Clinic for Infectious and Tropical Diseases, Clinical Center of Serbia, Belgrade, Serbia.
J Stroke Cerebrovasc Dis. 2013 May;22(4):424-9. doi: 10.1016/j.jstrokecerebrovasdis.2013.03.003. Epub 2013 Mar 27.
Poststroke infections are the most common medical complications of stroke and can occur in up to 65% of patients. The aim of this study was to assess the rate of infectious complications during hospitalization of stroke patients and to evaluate the impact of infection in general, including each of the urinary tract infection (UTI), pneumonia, and sepsis, on fatal and poor functional outcome at discharge.
This retrospective study enrolled patients who have been diagnosed with acute ischemic stroke treated in a 1-year period. Poor functional outcome at discharge was defined as severe invalidity and included patients with modified Rankin Scale score of 3-5. Univariate and multivariate analyses were performed.
We analyzed 133 patients with acute ischemic stroke. Poststroke infection occurred in 63 (47.4%) patients. The most common infection was UTI that was present in 27 (20.3%) patients. Multivariate logistic regression analysis after adjustment for confounders demonstrated that poststroke infection was an independent predictor of poor functional outcome (odds ratio [OR] 12.82, 95% confidence interval [CI] 4.09-40.0, P < .001) and death at discharge (OR 14.92, 95% CI 2.97-76.92, P = .001). When analyzing the impact of each infectious complication, multivariate logistic regression showed that UTIs were an independent predictor of poor functional outcome (OR 14.08, 95% CI 3.06-64.84, P = .001) and death (OR 9.81, 95% CI 1.46-65.68, P = .019) at discharge.
Infection is a frequent poststroke complication and represents an independent predictor of poor functional and fatal early stroke outcome.
卒中后感染是卒中最常见的医学并发症，多达 65%的患者会发生。本研究旨在评估卒中患者住院期间感染并发症的发生率，并评估感染（包括尿路感染[UTI]、肺炎和败血症）对出院时死亡和不良功能结局的总体影响。
本回顾性研究纳入了在 1 年期间被诊断为急性缺血性卒中的患者。出院时功能不良定义为严重残疾，包括改良 Rankin 量表评分为 3-5 分的患者。进行了单变量和多变量分析。
我们分析了 133 例急性缺血性卒中患者。63 例（47.4%）患者发生卒中后感染。最常见的感染是 UTI，有 27 例（20.3%）。多变量逻辑回归分析调整混杂因素后表明，卒中后感染是不良功能结局（比值比[OR] 12.82，95%置信区间[CI] 4.09-40.0，P <.001）和出院时死亡（OR 14.92，95% CI 2.97-76.92，P =.001）的独立预测因子。当分析每种感染性并发症的影响时，多变量逻辑回归显示 UTI 是不良功能结局（OR 14.08，95% CI 3.06-64.84，P =.001）和死亡（OR 9.81，95% CI 1.46-65.68，P =.019）的独立预测因子。
感染是卒中后的常见并发症，是不良功能和早期卒中死亡结局的独立预测因子。
