Abstract TP335: Hospital-Acquired Infection is Associated with Poor Outcome in Young Adults with Hemorrhagic Stroke

Abstract

Background and Purpose: Infections are associated with poor outcomes in young people with ischemic stroke, particularly if they are hospital-acquired. However, the influence of infection on hemorrhagic stroke outcomes in a young population is less well characterized. Methods: We conducted a single-center retrospective analysis of a prospectively collected stroke registry, for patients, aged 18-45, admitted with hemorrhagic stroke of any type from 01/2008 to 03/2015. We reviewed charts for study variables, including patient characteristics, risk factors, and hospital-acquired infections (HAI) or infections present on admission (POA). Poor outcome was defined as modified Rankin score of 3-6 at time of discharge. We compared patients with HAI and infection POA to those without an infection. Results: Of the 219 hemorrhage cases in young adults, 31 (14%) had an infection POA, and 65 (29.7%) had a HAI. As shown in the table, patients who had a HAI and a POA infection had higher baseline NIHSS than those without an infection. In the unadjusted analyses, POA infections (OR = 2. 96, 95%CI: 1.91-4.58) and HAI (OR= 6.51, 95%CI: 4.06 - 10.44) are associated with poor mRS on discharge for hemorrhagic stroke. Adjusting for NIHSS, the relationship between POA infections and poor outcome is no longer significant (OR = 1.45, 95%CI: 0.34- 6.27) while HAI remains associated with poor outcome (OR= 6.73, 95%CI: 2.22 - 20.41). In SAH only patients, after adjusting for NIHSS, HAI remains associated with poor outcome (OR = 21.61, 95%CI: 3.35 - 139) while POA infections are not associated (OR = 3.01, 95%CI: 0.294 - 30.8). In ICH only patients, after adjusting for NIHSS, neither HAI (OR = 3.18, 95%CI: 0.656 - 15.4) nor POA infections (OR = 2.19, 95%CI: 0.334- 14.3) are associated with poor outcomes. Conclusions: In our single-center study, HAI, but not infections POA, were associated with poor outcomes in young adults with SAH. This relationship was not seen in patients with ICH.