Impact of infections on long-term outcome after severe middle cerebral artery infarction
Abstract Post-stroke infections are the most important complications after acute stroke, accounting for almost 20% of in-hospital deaths and poor functional outcomes at discharge. Little is known about long-term effects of post-stroke infections on outcome. Here, we studied the impact of infections...
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| Veröffentlicht in: | Journal of the neurological sciences 2012-08, Vol.319 (1), p.15-17 |
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| creator | Ulm, Lena Harms, Hendrik Ohlraun, Stephanie Reimnitz, Peter Meisel, Andreas |
| description | Abstract Post-stroke infections are the most important complications after acute stroke, accounting for almost 20% of in-hospital deaths and poor functional outcomes at discharge. Little is known about long-term effects of post-stroke infections on outcome. Here, we studied the impact of infections on long-term outcome in 64 patients which had suffered from severe middle cerebral artery infarction. Mean follow-up time in the survivors was 6.5 ± 0.9 years. Structured telephone interviews were performed to assess the patients' current functional outcome. Where re-contacting was not successful, vital status of the patients was requested at the registration office of Berlin. Multiple logistic regression analysis identified three independent risk factors associated with mortality: infections within the first 11 days after stroke, age > 64 years, and female sex. Among surviving patients, functional outcome measured by Barthel Index was influenced by infections and immunocompetence measured by levels of monocytic HLA-DR expression on day 3 after stroke. In conclusion, the occurrence of post-stroke infections is the most important predictor of poor long-term outcome in this cohort of patients. Our observation warrants prospective trials on prevention or early treatment of post-stroke infections in order to improve long-term outcome after stroke. |
| doi_str_mv | 10.1016/j.jns.2012.05.042 |
| format | Article |
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Little is known about long-term effects of post-stroke infections on outcome. Here, we studied the impact of infections on long-term outcome in 64 patients which had suffered from severe middle cerebral artery infarction. Mean follow-up time in the survivors was 6.5 ± 0.9 years. Structured telephone interviews were performed to assess the patients' current functional outcome. Where re-contacting was not successful, vital status of the patients was requested at the registration office of Berlin. Multiple logistic regression analysis identified three independent risk factors associated with mortality: infections within the first 11 days after stroke, age > 64 years, and female sex. Among surviving patients, functional outcome measured by Barthel Index was influenced by infections and immunocompetence measured by levels of monocytic HLA-DR expression on day 3 after stroke. In conclusion, the occurrence of post-stroke infections is the most important predictor of poor long-term outcome in this cohort of patients. Our observation warrants prospective trials on prevention or early treatment of post-stroke infections in order to improve long-term outcome after stroke.</description><identifier>ISSN: 0022-510X</identifier><identifier>EISSN: 1878-5883</identifier><identifier>DOI: 10.1016/j.jns.2012.05.042</identifier><identifier>PMID: 22682764</identifier><identifier>CODEN: JNSCAG</identifier><language>eng</language><publisher>Amsterdam: Elsevier B.V</publisher><subject>Age Factors ; Aged ; Antibiotics ; Biological and medical sciences ; Central Nervous System Infections - etiology ; Central Nervous System Infections - mortality ; Female ; Follow-Up Studies ; Gender differences ; Humans ; Immunodepression ; Infarction, Middle Cerebral Artery - complications ; Infarction, Middle Cerebral Artery - mortality ; Interviews as Topic ; Long-term outcome ; Male ; Medical sciences ; Middle Aged ; Neurology ; Pneumonia ; Post-stroke infection ; Prognosis ; Risk Factors ; Sex Factors ; Stroke ; Stroke - complications ; Stroke - mortality ; Survival Rate ; Treatment Outcome ; Vascular diseases and vascular malformations of the nervous system</subject><ispartof>Journal of the neurological sciences, 2012-08, Vol.319 (1), p.15-17</ispartof><rights>Elsevier B.V.</rights><rights>2012 Elsevier B.V.</rights><rights>2015 INIST-CNRS</rights><rights>Copyright © 2012 Elsevier B.V. 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Little is known about long-term effects of post-stroke infections on outcome. Here, we studied the impact of infections on long-term outcome in 64 patients which had suffered from severe middle cerebral artery infarction. Mean follow-up time in the survivors was 6.5 ± 0.9 years. Structured telephone interviews were performed to assess the patients' current functional outcome. Where re-contacting was not successful, vital status of the patients was requested at the registration office of Berlin. Multiple logistic regression analysis identified three independent risk factors associated with mortality: infections within the first 11 days after stroke, age > 64 years, and female sex. Among surviving patients, functional outcome measured by Barthel Index was influenced by infections and immunocompetence measured by levels of monocytic HLA-DR expression on day 3 after stroke. In conclusion, the occurrence of post-stroke infections is the most important predictor of poor long-term outcome in this cohort of patients. Our observation warrants prospective trials on prevention or early treatment of post-stroke infections in order to improve long-term outcome after stroke.