Ischemic stroke outcome and early infection: Its deleterious effect seems to operate also among tissue plasminogen activator-treated patients

Background: Infection has been recognized as a significant predictor of outcome for ischemic stroke patients, although the mechanisms by which this association is operative have not been fully established, and their potential roles in a setting of close clinical monitoring, such as that of stroke units offering reperfusion therapies, have not been evaluated. Methods: We reviewed the medical records of 139 consecutive tissue plasminogen activator-treated stroke patients admitted to our stroke unit to evaluate potential predictors of neurological outcome. Results: 57 patients (41%) did not show neurological improvement by discharge, and 11.5% died during admission. Infections were related to lack of improvement (29.8 vs. 14.6%; p = 0.03) and PH-type hemorrhagic transformation (42.1 vs. 17.5%; p = 0.014); the latter was associated with a higher mortality rate (26.3 vs. 9.2%; p = 0.03). Conclusions: Infection may be associated with poor functional outcome among tissue plasminogen activator-treated stroke patients. © 2011 S. Karger AG, Basel.