Risk factors for early infection after an acute cerebral infarction.

BACKGROUND AND OBJECTIVE: Infection is a common complication after an acute stroke. This is important because it may cause death or delayed successful rehabilitation. Investigation of the risk factors for infection after an acute stroke is limited The objective of this study was to determine the risk factors for early infection after an acute cerebral infarction. DESIGN: Retrospective analystical study. MATERIAL AND METHOD: The medical records of patients admitted within 48 hours of onset of symptoms to Prasat Neurological Institute from 1 January 2002 to 31 December 2003, with a diagnosis of cerebral infarction, confirmed with CT or MRI of the brain were retrospectively studied. Collected data included clinical features, risk factors for stroke, comorbid conditions, infection, and results of diagnosis tests. Univariate and multiple logistic regression analyses were used to determine factors that were associated with the risk of early infection. RESULTS: During the 24-month study period, 332 cerebral infarct patients were identified. Early infection occurred in 7.6%. The most common infection was pneumonia (4.3%). In the final multiple logistic model, independent risk factors for early infections were atrial fibrillation (OR, 9.31; 95% CI, 2.18-39.75), thromboembolic infarction (large vessel disease) (OR, 6.04; 95% CI, 1.97-18.54), admission conscious level (subconscious or unconscious/coma) (OR, 4.82; 95% CI, 1.60-14.55) and previous stroke (OR, 3.20; 95% CI, 1.21-8.47) respectively. CONCLUSION: Atrial fibrillation, thromboembolic infarction (large vessel disease), admission conscious level (subconscious or unconscious/coma), and previous stroke were independent risk factors for development of early infection.

Body temperature and mortality in acute cerebral infarction.

BACKGROUND AND OBJECTIVE: In animal models, a rise in body temperature after cerebral ischemia consistently produces more extensive brain damage. In humans, however the relationship between body temperature and stroke outcome has been far less extensively investigated, providing conflicting results. The objective of the present study is to determine whether body temperature recorded during the first 72 hours after admission is an independent predictor of mortality in acute cerebral infarction. MATERIAL AND METHOD: The medical records of patients admitted within 48 hours of onset of symptoms to Prasat Neurological Institute between 1 January 2002 and 31 December 2003, with a diagnosis of cerebral infarction, confirmed by CT or MRI of the brain were retrospectively studied. The relationship between the highest temperature recorded during the first 72 hours after admission and mortality during hospital stay was evaluated. Multiple logistic regression analysis included relevant confounders and potential predictors such as gender, age, hypertension, diabetes, smoking, previous stroke, ischemic heart disease, atrial fibrillation, consciousness and infections was performed. RESULTS: There were 332 patients included in the present study. During the first 72 hours after admission, 88 (26.5%) patients had fever (> 37.5 degrees C). The highest temperature recorded during the first 72 hours after admission was a significant predictor of in hospital mortality in the final multivariate logistic regression model. For each 1 degree C increase in body temperature the odd ratio of mortality rose by 3.95 (OR, 3.95; 95%CI, 1.84 - 8.45). CONCLUSION: In the present study, the highest body temperature recorded during the first 72 hours after admission was shown to be a significant predictor of mortality in acute cerebral infarct patients.