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Risk Factors for Early Infection after an Acute Cerebral Infarction

Suchat Hanchaiphiboolkul, MD*

Affiliation : * Prasat Neurological Institute, Department of Medical services, Ministry of Public Health

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.
Materials and Methods : 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), throm- boembolic infarction (large vessel disease) (OR, 6.04; 95%CI, 1.97-18.54), admission conscious level (sub- conscious 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.

Keywords : Cerebral infarction, Complications, Infection, Risk factors


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