Predictors of early infection in cerebral ischemic stroke

Infection is the most common complication of stroke. To determine the risk factors and predictors of post-stroke infection (PSI), which developed within 7 days from the onset of acute ischemic stroke. The study included 60 ischemic stroke patients admitted in the Neurology Department of Zagazig Univ...

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Bibliographic Details
Published in:	Journal of medicine and life Vol. 9; no. 2; pp. 163 - 169
Main Authors:	Ashour, Wmr, Al-Anwar, A D, Kamel, A E, Aidaros, M A
Format:	Journal Article
Language:	English
Published:	Romania Carol Daila University Foundation 01-04-2016 Carol Davila University Press
Subjects:	Aged Brain Ischemia - blood Brain Ischemia - complications Brain Ischemia - microbiology Case Presentations Female Humans Interleukin-10 - blood Leukocyte Count Male Middle Aged Prognosis Regression Analysis Respiratory Tract Infections - blood Respiratory Tract Infections - complications Risk Factors Stroke - blood Stroke - complications Stroke - microbiology Tumor Necrosis Factor-alpha - blood Urinary Tract Infections - blood Urinary Tract Infections - complications post-stroke infection ischaemic stroke pneumonia immunodepression urinary tract infection
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Summary:	Infection is the most common complication of stroke. To determine the risk factors and predictors of post-stroke infection (PSI), which developed within 7 days from the onset of acute ischemic stroke. The study included 60 ischemic stroke patients admitted in the Neurology Department of Zagazig University, Egypt, who were subdivided into: [Non Stroke Associated Infection group (nSAI); 30 patients having stroke without any criteria of infection within 7 days from the onset and Stroke Associated Infection group (SAI); 30 patients having stroke with respiratory tract infection (RTI) or urinary tract infection within 7 days], in addition to 30 healthy sex and age-matching subjects as control. All the patients had a detailed history taking, thorough clinical general and neurological examination, laboratory tests (Urine analysis & urine culture, blood sugar, lipid profile and serum tumor necrosis factor-alpha (TNF-α) and interleukin (IL)-10), a chest radiography to assess RTI and brain computed tomography (CT) to exclude the hemorrhagic stroke and to confirm the ischemic stroke. SAI patients were found to be significantly older with higher baseline blood glucose level. Also the number of patients with tube feeding, lower conscious level, more stroke severity and more large size infarcts were significantly higher in SAI patients. There was a significant elevation in the IL-10, a significant decrease in the TNF-α and a significant decrease in the TNF-α/ IL-10 ratio, in the SAI group. The baseline serum level of IL-10 ≥ 14.5 pg/ ml and size of infarct area > 3.5 cm3 were found to be the independent predictors of PSI. Patients with older age, tube feeding, lower conscious level, worse baseline stroke severity, large cerebral infarcts in CT scan, and increased IL-10 serum level were more susceptible to infection. The baseline serum level of IL-10 ≥ 14.5 pg/ ml and the size of infarct area > 3.5 cm3 were the independent predictors of PSI.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	1844-122X 1844-3117