The Prognostic Significance of Infection in Acute Stroke: Preliminary study

ABSTRACT

BACKGROUND & OBJECTIVE: Infection is one of the common complications of acute stoke. However, it's characteristics and prognostic significance have not yet been sufficiently studied. METHOD: We prospectively investigated the frequency of infection and the conditions prone to develop it, and the influence of infection on patients prognosis in acute stroke. We assessed each patient with modified National Institute of Health (NIH) stroke scale immediately after the admission(NIH-0), at the hospital day 1(NIH-1), 3(NIH-3), 7(NIH-7), at the discharge(NIH-d). The degree of improvement was evaluated by improvement ratio([NIH-0-NIH-d]/NIH-0). RESULT: One hundred and twenty five patients were enrolled. Twenty-eight patients (22.4%) were infected during admission. Pneumonia(23), UTI(10), sepsis(4), URI(2), aseptic meningitis(1) and FUO(1) were developed in that order of frequency. Using indwelling instruments and poor initial neurological status were factors prone to develop infection. Mean NIH-0 score was 26.50 in patients with infection, and 8.13 in those without infection(p<0.05). There were significant differences in the improvement ratio between infected and non-infected patients both at the 7th hospital day(-0.64 vs. 0.28) and at the discharge (-0.016 vs. 0.27). CONCLUSION: About one fifth of acute stroke patients were infected during their admissions. Infection, especially pneumonia, was significantly correlated with the poor prognosis. The prevention and the appropriate control of infection may improve neurologic outcomes in stroke patients.