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Stroke Research and Treatment
Volume 2011 (2011), Article ID 830614, 8 pages
http://dx.doi.org/10.4061/2011/830614
Clinical Study

Infection after Acute Ischemic Stroke: Risk Factors, Biomarkers, and Outcome

1Department of Neurology, Martin Luther University Halle-Wittenberg, Ernst-Grube-Strasse 40, 06120 Halle (Saale), Germany
2Department of Neurology, Klinikum Altenburger Land, Am Waldessaum 10, 04600 Altenburg, Germany
3Department of General Surgery, Klinikum Altenburger Land, Am Waldessaum 10, 04600 Altenburg, Germany
4Central Laboratory, Klinikum Altenburger Land, Am Waldessaum 10, 04600 Altenburg, Germany
5Division of Neurocritical Care, Neurological Institute, Columbia University College of Physicians and Surgeons, 710 West 168th Street, New York, NY 10032, USA

Received 22 February 2011; Accepted 31 March 2011

Academic Editor: Byung Woo Yoon

Copyright © 2011 Katja E. Wartenberg et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background. The activation of inflammatory cascades triggered by ischemic stroke may play a key role in the development of infections. Methods. Patients admitted with ischemic stroke within 24 hours were prospectively enrolled. Biomarkers of infection were measured on days 1, 3, and 5. The patients were continuously monitored for predefined infections. Results. Patients with infection were older (OR 1.06 per year, 95% CI 1.01–1.11) and had a higher National Institute of Health Stroke Scale Score (NIHSS, OR 1.21, 95% CI 1.10–1.34), localization in the insula, and higher stroke volumes on diffusion-weighted imaging. The maximum temperature on days 1 and 3, leukocytes, interleukin-6, lipopolysaccharide-binding protein on days 1, 3, and 5, C-reactive protein on days 3 and 5, and procalcitonin on day 5 were higher and HLA-DR-expression on monocytes on days 1, 3, and 5 lower in patients with infection. Age and NIHSS predicted the development of infections. Infection was an independent predictor of poor functional outcome. Conclusions. Severe stroke and increasing age were shown to be early predictors for infections after stroke.