Abstract W P230: A Simple Prediction Score for Hospital-Acquired Infections in Acute Ischemic Stroke
Background: Hospital-acquired infections (HAI) are a major cause of morbidity and mortality in acute ischemic stroke (AIS) patients. While prior scoring systems have been developed to predict pneumonia (PNA) in AIS patients, these scores were not designed to predict other infections that complicate hospital stays. We sought to develop a simple scoring system for any HAI.
Methods: Patients admitted to our stroke center (07/08-06/12) were retrospectively assessed. Patients were excluded if they had an in-hospital stroke, unknown time from symptom onset, or delay from symptom onset to hospital arrival >48 hours. Infections were diagnosed via clinical, laboratory and imaging methods using standards set forth by our center. A scoring system was created to predict infections based on patient characteristics available at the time of admission.
Results: Of the 568 people who met inclusion criteria, 84 (14.8%) developed an infection during their inpatient stay. Patients who developed infection were older (73 vs. 64, p<0.0001), were more frequently diabetic (43.9% vs. 29.1%, p=0.0077), and had more severe strokes on admission (NIHSS 12 vs. 5, p15 5 points). Patients with an infection score of >4 were at 5 times greater odds of developing an infection (OR 5.67, 95% CI 3.28-9.81, p<0.0001). The area under the curve for this score showed fair sensitivity and specificity for predicting HAI after AIS (AUC=0.7311).
Conclusion: In our sample of AIS patients, clinical and laboratory characteristics available on presentation identified patients at risk for infections during their acute hospitalizations. Validation is required in other populations. If validated, this score could assist providers in predicting and preventing infections after hospitalization for AIS.
Author Disclosures: A. Friedant: None. B. Gouse: None. A.K. Boehme: None. J.E. Siegler: None. K.C. Albright: None. D. Monlezun: None. A. George: None. T. Beasley: None. S. Martin-Schild: None.
- © 2014 by American Heart Association, Inc.