title: Ischemic stroke outcome and early infection: its deleterious effect seems to operate also among tissue plasminogen activator-treated patients.
abstract: BACKGROUND
  Infection has been recognized as a significant predictor of outcome for ischemic stroke patients, although the mechanisms by which this association is operative have not been fully established, and their potential roles in a setting of close clinical monitoring, such as that of stroke units offering reperfusion therapies, have not been evaluated.
  
  
  METHODS
  We reviewed the medical records of 139 consecutive tissue plasminogen activator-treated stroke patients admitted to our stroke unit to evaluate potential predictors of neurological outcome.
  
  
  RESULTS
  57 patients (41%) did not show neurological improvement by discharge, and 11.5% died during admission. Infections were related to lack of improvement (29.8 vs. 14.6%; p = 0.03) and PH-type hemorrhagic transformation (42.1 vs. 17.5%; p = 0.014); the latter was associated with a higher mortality rate (26.3 vs. 9.2%; p = 0.03).
  
  
  CONCLUSIONS
  Infection may be associated with poor functional outcome among tissue plasminogen activator-treated stroke patients.
authors.affiliation: Neurovascular Research Laboratory and Neurovascular Unit, Department of Neurology, Hospital Vall d'Hebron, Barcelona, Spain.
authors.forename: David
authors.initials: D
authors.lastname: Salat
authors.forename: Pilar
authors.initials: P
authors.lastname: Delgado
authors.forename: Sara
authors.initials: S
authors.lastname: Alonso
authors.forename: Marc
authors.initials: M
authors.lastname: Ribó
authors.forename: Estevo
authors.initials: E
authors.lastname: Santamarina
authors.forename: Manuel
authors.initials: M
authors.lastname: Quintana
authors.forename: José
authors.initials: J
authors.lastname: Alvarez-Sabín
authors.forename: Joan
authors.initials: J
authors.lastname: Montaner
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002543:Cerebral Hemorrhage / Q000150:complications; D005260:Female; D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D006801:Humans; D007239:Infections / Q000150:complications*; D008297:Male; D012189:Retrospective Studies; D020521:Stroke / Q000150:complications* / Q000188:drug therapy*; D010959:Tissue Plasminogen Activator / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D005343:Fibrinolytic Agents; D010959:Tissue Plasminogen Activator