted from our local stroke database. Complete data sets including long-term functional outcome measured by the modified Rankin Scale (mRS), and baseline computed tomography data could be obtained in 113. The charts of these patients were screened for the presence and cause of infection, and baseline and maximal C-reactive protein (CRP) levels were recorded.
We identified 52 patients (50.5%) with infection during their hospital stay. Patients with infection, had significantly larger hemorrhages (28.7 vs. 11.9 ml; p = 0.002), a poorer admission status (National Institutes of Health Stroke Scale, NIHSS, score 14 vs. 6; p = 0.002) and more frequently intraventricular hemorrhage extension (46.2 vs. 23.5%; p = 0.016) than those without infection. In a multivariate logistic regression model, baseline NIHSS score (odds ratio, OR, 1.2, 95% confidence interval, CI, 1.1-1.31, p < 0.001), age (OR 1.1, 95% CI 1.03-1.16, p = 0.002) and maximal CRP levels (OR 1.72, 95% CI 1.12-2.64, p = 0.013) were independent predictors of poor long-term functional outcome (mRS >2).
Infections were frequent complications in our cohort of ICH patients and occurred significantly more often in patients with poor functional outcome. Maximal CRP levels were an independent predictor of poor outcome in a multivariate model.
本研究旨在评估幕上脑出血（ICH）患者感染的发生率及其对短期和长期预后的影响。
从我们当地的卒中数据库中提取247例幕上脑出血患者。在113例患者中可获得完整数据集，包括用改良Rankin量表（mRS）测量的长期功能预后以及基线计算机断层扫描数据。对这些患者的病历进行筛查，以确定感染的存在和原因，并记录基线和最高C反应蛋白（CRP）水平。
我们确定52例患者（50.5%）在住院期间发生感染。与未感染患者相比，感染患者的出血量明显更大（28.7 vs. 11.9 ml；p = 0.002），入院时状况更差（美国国立卫生研究院卒中量表，NIHSS，评分14 vs. 6；p = 0.002），脑室内出血扩展更频繁（46.2 vs. 23.5%；p = 0.016）。在多因素逻辑回归模型中，基线NIHSS评分（比值比，OR，1.2，95%置信区间，CI，1.1 - 1.31，p < 0.001）、年龄（OR 1.1，95% CI 1.03 - 1.16，p = 0.002）和最高CRP水平（OR 1.72，95% CI 1.12 - 2.64，p = 0.013）是长期功能预后不良（mRS >2）的独立预测因素。
感染是我们脑出血患者队列中的常见并发症，在功能预后不良的患者中发生频率明显更高。在多因素模型中，最高CRP水平是预后不良的独立预测因素。
