Аннотация:346
WSC-0659
POSTER SESSION
NEUROCRITICAL MANAGEMENT
NOSOCOMIAL INFECTIONS IN STROKE
PATIENTS IN THE NEUROCRITICAL CARE
SETTING
D. Sergeev1, D. Gorbatyuk2, P. Prokazova1, J. Ryabinkina1 ;
M. Piradov1
1Research Center of Neurology, Neurocritical Care, Moscow, Russia
2Moscow State University, Faculty of Basic Medicine, Moscow, Russia
Background/Objectives: We aimed to study local profile of nosocomial
infections and its influence on stroke outcome.
Design: Data was collected in a prospective observational study in stroke
patients admitted to Neurocritical Care Unit.
Results: 29 subjects were included (62% males, median age 53.5), 69% had
ischemic stroke, 31% - ICH; median baseline NIHSS 15.5; 75% required
mechanical ventilation. Nosocomial infections were identified in 86%
patients and included pneumonia, urinary tract infections (UTI), catheter-
associated bloodstream infections (BSI), and sinusitis (79%, 48%, 45%
and 28%, respectively). Up to 90% of ischemic stroke patients had pneumonia,
(ventilator-associated pneumonia 56%). Age >55 years and
baseline NIHSS>15 predicted infection. At least two infections was
found in 38% patients.
Median time for pneumonia development was 6 days from admission, and
14 and 24 days for UTI and BSI, respectively.
Nosocomial infections were associated with increased duration of ICU
stay (median 42.5 in at least 1 infection vs 14.0 days without infection) and
mechanical ventilation (median 58.5 days vs 6.5 days, respectively).
Mortality was similar for no or 1, or 2 types of infections (9%, 11%,
and 14%, respectively, p>0.05), while all patients with 3 types of infection
survived and 40% of patients with 4 infections died. However, infectious
complication was never considered as an immediate cause of death.
Conclusion: ICU stroke patients are at high risk of infectious complications
that may dramatically increase length of stay and mechanical ventilation.
Combination of several types of infections is the most harmful and may
increase mortality.