Infection after acute stroke is associated with poor short-term outcome
Infection after acute stroke is associated with poor short-term outcome
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DOI：
10.1111/j.1600-0404.2006.00783.x
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发表时间：
2007-05-01
影响因子：
3.5
通讯作者：
Hand, P.
中科院分区：
文献类型：
--
作者：
Kwan, J.;Hand, P.
背景-我们试图探索卒中后感染（PSI）的频率、危险因素和临床后果。方法：我们评估了连续的疑似中风患者.在第1天，我们记录了患者的基线特征、卒中亚型和严重程度、生理参数和实验室结果。在第5天，我们记录了并发症的发生，包括感染和功能结果。结果：我们招募了439名患者[398名中风患者和41名短暂性脑缺血发作（TIA）患者]，其中73名（17%）在第5天发生PSI（67名中风患者和6名TIA患者）。与没有PSI的患者相比，PSI患者更有可能：（i）年龄较大（平均年龄78岁vs 73岁，P = 0.001）;（ii）入院前有依赖性（47%对24%，P < 0.001）;（iii）有完全前循环卒中（40%vs20%，P < 0.001）（35%对17%，P = 0.001）;（v）有导尿管（43% vs 16%，P < 0.001），（vi）出现压疮（7% vs 2%，P = 0.022）和癫痫发作（12% vs 2%，P < 0.001）。在调整病例组合后，PSI与院内死亡（OR 2.50，95%CI 1.27-4.90，P = 0.008）和出院时住院（OR 1.86，95%CI 1.00-3.43，P = 0.049）显著相关。结论：卒中后感染可以影响TIA和急性卒中患者，并且可能与不良的短期结局相关。
Background - We sought to explore the frequency, risk factors, and clinical consequences of post-stroke infections (PSI). Methods - We assessed consecutive patients admitted with suspected stroke. On day 1, we recorded the patients' baseline characteristics, stroke subtype and severity, physiological parameters, and laboratory results. On day 5, we recorded the occurrence of complications including infections, and functional outcome. Results - We recruited 439 patients [398 with stroke and 41 with transient ischaemic attack (TIA)], of whom 73 (17%) had PSI (67 with stroke and 6 with TIA) by day 5. Compared to patients without PSI, those with PSI were significantly more likely to: (i) be older (mean age 78 vs 73 years, P = 0.001); (ii) be dependent before admission (47% vs 24%, P < 0.001); (iii) have total anterior circulation strokes (40% vs 20%, P < 0.001); (iv) be hypoxic on arrival (35% vs 17%, P = 0.001); (v) have urinary catheters (43% vs 16%, P < 0.001), and (vi) develop pressure sores (7% vs 2%, P = 0.022) and seizures (12% vs 2%, P < 0.001). After adjusting for case mix, PSI was significantly associated with in-hospital death (OR 2.50, 95% CI 1.27-4.90, P = 0.008) and institutionalization on discharge (OR 1.86, 95% CI 1.00-3.43, P = 0.049). Conclusions - Post-stroke infection can affect patients admitted with TIA as well as acute stroke, and it may be associated with poor short-term outcomes.