感染作为卒中的触发因素。
Infection as a Stroke Trigger.
机构信息
From the Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY.
出版信息
Stroke. 2019 Aug;50(8):2216-2218. doi: 10.1161/STROKEAHA.119.025872. Epub 2019 Jun 27.
Background and Purpose- The relationships between different infection types and stroke subtype are not well-characterized. We examined exposure to infections in different organ systems in different time periods before the acute ischemic stroke, intracerebral hemorrhage, and subarachnoid hemorrhage. Methods- We used the New York State Inpatient Databases and Emergency Department Databases (2006-2013). Validated International Classification of Diseases, Ninth Edition definitions identified index hospitalizations for acute ischemic stroke, intracerebral hemorrhage, and subarachnoid hemorrhage, and emergency department visits and hospitalizations for infection (skin, urinary tract infection, septicemia, abdominal, and respiratory). We used case cross-over analysis with conditional logistic regression to estimate odds ratios (OR) for the association between each infection type during case periods compared with control periods 1 year before. Results- Every infection type was associated with an increased likelihood of acute ischemic stroke. The greatest association was for urinary tract infection, with OR of 5.32 (95% CI, 3.69-7.68) within the 7-day window. The magnitude of association between urinary tract infection and intracerebral hemorrhage was of lesser magnitude, with OR of 1.80 (1.04-3.11) in the 14-day exposure period and OR of 1.54 (1.23-1.94) in the 120-day exposure period. Only respiratory infection was associated with subarachnoid hemorrhage, with OR of 3.67 (1.49-9.04) in the 14-day window and 1.95 (1.44-2.64) in the 120-day window. Conclusions- All infection types were associated with subsequent acute ischemic stroke, with the greatest association for urinary tract infection.
背景与目的-不同类型的感染与卒中亚型之间的关系尚未得到充分阐明。我们研究了在急性缺血性卒中、脑出血和蛛网膜下腔出血之前的不同时间段内不同器官系统感染的暴露情况。
方法-我们使用了纽约州住院患者数据库和急诊数据库(2006-2013 年)。经验证的国际疾病分类,第九版定义确定了索引住院治疗为急性缺血性卒中、脑出血和蛛网膜下腔出血,以及急诊就诊和感染(皮肤、尿路感染、败血症、腹部和呼吸道)住院治疗。我们使用病例交叉对照分析和条件逻辑回归来估计每种感染类型在病例期与对照期(1 年前)相比的比值比(OR)。
结果-每种感染类型均与急性缺血性卒中的发生几率增加相关。尿路感染的相关性最大,7 天窗口期内的 OR 为 5.32(95%CI,3.69-7.68)。尿路感染与脑出血之间的关联强度较小,14 天暴露期的 OR 为 1.80(1.04-3.11),120 天暴露期的 OR 为 1.54(1.23-1.94)。只有呼吸道感染与蛛网膜下腔出血相关,14 天窗口期的 OR 为 3.67(1.49-9.04),120 天窗口期的 OR 为 1.95(1.44-2.64)。
结论-所有感染类型均与随后的急性缺血性卒中相关,尿路感染的相关性最大。