Clinical risk factors for acute ischaemic and haemorrhagic stroke in patients with infective endocarditis
Autor: | Ives A Valenzuela, Jose Gutierrez, Joshua Z. Willey, Isaac George, Lauren Dunn, Bradley Klein, Kathryn M Sundheim, Madeleine D Hunter, Robert Sorabella, Sang M. Han |
---|---|
Rok vydání: | 2018 |
Předmět: |
medicine.medical_specialty
Univariate analysis Heart disease business.industry Retrospective cohort study Odds ratio 030204 cardiovascular system & hematology medicine.disease 03 medical and health sciences 0302 clinical medicine Infective endocarditis Internal medicine Internal Medicine medicine Endocarditis Risk assessment business Stroke 030217 neurology & neurosurgery |
Zdroj: | Internal Medicine Journal. 48:1072-1080 |
ISSN: | 1444-0903 |
DOI: | 10.1111/imj.13958 |
Popis: | Background Stroke as a complication of infective endocarditis portends a poor prognosis, yet risk factors for stroke subtypes have not been well defined. Aim To identify risk factors associated with ischaemic and haemorrhagic strokes. Methods A retrospective patient chart review was performed at a single US academic centre to identify risk factors and imaging for patients who were 18 years or older with infectious endocarditis (IE) and stroke diagnoses. Differences in patient characteristics by stroke status were assessed using univariate analysis, χ2 or student's t-test as well as logistic regression models for multivariable analyses and correlation matrices to identify possible collinearity between variables and to obtain odds ratios (OR) and their 95% confidence intervals. Results A final sample of 1157 participants was used for this analysis. The total number of non-surgical strokes was 178, with a prevalence of 15.4% (78% ischaemic, 10% parenchymal haemorrhages, 8% subarachnoid haemorrhages and 4% mixed ischaemic/haemorrhagic). Multivariate risk factors for ischaemic stroke included prior stroke (OR 2.0, 1.3-3.1), Staphylococcus infection (OR 2.0, 1.3-3.0), mitral vegetations (OR 2.2, 1.4-3.3) and valvular abscess (OR 2.7, 1.7-4.3). Risk factors for haemorrhagic stroke included fungal infection (OR 6.4, 1.2-34.0), male gender (OR 3.5, 1.4-8.3) and rheumatic heart disease (OR 3.3, 1.1-10.4). Conclusion Among patients with IE, there exist characteristics that relate differentially to ischaemic and haemorrhagic stroke risk. |
Databáze: | OpenAIRE |
Externí odkaz: |