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Article: Impact of stroke-associated infection on long-term survival: a cohort study

TitleImpact of stroke-associated infection on long-term survival: a cohort study
Authors
Issue Date2013
PublisherB M J Publishing Group. The Journal's web site is located at http://www.jnnp.com/
Citation
Journal of Neurology, Neurosurgery and Psychiatry, 2013, v. 84 n. 3, p. 297-304 How to Cite?
AbstractBACKGROUND AND OBJECTIVE: The effects of stroke-associated infection (SAI) on long-term survival are unclear. We performed a prospective evaluation to explore risk factors of SAI, and compared survival status over the 3 years following stroke onset between those who experienced SAI and those who did not. METHODS: Consecutive patients with acute stroke admitted to a stroke unit between April 2005 and December 2006 were invited to participate. We prospectively collected data on demographics, pathological and clinical stroke subtype, stroke severity, and neurological and functional consequences, and abstracted additional data on occurrence and timing of SAI in hospital from medical notes. Survival status 3 years after stroke onset was obtained. RESULTS: We recruited 413 acute stroke patients, 161 (39%) experienced SAI. After excluding patients with infection at onset, patients with intracerebral haemorrhage (p=0.014), dysphagia (p=0.003) and urinary incontinence/catheterisation (p=0.000) were at higher risk of infection after controlling for case mix. The risk of death in hospital was greater following an SAI (HR 3.56; 95% CI 1.94 to 6.53; p=0.000), as was risk of death calculated over the whole 3-year follow-up period among those acquiring SAI within 2 weeks of onset (HR 1.66; 95% CI 1.14 to 2.40; p=0.031). CONCLUSIONS: SAIs have long-lasting effects on patient survival. This serves to emphasise the importance of immediate access to organised stroke unit care for people with acute stroke, with active physiological monitoring and protocols for early detection and treatment of SAIs.
Persistent Identifierhttp://hdl.handle.net/10722/194539
ISSN
2015 Impact Factor: 6.431
2015 SCImago Journal Rankings: 2.913
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorKwan, SKJ-
dc.contributor.authorPickering, RM-
dc.contributor.authorKunkel, D-
dc.contributor.authorFitton, C-
dc.contributor.authorJenkinson, D-
dc.contributor.authorPerry, VH-
dc.contributor.authorAshburn, AM-
dc.contributor.authorStroke Association Rehabilitation Research Centre-
dc.date.accessioned2014-02-07T02:11:11Z-
dc.date.available2014-02-07T02:11:11Z-
dc.date.issued2013-
dc.identifier.citationJournal of Neurology, Neurosurgery and Psychiatry, 2013, v. 84 n. 3, p. 297-304-
dc.identifier.issn0022-3050-
dc.identifier.urihttp://hdl.handle.net/10722/194539-
dc.description.abstractBACKGROUND AND OBJECTIVE: The effects of stroke-associated infection (SAI) on long-term survival are unclear. We performed a prospective evaluation to explore risk factors of SAI, and compared survival status over the 3 years following stroke onset between those who experienced SAI and those who did not. METHODS: Consecutive patients with acute stroke admitted to a stroke unit between April 2005 and December 2006 were invited to participate. We prospectively collected data on demographics, pathological and clinical stroke subtype, stroke severity, and neurological and functional consequences, and abstracted additional data on occurrence and timing of SAI in hospital from medical notes. Survival status 3 years after stroke onset was obtained. RESULTS: We recruited 413 acute stroke patients, 161 (39%) experienced SAI. After excluding patients with infection at onset, patients with intracerebral haemorrhage (p=0.014), dysphagia (p=0.003) and urinary incontinence/catheterisation (p=0.000) were at higher risk of infection after controlling for case mix. The risk of death in hospital was greater following an SAI (HR 3.56; 95% CI 1.94 to 6.53; p=0.000), as was risk of death calculated over the whole 3-year follow-up period among those acquiring SAI within 2 weeks of onset (HR 1.66; 95% CI 1.14 to 2.40; p=0.031). CONCLUSIONS: SAIs have long-lasting effects on patient survival. This serves to emphasise the importance of immediate access to organised stroke unit care for people with acute stroke, with active physiological monitoring and protocols for early detection and treatment of SAIs.-
dc.languageeng-
dc.publisherB M J Publishing Group. The Journal's web site is located at http://www.jnnp.com/-
dc.relation.ispartofJournal of Neurology, Neurosurgery and Psychiatry-
dc.rightsJournal of Neurology, Neurosurgery and Psychiatry. Copyright © B M J Publishing Group.-
dc.rightsThis article has been accepted for publication in Journal of Neurology, Neurosurgery and Psychiatry. The definitive copyedited, typeset version Journal of Neurology, Neurosurgery and Psychiatry, 2013, v. 84 n. 3, p. 297-304 is available online at: http://jnnp.bmj.com/content/84/3/297-
dc.subject.meshInfection - complications - mortality-
dc.subject.meshProspective Studies-
dc.subject.meshStroke - complications - mortality-
dc.subject.meshSurvival Analysis-
dc.subject.meshTime Factors-
dc.titleImpact of stroke-associated infection on long-term survival: a cohort studyen_US
dc.typeArticleen_US
dc.identifier.emailKwan, SKJ: jskkwan@hku.hk-
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1136/jnnp-2012-302552-
dc.identifier.pmid23160703-
dc.identifier.hkuros227907-
dc.identifier.volume84-
dc.identifier.issue3-
dc.identifier.spage297-
dc.identifier.epage304-
dc.identifier.isiWOS:000315041400015-
dc.publisher.placeUnited Kingdom-

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