Stroke Severity Is the Major Player in Post-Stroke Urinary Tract Infection in Patients with First Ever Ischemic Stroke

Abstract

Background: Urinary tract infections UTIs occur repeatedly after stroke and are related to bad outcomes with increased rates of deterioration in neurological state during hospitalization, death or long term disability as well as increased length of hospitalization. Factors found to predict UTI include stroke severity, depressed consciousness level, increased post-void residual urine volume, and diabetes mellitus. Stroke severity appears to be the most important predictor of infection risk. We aimed to determine the risk factors associated with UTI after acute stroke, and its association with outcome. Subjects and Methods: This is prospective cohort study. We analysed clinical data of 100 patients with first ever ischemic stroke. We assessed risk factors for UTI, as well as clinical outcome. Results: Urinary tract infection was found in 72% of our subjects. On univariate analysis, patients with UTI were more likely to have had a more severe stroke, more likely to be catheterized and more likely to have a higher serum creatinine level. The multivariate analysis revealed that greater stroke severity was independently associated with increased risk of developing UTI. Greater stroke severity measured by CSS was independently associated with unfavorable outcome on discharge. Conclusion: UTI is common after acute stroke. It is associated with more severe stroke.