Influence of lung infection on the course and outcome in patients with stroke

Purpose: Occurance of acute bacterial lung infectuns affects the course of disease and outcome in stroke patients. Aim of the study was to explore the frequency of hypostatic and aspiration pneumonia, their risk factor and their effect on outcome in patinets with acute stroke. Metods: In this retrospective study, we evaluated patients with stroke who were hospitalized at the Department of Neurology in Nis, between January- December 2011.There were a total of 1312 patients with stroke. 824(62,80%) had ischaemic stroke, and 488 (37,20%) had haemorrhagic. Patients were evaluated and had the same investigations with anamnestic, clinical, neurological, biochemical analisys, physical examination by a specialist for pulmonary diseases, lung X-ray, Color-Doppler of the neck blood vessels, EEG, CT of lung, CT/MRI of brain, MRA angiography. Results: Of a total of 1312 patients with stroke, 59 patients (4,49%) of them had pulmonary complications within 10 day from the event. There were 36 male and 23 female patients, age from 41 to 82 years. Pulmonary infections in all of the patients was confirmed by x-ray imaging and biochemical analisys. 28(47,46%) patients had lobar pneumonia, 23(38,98%) had bilateral bronchopneumonic changes and 8(13,56%) had pleural effusion. All of the patients were higly febrile, with increased sedimentation and leucocitosys with dominant neutrophiles. Despite the intensive antibiotic treatment, using two or more antibiotics in combination, 14 patients has died. Conclusion: Hypostatic and aspiration pneumonia are frequent complications of stroke associated with poor outcome. Regading to this fact, an intensive prevention of complications is necessary immediately after hospitalization.