卒中后感染对急性缺血性卒中患者出院 结局的影响.

Objective To explore the risk factors of adverse discharge outcomes in patients with acute ischemic stroke (AIS), and the effects of post-stroke infection on discharge outcomes. Methods AIS patients who were hospitalized in the Department of Neurology, Beijing Tiantan Hospital, Capital Medical University from June 2019 to June 2022 were retrospectively included in this study. The patients were divided into good outcome group (mRS score<3) and poor outcome group (mRS score >3 or death during hospitalization) according to discharge outcome. The clinical characteristics and post-stroke infection(pulmonary infection, urinary tract infection and central nervous system infection) were compared between the two groups. Multivariate logistic regression was used to analyze the risk factors for adverse discharge outcomes in AIS patients. Results A total of 1024 patients with AIS were included in this study, with a mean age of (60.3±12.4) years old and 788 males (77.0%). There were 761 (74.3%) patients in the good outcome group and 263(25.7%) patients in the poor outcome group. 85 (8.3%) patients developed infection after stroke, of which 69 (6.7%) were pulmonary infections, 16 (1.6%) were urinary tract infections, and 3 (0.3%) were central nervous system infections. Multivariate analysis showed that pulmonary infection (OR 2.522, 95%CI 1.318-4.828, P=0.005), diabetes (OR 1.486, 95%CI 1.048-2.106, P=0.026), increased NIHSS score on admission (OR 1.286, 95%CI 1.233-1.342, P<0.001) and increased white blood cell count (OR 1.094, 95%CI 1.014-1.180, P=0.020) were risk factors for poor discharge outcomes in AIS patients. Conclusions Pulmonary infection may significantly increase the risk of poor discharge outcomes in patients with AIS. [ABSTRACT FROM AUTHOR]