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J Neurol Neurosurg Psychiatry doi:10.1136/jnnp.2009.182394

The impact of lesion location and lesion size on post-stroke infection frequency

  1. Jens Minnerup (minnerup{at}uni-muenster.de)
  1. University of Muenster, Germany
    1. Heike Wersching
    1. University of Muenster, Germany
      1. Benjamin Browinkel
      1. University of Muenster, Germany
        1. Rainer Dziewas
        1. University Hospital Münster, Germany
          1. Peter Ulrich Heuschmann
          1. Center for Stroke Research Berlin, United Kingdom
            1. Darius Nabavi
            1. Vivantes Klinikum Neukölln, Germany
              1. Erich Bernd Ringelstein
              1. University of Muenster, Germany
                1. Wolf-Rüdiger Schäbitz
                1. University of Muenster and EVK Bielefeld, Germany
                  1. Martin Andreas Ritter
                  1. University of Muenster, Germany
                    • Published Online First 2 September 2009

                    Abstract

                    Objectives: Infections in stroke patients are common and significantly affect outcome. Various predictors of post-stroke infections were determined, such as degree of neurological impairment and implementation of therapeutic interventions. We investigated whether stroke location and stroke size are independent risk factors for post-stroke infections.

                    Methods: Five hundred ninety-one patients with acute stroke who were treated on our stroke unit were included in a prospective observational study. Pre-defined endpoints were pneumonia, urinay tract infection (UTI) and other infections. The odds ratio (OR) of infections was calculated for various stroke locations, stroke lateralization and three categories of stroke size. Logistic regression models were used to adjust for factors significantly associated with post-stroke infections in single factor analysis.

                    Results: In single factor analysis the left anterior cerebral artery territory was associated with pneumonia. After adjustment for relevant covariates this association was no longer statistically significant. Stroke lateralization showed no association with infection frequency. The largest stroke size was positively associated with pneumonia (OR 3.5, P<0.001). The smallest lesion size was significantly less associated with the occurrence of UTI (OR 0.4, P<0.01).

                    Conclusion: In our study lesion size is an independent risk factor for the development of post-stroke infection. Particular brain regions associated with infections could not be determined.

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