Infections Up to 76 Days After Stroke Increase Disability and Death

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dc.contributor.authorLearoyd, Annastazia E.
dc.contributor.authorWoodhouse, Lisa
dc.contributor.authorShaw, Laurence
dc.contributor.authorSprigg, Nikola
dc.contributor.authorBereczki, Daniel
dc.contributor.authorBerge, Eivind
dc.contributor.authorCaso, Valeria
dc.date.accessioned2020-03-26T19:41:54Z
dc.date.available2020-03-26T19:41:54Z
dc.date.issued2017
dc.departmentSelçuk Üniversitesien_US
dc.description.abstractEarly infection after stroke is associated with a poor outcome. We aimed to determine whether delayed infections (up to 76 days post-stroke) are associated with poor outcome at 90 days. Data came from the international Efficacy of Nitric Oxide Stroke (ENOS, ISRCTN99414122) trial. Post hoc data on infections were obtained from serious adverse events reports between 1 and 76 days following stroke in this large cohort of patients. Regression models accounting for baseline covariates were used to analyse fatalities and functional outcomes (modified Rankin Scale (mRS), Barthel Index, Euro-Qol-5D) at 90 days, in patients with infection compared to those without infection. Of 4011 patients, 242 (6.0%) developed one or more serious infections. Infections were associated with an increased risk of death (p < 0.001) and an increased likelihood of dependency (measured by mRS) compared to those of all other patients (p < 0.001). This remained when only surviving patients were analysed, indicating that the worsening of functional outcome is not due to mortality (p < 0.001). In addition, the timing of the infection after stroke did not alter its detrimental association with fatality (p = 0.14) or functional outcome (p = 0.47). In conclusion, severe post-stroke infections, whether occurring early or late after stroke, are associated with an increased risk of death and poorer functional outcome, independent of differences in baseline characteristics or treatment. Not only are strategies needed for reducing the risk of infection immediately after stroke, but also during the first 3 months following a stroke. This study is registered: ISRCTN registry, number ISRCTN99414122, Identifier, NCT00989716.en_US
dc.description.sponsorshipMedical Research CouncilMedical Research Council UK (MRC) [G0501797]; Biotechnology and Biological Sciences Research CouncilBiotechnology and Biological Sciences Research Council (BBSRC) [BB/F016956/1]; Agency for Science, Technology, and Research (Singapore)Agency for Science Technology & Research (ASTAR); BUPA Foundation (UK); Hypertension Trust (UK); Queen Elizabeth II Health Sciences Centre Research Fund (Canada); Reichstadt family (UK); Stroke Association (UK through Division of Stroke, University of Nottingham, Nottingham, UK); University of Nottinghamen_US
dc.description.sponsorshipThis work was supported by the Medical Research Council [grant number G0501797] and the Biotechnology and Biological Sciences Research Council [grant number BB/F016956/1]. Other funders who supported the ENOS trial were the Agency for Science, Technology, and Research (Singapore), BUPA Foundation (UK), Hypertension Trust (UK), Queen Elizabeth II Health Sciences Centre Research Fund (Canada), Reichstadt family (UK), and The Stroke Association (UK, through its funding of the Division of Stroke, University of Nottingham, Nottingham, UK). PB is the Chief Investigator of the ENOS and is the Stroke Association Professor of Stroke Medicine. ENOS was sponsored by the University of Nottingham. Neither funder nor sponsor had any input into the study.en_US
dc.identifier.doi10.1007/s12975-017-0553-3en_US
dc.identifier.endpage548en_US
dc.identifier.issn1868-4483en_US
dc.identifier.issn1868-601Xen_US
dc.identifier.issue6en_US
dc.identifier.pmid28752410en_US
dc.identifier.scopusqualityQ1en_US
dc.identifier.startpage541en_US
dc.identifier.urihttps://dx.doi.org/10.1007/s12975-017-0553-3
dc.identifier.urihttps://hdl.handle.net/20.500.12395/35205
dc.identifier.volume8en_US
dc.identifier.wosWOS:000413236900004en_US
dc.identifier.wosqualityQ1en_US
dc.indekslendigikaynakWeb of Scienceen_US
dc.indekslendigikaynakScopusen_US
dc.indekslendigikaynakPubMeden_US
dc.language.isoenen_US
dc.publisherSPRINGERen_US
dc.relation.ispartofTRANSLATIONAL STROKE RESEARCHen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/openAccessen_US
dc.selcuk20240510_oaigen_US
dc.subjectStrokeen_US
dc.subjectInfectionen_US
dc.subjectGlyceryl trinitrateen_US
dc.subjectDisabilityen_US
dc.titleInfections Up to 76 Days After Stroke Increase Disability and Deathen_US
dc.typeArticleen_US

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