Infections in Acute Older Stroke Inpatients Undergoing Rehabilitation

Chen C-M, Hsu H-C, Tsai W-S, Chang C-H, Chen K-H, Hong C-Z: Infections in acute older stroke inpatients undergoing rehabilitation. Am J Phys Med Rehabil 2012;91:211Y219. Objective: The present study compares the incidence of various infections among patients in acute and rehabilitation wards and examines the risk factors and pathogens involved in rehabilitation ward infections. Design: The study included 341 acute stroke patients (age, >= 65 yrs). The assessment of risk factors was done by comparison of patients with or without infection, urinary tract infection, and pneumonia. Possible precipitating factors in each comparison were included in the statistical analysis. Results: Ninety-five (27.9%) patients experienced infections, and the most common type in the rehabilitation ward was urinary tract infection. The frequency of incidence of pneumonia in the rehabilitation ward (6.7%) was significantly lower than in the acute ward (23.8%) (P < 0.001). Patients with infection had a longer rehabilitation ward stay compared with those without infection (30.9 vs. 18.8 days, P = 0.002). A postvoid residual urine volume greater than 50 ml (odds ratio, 2.314; 95% CI, 1.204Y4.448, P = 0.012) was found to be the most important risk factor for infection. Conclusions: Infection may prolong the length of stay in acute stroke patients in a rehabilitation ward. The present study provides important information for clinicians to help identify risk factors for infection.