Infections Increase Mortality Risk for Stroke Patients with Diabetes

Published on December 1, 2022

Imagine your body is a fortress protecting an important treasure. Now imagine that treasure is your health, specifically your brain health. Now picture a sneaky enemy called infection trying to break through the fortress walls and cause damage. Well, in stroke patients with co-morbid diabetes mellitus (DM), this enemy is not to be taken lightly. A recent study examined the effects of infection on acute ischemic stroke (AIS) in patients with DM and found that infection was associated with a higher risk of in-hospital mortality. In fact, patients who developed pneumonia or urinary tract infections during their hospital stay had a mortality rate of 3.4%. This means that infection, like a crafty intruder, can weaken the defenses of the fortress and significantly impact the outcome of stroke patients with DM. The study also identified several other factors that increased the risk of in-hospital mortality, such as older age, male gender, and higher fasting plasma glucose levels at admission. On the other hand, receiving antiplatelet drug therapy and having a longer hospital stay were identified as protective factors against in-hospital mortality for infected patients. These findings highlight the importance of preventing and managing infections in stroke patients with DM to improve their chances of survival and recovery. If you’re curious to dive deeper into this fascinating research, click the link below to access the full article.

Background and objectiveThe association between infection and acute ischemic stroke (AIS) with diabetes mellitus (DM) remains unknown. Therefore, this study aimed to explore the effect of infection on AIS with DM.Materials and methodsThe data of patients with AIS and DM were extracted from the Chinese Stroke Center Alliance (CSCA) database from August 2015 to July 2019. The association between infections [pneumonia or urinary tract infection (UTI)] and in-hospital mortality was analyzed. Logistic regression models were used to identify the risk factors for in-hospital mortality of patients with infection.ResultsIn total, 1,77,923 AIS patients with DM were included in the study. The infection rate during hospitalization was 10.5%, and the mortality rate of infected patients was 3.4%. Stroke-associated infection was an independent risk factor for an early poor functional outcome [odds ratio (OR) = 2.26, 95% confidence interval (CI): 1.97–2.34, P < 0.0001] and in-hospital mortality in AIS patients with DM. The in-hospital mortality after infection was associated with age (OR = 1.02, 95% CI: 1.01–1.03, P < 0.0001), male (OR = 1.39, 95% CI: 1.13–1.71, P = 0.0018), reperfusion therapy (OR = 2.00, 95% CI: 1.56–2.56, P < 0.0001), and fasting plasma glucose at admission (OR = 1.05, 95% CI: 1.03–1.08, P < 0.0001). In contrast, antiplatelet drug therapy (OR = 0.63, 95% CI: 0.50–0.78, P < 0.0001) and hospital stay (OR = 0.96, 95% CI: 0.94–0.97, P < 0.0001) were independent protecting factors against in-hospital mortality of patients with infection.ConclusionInfection is an independent risk factor of in-hospital mortality for patients with AIS and DM, and those patients require strengthening nursing management to prevent infection.

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