Nosocomial infections in patients with spontaneous intracerebral hemorrhage.
BACKGROUND
Nosocomial infections are frequent complications in patients with intracerebral hemorrhage.


OBJECTIVE
To determine the prevalence, risk factors, and outcomes of nosocomial infections in patients with intracerebral hemorrhage.


METHODS
Prospectively collected data on patients with spontaneous intracerebral hemorrhage between January 2009 and June 2012 were retrospectively reviewed. Patients who had nosocomial infection during the hospital stay were compared with patients who did not. Poor outcome was defined as death or discharge to a long-term nursing facility.


RESULTS
At least 1 nosocomial infection developed in 26% of 202 patients with intracerebral hemorrhage. The most common infections were pneumonia (18%), urinary tract infection (12%), meningitis or ventriculitis (3%), and bacteremia (1%). On univariate analysis, independent predictors of nosocomial infection were intraventricular hemorrhage, hydrocephalus, low score on the Glasgow Coma Scale at admission, hyperglycemia at admission, and treatment with mechanical ventilation. On multivariate regression analysis, the only significant predictor of nosocomial infection was intraventricular hemorrhage (odds ratio, 5.4; 95% CI, 1.2-11.4; P = .02). Patients with nosocomial infection were more likely than those without to require a percutaneous gastrostomy tube (odds ratio, 33.1, 95% CI, 23.3-604.4; P < .001) and to have a longer stay in the intensive care unit or hospital without a significant increase in mortality. Patients with nosocomial pneumonia were also more likely to have a poor outcome (P < .001).


CONCLUSIONS
Pneumonia was the most common infection among patients with intracerebral hemorrhage.
Archana Hinduja is an assistant professor, Jamil Dibu, Eugene Achi, and Anand Patel are neurology residents, Department of Neurology, and Rohan Samant is an assistant professor, Department of Radiology, University of Arkansas for Medical Sciences, Little Rock, Arkansas. Shadi Yaghi is a fellow at Columbia University, New York, New York. aphinduja@yahoo.com.
Archana
A
Hinduja
Archana Hinduja is an assistant professor, Jamil Dibu, Eugene Achi, and Anand Patel are neurology residents, Department of Neurology, and Rohan Samant is an assistant professor, Department of Radiology, University of Arkansas for Medical Sciences, Little Rock, Arkansas. Shadi Yaghi is a fellow at Columbia University, New York, New York.
Jamil
J
Dibu
Archana Hinduja is an assistant professor, Jamil Dibu, Eugene Achi, and Anand Patel are neurology residents, Department of Neurology, and Rohan Samant is an assistant professor, Department of Radiology, University of Arkansas for Medical Sciences, Little Rock, Arkansas. Shadi Yaghi is a fellow at Columbia University, New York, New York.
Eugene
E
Achi
Archana Hinduja is an assistant professor, Jamil Dibu, Eugene Achi, and Anand Patel are neurology residents, Department of Neurology, and Rohan Samant is an assistant professor, Department of Radiology, University of Arkansas for Medical Sciences, Little Rock, Arkansas. Shadi Yaghi is a fellow at Columbia University, New York, New York.
Anand
A
Patel
Archana Hinduja is an assistant professor, Jamil Dibu, Eugene Achi, and Anand Patel are neurology residents, Department of Neurology, and Rohan Samant is an assistant professor, Department of Radiology, University of Arkansas for Medical Sciences, Little Rock, Arkansas. Shadi Yaghi is a fellow at Columbia University, New York, New York.
Rohan
R
Samant
Archana Hinduja is an assistant professor, Jamil Dibu, Eugene Achi, and Anand Patel are neurology residents, Department of Neurology, and Rohan Samant is an assistant professor, Department of Radiology, University of Arkansas for Medical Sciences, Little Rock, Arkansas. Shadi Yaghi is a fellow at Columbia University, New York, New York.
Shadi
S
Yaghi
D001131:Arkansas / Q000453:epidemiology; D002543:Cerebral Hemorrhage / Q000453:epidemiology*; D015897:Comorbidity; D003428:Cross Infection / Q000453:epidemiology*; D005260:Female; D006801:Humans; D007362:Intensive Care Units / Q000706:statistics & numerical data; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011446:Prospective Studies; D012189:Retrospective Studies; D012307:Risk Factors