title: Can't swallow, can't transfer, can't toilet: factors predicting infections in the first week post stroke.
abstract: Post stroke infections are a significant clinical problem. Dysphagia occurs in approximately half of stroke patients and is associated with respiratory infections; however it is unclear what other factors contribute to an increased risk. This study aimed to determine which factors are most strongly predictive of infections in the first 7 days post stroke admission. A retrospective review of 536 stroke patients admitted to Australian hospitals in 2010 was conducted. Data were collected on 37 clinical and demographic parameters. Univariate and multivariate logistic regression analysis was performed. The overall incidence of infection was 21%. Full assistance with mobility and incontinence on admission were associated with increased odds of general infection. Nil by mouth and presence of a nasogastric tube were significantly associated with patients developing respiratory infections. Urinary incontinence was a significant predictor for a urinary tract infection. Incidence of infection was highest on day two post admission. This study found enteral feeding, requiring full assistance with mobility and incontinence were significantly associated with developing infections in acute stroke. It contributes valuable new data from a large cohort of stroke patients demonstrating a period of susceptibility to infection in the very acute post stroke period.
authors.affiliation: Speech Pathology Department, Sir Charles Gairdner Hospital, 3rd Floor A Block, Hospital Avenue, Nedlands, WA 6009, Australia. Electronic address: emily.brogan@live.com.au.
authors.forename: Emily
authors.initials: E
authors.lastname: Brogan
authors.affiliation: Western Australian Department of Health, East Perth, WA, Australia.
authors.forename: Claire
authors.initials: C
authors.lastname: Langdon
authors.affiliation: Speech Pathology Department, Sir Charles Gairdner Hospital, 3rd Floor A Block, Hospital Avenue, Nedlands, WA 6009, Australia.
authors.forename: Kim
authors.initials: K
authors.lastname: Brookes
authors.affiliation: Centre for Applied Statistics, University of Western Australia, Crawley, WA, Australia; Department of Research, Sir Charles Gairdner Hospital, Nedlands, WA, Australia.
authors.forename: Charley
authors.initials: C
authors.lastname: Budgeon
authors.affiliation: Neurology Department, Sir Charles Gairdner Hospital, Nedlands, WA, Australia; The School of Medicine and Pharmacology, University of Western Australia, Crawley, WA, Australia.
authors.forename: David
authors.initials: D
authors.lastname: Blacker
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001315:Australia / Q000453:epidemiology; D015331:Cohort Studies; D003680:Deglutition Disorders / Q000453:epidemiology / Q000209:etiology*; D004750:Enteral Nutrition / Q000706:statistics & numerical data*; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D015994:Incidence; D007441:Intubation, Gastrointestinal / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D051346:Mobility Limitation; D012141:Respiratory Tract Infections / Q000453:epidemiology / Q000209:etiology*; D012189:Retrospective Studies; D020521:Stroke / Q000150:complications* / Q000453:epidemiology; D014549:Urinary Incontinence / Q000453:epidemiology / Q000209:etiology*; D014552:Urinary Tract Infections / Q000453:epidemiology / Q000209:etiology*
keywords: Enteral nutrition; Pneumonia; Stroke; Swallowing disorders; Urinary tract infection