</description><subject>Age Factors</subject><subject>Aged</subject><subject>Antibiotics</subject><subject>Biological and medical sciences</subject><subject>Central Nervous System Infections - etiology</subject><subject>Central Nervous System Infections - mortality</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Gender differences</subject><subject>Humans</subject><subject>Immunodepression</subject><subject>Infarction, Middle Cerebral Artery - complications</subject><subject>Infarction, Middle Cerebral Artery - mortality</subject><subject>Interviews as Topic</subject><subject>Long-term outcome</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Neurology</subject><subject>Pneumonia</subject><subject>Post-stroke infection</subject><subject>Prognosis</subject><subject>Risk Factors</subject><subject>Sex Factors</subject><subject>Stroke</subject><subject>Stroke - complications</subject><subject>Stroke - mortality</subject><subject>Survival Rate</subject><subject>Treatment Outcome</subject><subject>Vascular diseases and vascular malformations of the nervous system</subject><issn>0022-510X</issn><issn>1878-5883</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2012</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kU9rFDEYxoModlv9AF4kF8HLjPkz-VMEoRSthYIHFXoL2eSNZJ1J1mSmsN_ejLsqePCUN-T3PAm_IPSCkp4SKt_s-l2qPSOU9UT0ZGCP0IZqpTuhNX-MNoQw1glK7s_Qea07QojU-vIpOmNMaqbksEH3t9PeuhnngGMK4OaYU8U54TGnb90MZcJ5mV2eANvQtrjCAxTAU_R-BOzavC12xLa0w8PaYcuvkmfoSbBjheen9QJ9_fD-y_XH7u7Tze311V3nBBnmTinhNA_OccUtl8wqJkQQ28GHwSsNUvJLLriydAhbrwdBpeCwQtp7JYFfoNfH3n3JPxaos5lidTCONkFeqqGE0TXFZEPpEXUl11ogmH2Jky2HBplVqNmZJtSsQg0RpgltmZen-mU7gf-T-G2wAa9OgK3OjqHY5GL9y0nClWa6cW-PHDQZDxGKqS5CcuBjadqNz_G_z3j3T9qNMcV24Xc4QN3lpaRm2VBTW8Z8Xn9-_XjK2qSI4D8B5lOnyg</recordid><startdate>20120815</startdate><enddate>20120815</enddate><creator>Ulm, Lena</creator><creator>Harms, Hendrik</creator><creator>Ohlraun, Stephanie</creator><creator>Reimnitz, Peter</creator><creator>Meisel, Andreas</creator><general>Elsevier B.V</general><general>Elsevier</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20120815</creationdate><title>Impact of infections on long-term outcome after severe middle cerebral artery infarction</title><author>Ulm, Lena ; Harms, Hendrik ; Ohlraun, Stephanie ; Reimnitz, Peter ; Meisel, Andreas</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c504t-775c83fcc373a362a7255f5b4df4d78e66393537a14fbd8451653e72558dd76e3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2012</creationdate><topic>Age Factors</topic><topic>Aged</topic><topic>Antibiotics</topic><topic>Biological and medical sciences</topic><topic>Central Nervous System Infections - etiology</topic><topic>Central Nervous System Infections - mortality</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Gender differences</topic><topic>Humans</topic><topic>Immunodepression</topic><topic>Infarction, Middle Cerebral Artery - complications</topic><topic>Infarction, Middle Cerebral Artery - mortality</topic><topic>Interviews as Topic</topic><topic>Long-term outcome</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Neurology</topic><topic>Pneumonia</topic><topic>Post-stroke infection</topic><topic>Prognosis</topic><topic>Risk Factors</topic><topic>Sex Factors</topic><topic>Stroke</topic><topic>Stroke - complications</topic><topic>Stroke - mortality</topic><topic>Survival Rate</topic><topic>Treatment Outcome</topic><topic>Vascular diseases and vascular malformations of the nervous system</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Ulm, Lena</creatorcontrib><creatorcontrib>Harms, Hendrik</creatorcontrib><creatorcontrib>Ohlraun, Stephanie</creatorcontrib><creatorcontrib>Reimnitz, Peter</creatorcontrib><creatorcontrib>Meisel, Andreas</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of the neurological sciences</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Ulm, Lena</au><au>Harms, Hendrik</au><au>Ohlraun, Stephanie</au><au>Reimnitz, Peter</au><au>Meisel, Andreas</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Impact of infections on long-term outcome after severe middle cerebral artery infarction</atitle><jtitle>Journal of the neurological sciences</jtitle><addtitle>J Neurol Sci</addtitle><date>2012-08-15</date><risdate>2012</risdate><volume>319</volume><issue>1</issue><spage>15</spage><epage>17</epage><pages>15-17</pages><issn>0022-510X</issn><eissn>1878-5883</eissn><coden>JNSCAG</coden><abstract>Abstract Post-stroke infections are the most important complications after acute stroke, accounting for almost 20% of in-hospital deaths and poor functional outcomes at discharge. Little is known about long-term effects of post-stroke infections on outcome. Here, we studied the impact of infections on long-term outcome in 64 patients which had suffered from severe middle cerebral artery infarction. Mean follow-up time in the survivors was 6.5 ± 0.9 years. Structured telephone interviews were performed to assess the patients' current functional outcome. Where re-contacting was not successful, vital status of the patients was requested at the registration office of Berlin. Multiple logistic regression analysis identified three independent risk factors associated with mortality: infections within the first 11 days after stroke, age > 64 years, and female sex. Among surviving patients, functional outcome measured by Barthel Index was influenced by infections and immunocompetence measured by levels of monocytic HLA-DR expression on day 3 after stroke. 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| subjects | Age Factors Aged Antibiotics Biological and medical sciences Central Nervous System Infections - etiology Central Nervous System Infections - mortality Female Follow-Up Studies Gender differences Humans Immunodepression Infarction, Middle Cerebral Artery - complications Infarction, Middle Cerebral Artery - mortality Interviews as Topic Long-term outcome Male Medical sciences Middle Aged Neurology Pneumonia Post-stroke infection Prognosis Risk Factors Sex Factors Stroke Stroke - complications Stroke - mortality Survival Rate Treatment Outcome Vascular diseases and vascular malformations of the nervous system |
| title | Impact of infections on long-term outcome after severe middle cerebral artery infarction |
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