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The impact of lesion location and lesion size on poststroke infection frequency
  1. Jens Minnerup1,
  2. Heike Wersching1,
  3. Benjamin Brokinkel1,
  4. Rainer Dziewas1,
  5. Peter Ulrich Heuschmann2,
  6. Darius Günther Nabavi3,
  7. Erich Bernd Ringelstein1,
  8. Wolf-Rüdiger Schäbitz4,
  9. Martin Andreas Ritter1
  1. 1Department of Neurology, University of Münster, Münster, Germany
  2. 2Center for Stroke Research Berlin, Charité-Universitätsmedizin, Berlin, Germany
  3. 3Department of Neurology, Vivantes Klinikum Neukölln, Berlin, Germany
  4. 4Department of Neurology, University of Münster and Evangelisches Krankenhaus Bielefeld, Bielefeld, Germany
  1. Correspondence to Dr Jens Minnerup, Universitätsklinikum Münster, Klinik und Poliklinik für Neurologie, Albert-Schweitzer-Straße 33, 48149 Münster, Germany; minnerup{at}


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

Methods 591 patients with acute stroke who were treated on our stroke unit were included in a prospective observational study. Predefined endpoints were pneumonia, urinary-tract infection (UTI) and other infections. The OR of infections was calculated for various stroke locations, stroke lateralisation and three categories of stroke size. Logistic regression models were used to adjust for factors significantly associated with poststroke infections in a single-factor analysis.

Results In the 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 lateralisation 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 this study, lesion size is an independent risk factor for the development of poststroke infection. Particular brain regions associated with infections could not be determined.

  • Stroke
  • infection
  • stroke induced immunosuppression
  • pneumonia
  • infectious disease

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  • JM and HW contributed equally to this work.

  • Competing interests None.

  • Provenance and peer review Not commissioned; externally peer reviewed.