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Post-Stroke Infections: Insights from Big Data Using Clinical Data Warehouse (CDW)
Moa Jung1, Hae-Yeon Park1, Geun-Young Park1
1Department of Rehabilitation Medicine, Bucheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea.
Insights
Male sex, brain surgery, mechanical ventilation, enteral feeding, and certain medications increase infection risk after stroke. Careful risk-benefit evaluation is crucial for high-risk patients.
Area of Science:
- Neurology
- Infectious Diseases
- Health Informatics
Background:
- Post-stroke infections are a significant complication, impacting patient outcomes.
- Identifying specific risk factors is essential for targeted prevention strategies.
Purpose of the Study:
- To analyze electronic medical records (EMRs) and identify clinical risk factors associated with post-stroke infections.
- To provide data for optimizing patient care and reducing infection rates.
Main Methods:
- Retrospective analysis of a large digitized EMR database.
- Inclusion of 41,236 patients with a first stroke diagnosis (ICD-10 codes I60, I61, I63, I64) from 2011-2020.
- Logistic regression analysis to determine the association between clinical variables and post-stroke infection.
Main Results:
- Male sex, brain surgery, mechanical ventilation, and enteral tube feeding were significantly associated with increased infection risk.
- Lower functional activity (Modified Barthel Index) and use of steroids or acid-suppressant drugs also elevated infection risk.
- Odds ratios highlight the substantial impact of factors like mechanical ventilation (OR: 18.26) and brain surgery (OR: 7.89).
Conclusions:
- Several clinical factors and medications significantly increase the risk of post-stroke infections.
- A careful assessment of the benefits versus the increased infection risk is necessary when considering steroids or acid-suppressant drugs for high-risk stroke patients.
- These findings underscore the importance of proactive infection control measures in stroke care.
Abstract:
This study analyzed a digitized database of electronic medical records (EMRs) to identify risk factors for post-stroke infections. The sample included 41,236 patients hospitalized with a first stroke diagnosis (ICD-10 codes I60, I61, I63, and I64) between January 2011 and December 2020. Logistic regression analysis was performed to examine the effect of clinical variables on post-stroke infection. Multivariable analysis revealed that post-stroke infection was associated with the male sex (odds ratio [OR]: 1.79; 95% confidence interval [CI]: 1.49-2.15), brain surgery (OR: 7.89; 95% CI: 6.27-9.92), mechanical ventilation (OR: 18.26; 95% CI: 8.49-44.32), enteral tube feeding (OR: 3.65; 95% CI: 2.98-4.47), and functional activity level (modified Barthel index: OR: 0.98; 95% CI: 0.98-0.98). In addition, exposure to steroids (OR: 2.22; 95% CI: 1.60-3.06) and acid-suppressant drugs (OR: 1.44; 95% CI: 1.15-1.81) increased the risk of infection. On the basis of the findings from this multicenter study, it is crucial to carefully evaluate the balance between the potential benefits of acid-suppressant drugs or corticosteroids and the increased risk of infection in patients at high risk for post-stroke infection.
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