Antibiotics (Apr 2023)

Post-Stroke Infections: Insights from Big Data Using Clinical Data Warehouse (CDW)

  • Moa Jung,
  • Hae-Yeon Park,
  • Geun-Young Park,
  • Jong In Lee,
  • Youngkook Kim,
  • Yeo Hyung Kim,
  • Seong Hoon Lim,
  • Yeun Jie Yoo,
  • Sun Im

DOI
https://doi.org/10.3390/antibiotics12040740
Journal volume & issue
Vol. 12, no. 4
p. 740

Abstract

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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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