UTI, other infections can trigger acute ischemic stroke

  • Sebastian S & al.
  • Stroke
  • 27 Jun 2019

  • International Clinical Digest
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Takeaway

  • Multiple infections trigger acute ischemic stroke (AIS), but urinary tract infection (UTI) carried the greatest magnitude (5-fold) of increased risk.
  • Across all infection types, greatest stroke potential was within short time window.
  • Preceding UTI, respiratory tract infection, sepsis significantly increased risk for intracerebral hemorrhage (ICH).
  • Only respiratory tract infection appeared to increase risk for subarachnoid hemorrhage (SAH).

Why this matters

  • Consider potential interventions to address infections and obviate thrombosis, bleeding risks on admission (e.g., intensive thrombotic treatment, specific antibiotic regimens).
  • Ensure that patients are up to date on relevant vaccinations.

Key results

  • Admissions: AIS (n= 152,356), ICH (n=27,257), SAH (n=11,853).
  • UTI associated with ≥5 times magnitude for AIS at 7 days' time window (OR=5.32, P<.0001>
  • Corresponding risk magnitude decreased with longer time window for all infections.
  • ICH: UTI (OR, 1.80 at 14 days; P=.0351), septicemia (OR, 3.25 at 60 days; P=.0393), respiratory tract infection (OR, 2.11 at 7 days; P=.009).
  • Only respiratory tract infection was linked to increased ICH risk, highest at 14 days (OR, 3.67; P=.0048).

Study design

  • Case crossover analysis of differential associations between various infections and risk for AIS, ICH, SAH.
  • Funding: None disclosed.

Limitations

  • Classification bias.
  • Limited to admitted patients.