Department of Neurology, University of Münster, Münster, Germany.
J Neurol Neurosurg Psychiatry. 2010 Feb;81(2):198-202. doi: 10.1136/jnnp.2009.182394. Epub 2009 Sep 2.
Infections in patients with stroke are common and significantly affect outcome. Various predictors of poststroke infections were determined, such as degree of neurological impairment and implementation of therapeutic interventions. The authors investigated whether stroke location and stroke size are independent risk factors for poststroke infections.
591 patients with acute stroke who were treated on our stroke unit were included in a prospective observational study. Predefined endpoints were pneumonia, urinary-tract infection (UTI) and other infections. The OR of infections was calculated for various stroke locations, stroke lateralisation and three categories of stroke size. Logistic regression models were used to adjust for factors significantly associated with poststroke infections in a single-factor analysis.
In the single-factor analysis, the left anterior cerebral artery territory was associated with pneumonia. After adjustment for relevant covariates, this association was no longer statistically significant. Stroke lateralisation showed no association with infection frequency. The largest stroke size was positively associated with pneumonia (OR 3.5, p<0.001). The smallest lesion size was significantly less associated with the occurrence of UTI (OR 0.4, p<0.01).
In this study, lesion size is an independent risk factor for the development of poststroke infection. Particular brain regions associated with infections could not be determined.
脑卒中患者的感染较为常见，并显著影响预后。本研究旨在确定脑卒中后感染的各种预测因素，如神经功能缺损程度和治疗干预措施的实施。作者研究了脑卒中部位和脑卒中体积是否为脑卒中后感染的独立危险因素。
591 例急性脑卒中患者在我院卒中单元接受治疗，本研究为前瞻性观察研究。预先设定的终点事件包括肺炎、尿路感染（UTI）和其他感染。使用逻辑回归模型，对单因素分析中与脑卒中后感染显著相关的因素进行调整，计算各种脑卒中部位、脑卒中侧化和脑卒中体积 3 个分类的感染比值比（OR）。
在单因素分析中，大脑前动脉前循环梗死与肺炎相关。校正相关协变量后，这种相关性不再具有统计学意义。脑卒中侧化与感染频率无相关性。最大脑卒中体积与肺炎呈正相关（OR 3.5，p<0.001）。最小病变体积与 UTI 的发生显著相关（OR 0.4，p<0.01）。
在本研究中，病变体积是脑卒中后感染发生的独立危险因素。未能确定与感染相关的特定脑区。
