title: Intraventricular Bleeding and Hematoma Size as Predictors of Infection Development in Intracerebral Hemorrhage: A Prospective Cohort Study.
abstract: BACKGROUND
  Acute intracerebral hemorrhage (ICH) is associated with increased susceptibility to bacterial infection. The physiopathology of this phenomenon is not very clear. We conducted a prospective observational study investigating the correlation and independent predictors of infections in patients with ICH.
  
  
  METHODS
  Patients admitted between April 1997 and June 2013 with ICH diagnosis were evaluated for inclusion and exclusion criteria.
  
  
  RESULTS
  Two hundred twenty-two patients were included in this study. Ninety four patients (42.6%) presented with an infection during hospitalization being more common than pneumonia (30%) and urinary tract infections (14%). Intraventricular hemorrhage (IVH) (95% confidence interval [CI], 62.7% versus 39.3%; P < .001) and higher ICH score (95% CI, 2.31% versus 1.67%; P = .0014) were more common in patients who had infections. We found the following risk factors for having an infection in patients with ICH: IVH (odds ratio [OR] 2.3; 95% IC, 1.3-4.1), each point of ICH score (OR 1.3; 95% CI, 1.1-1.6), and having a hematoma volume larger than 30 cc (OR 2.0; 95% CI, 1.1-3.5). The localization of the hematoma was not found to be relevant.
  
  
  CONCLUSIONS
  ICH score, size of the hematoma, and presence of IVH are independent risk factors for having an infection after ICH.
authors.affiliation: Servicio de Neurología, Depártamento de Medicina, Clínica Alemana-Universidad del Desarrollo, Santiago, Chile.
authors.forename: Felipe
authors.initials: F
authors.lastname: Vial
authors.affiliation: Servicio de Neurología, Depártamento de Medicina, Clínica Alemana-Universidad del Desarrollo, Santiago, Chile.
authors.forename: Alejandro
authors.initials: A
authors.lastname: Brunser
authors.affiliation: Servicio de Neurología, Depártamento de Medicina, Clínica Alemana-Universidad del Desarrollo, Santiago, Chile.
authors.forename: Pablo
authors.initials: P
authors.lastname: Lavados
authors.affiliation: Servicio de Neurología, Depártamento de Medicina, Clínica Alemana-Universidad del Desarrollo, Santiago, Chile. Electronic address: sergio.illanes@gmail.com.
authors.forename: Sergio
authors.initials: S
authors.lastname: Illanes
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001424:Bacterial Infections / Q000175:diagnosis / Q000276:immunology / Q000382:microbiology*; D002533:Cerebral Angiography / Q000379:methods; D002543:Cerebral Hemorrhage / Q000150:complications* / Q000000981:diagnostic imaging / Q000276:immunology; D016009:Chi-Square Distribution; D000072226:Computed Tomography Angiography; D003428:Cross Infection / Q000175:diagnosis / Q000276:immunology / Q000382:microbiology*; D004185:Disability Evaluation; D005260:Female; D006406:Hematoma / Q000000981:diagnostic imaging / Q000209:etiology* / Q000276:immunology; D006801:Humans; D016867:Immunocompromised Host; D016015:Logistic Models; D018810:Magnetic Resonance Angiography; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D055815:Young Adult
keywords: ICH; Intracerebral hemorrhage; hemorrhagic stroke; immune response; infections; stroke inflammation