Frequency and determinants of pneumonia and urinary tract infection during stroke hospitalization.
BACKGROUND
Patients with acute stroke are at risk for pneumonia and urinary tract infection (UTI). Identifying patients with stroke at high risk for common infections could enhance timely treatment and improve clinical outcomes. We aimed to identify risk factors associated with the occurrence of pneumonia and UTI during stroke hospitalization.


METHODS
We analyzed the frequency of pneumonia and UTI and their influence on outcomes during hospitalization in patients diagnosed with ischemic stroke in the California Acute Stroke Prototype Registry. Generalized estimating equations were used to identify factors and outcomes independently associated with pneumonia and UTI.


RESULTS
Overall, 663 patients were admitted with acute ischemic stroke at 11 hospitals. Pneumonia occurred in 66 (10%) and UTI in 84 (13%). Older age, atrial fibrillation, and congestive heart failure were independently associated with greater risk for developing pneumonia, whereas a history of dementia was associated with lesser risk. Women and patients with a history of cerebrovascular events were significantly more likely to experience a UTI. Both pneumonia and UTI were associated with significantly greater length of stay, but only pneumonia was independently associated with higher inpatient mortality and poorer discharge ambulatory status.


CONCLUSIONS
Several factors are associated with an increased risk of developing pneumonia and UTI during ischemic stroke hospitalization. Early identification and treatment of these patients may improve clinical outcomes.
Ovbiagele
Bruce
B
Stroke Center and Department of Neurology, University of California at Los Angeles Medical Center, Los Angeles, California, USA.
Hills
Nancy K
NK
Saver
Jeffrey L
JL
Johnston
S Claiborne
SC