The impact of lesion location and lesion size on poststroke infection frequency.
OBJECTIVE
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).


CONCLUSIONS
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.
Minnerup
Jens
J
Department of Neurology, University of Münster, Münster, Germany. minnerup@uni-muenster.de
Wersching
Heike
H
Brokinkel
Benjamin
B
Dziewas
Rainer
R
Heuschmann
Peter Ulrich
PU
Nabavi
Darius Günther
DG
Ringelstein
Erich Bernd
EB
Schäbitz
Wolf-Rüdiger
WR
Ritter
Martin Andreas
MA
D000368:Aged; D001424:Bacterial Infections / Q000097:blood / Q000453:epidemiology*; D003680:Deglutition Disorders / Q000175:diagnosis / Q000453:epidemiology; D004401:Dysarthria / Q000175:diagnosis / Q000453:epidemiology; D005158:Facial Paralysis / Q000175:diagnosis / Q000453:epidemiology; D005163:Factor Analysis, Statistical; D005260:Female; D007839:Functional Laterality / Q000502:physiology; D006801:Humans; D008297:Male; D011014:Pneumonia / Q000097:blood / Q000453:epidemiology*; D015995:Prevalence; D020521:Stroke / Q000453:epidemiology* / Q000473:pathology*; D014552:Urinary Tract Infections / Q000097:blood / Q000453:epidemiology*