Infection while being hospitalized for acute ischemic stroke (AIS) increases the patient’s short-term risk of stroke recurrence, according to a new study of more than 800,000 patients. The analysis, published in Stroke, gathered data from the Chinese Stroke Center Alliance (CSCA) and Third China National Stroke Registry (CNSR-III).
The infection rate for hospitalized AIS patients is as high as 30%, the authors observed, and prior studies have linked infection with a variety of inflammatory complications. To track its impact on stroke recurrence, the team explored data from more than 789,000 patients in the CSCA and more than 13,000 patients in the CNSR-III. Patients in the CSCA were treated from Aug. 1, 2015, to July 31, 2019, and patients in the CNSR-III were treated from August 3, 2015, to March 5, 2018.
Recurrent stroke was defined as the “new onset of focal neurological deficit induced by cerebral ischemic or hemorrhagic events” and confirmed using medical imaging.
Overall, the team found that infection during hospitalization was associated with a greater risk of recurrent stroke. An infection within two weeks of stroke onset was also associated with a greater risk of recurrent stroke during the patient’s hospitalization.
It could not be determined, however, how infection impacted a patient’s long-term risk of stroke recurrence.
The authors found some other key connections while completing this study.
“In our analysis, ischemic stroke patients with infection had a higher risk of hemorrhagic transformation (in CSCA and CNSR-III) and intracerebral hemorrhage (in CSCA) during hospitalization,” wrote lead author Jie Xu, MD, Beijing Tiantan Hospital in China, and colleagues. “Tissue ischemia and reperfusion injury following AIS may increase vulnerability of cerebral vessels. Moreover, increased inflammatory cytokines and proteins following infection may intensify vascular injury by promoting endothelial dysfunction and disrupture of blood-brain barrier and, therefore, may contribute to more hemorrhagic events.”
Michael has more than 16 years of experience as a professional writer and editor. He has written at length about cardiology, radiology, artificial intelligence and other key healthcare topics.