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Translational Stroke Research

pp 1–8

First Online: 27 July 2017Received: 04 April 2017Revised: 02 July 2017Accepted: 03 July 2017


Early infection after stroke is associated with a poor outcome. We aimed to determine whether delayed infections up to 76 days post-stroke are associated with poor outcome at 90 days. Data came from the international Efficacy of Nitric Oxide Stroke ENOS, ISRCTN99414122 trial. Post hoc data on infections were obtained from serious adverse events reports between 1 and 76 days following stroke in this large cohort of patients. Regression models accounting for baseline covariates were used to analyse fatalities and functional outcomes modified Rankin Scale mRS, Barthel Index, Euro-Qol-5D at 90 days, in patients with infection compared to those without infection. Of 4011 patients, 242 6.0% developed one or more serious infections. Infections were associated with an increased risk of death p < 0.001 and an increased likelihood of dependency measured by mRS compared to those of all other patients p < 0.001. This remained when only surviving patients were analysed, indicating that the worsening of functional outcome is not due to mortality p < 0.001. In addition, the timing of the infection after stroke did not alter its detrimental association with fatality p = 0.14 or functional outcome p = 0.47. In conclusion, severe post-stroke infections, whether occurring early or late after stroke, are associated with an increased risk of death and poorer functional outcome, independent of differences in baseline characteristics or treatment. Not only are strategies needed for reducing the risk of infection immediately after stroke, but also during the first 3 months following a stroke. This study is registered: ISRCTN registry, number ISRCTN99414122, Identifier, NCT00989716.

KeywordsStroke Infection Glyceryl trinitrate Disability Members of the ENOS Trial investigators are listed in ENOS trial investigators. Lancet. 2015;3859968:617–28

Electronic supplementary materialThe online version of this article doi:10.1007-s12975-017-0553-3 contains supplementary material, which is available to authorized users.

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Autor: Annastazia E. Learoyd - Lisa Woodhouse - Laurence Shaw - Nikola Sprigg - Daniel Bereczki - Eivind Berge - Valeria Caso - H


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