London, United Kingdom 2013 Poster Session Blue Cerebrovasc Dis 2013; 35 (suppl 3)1-854 637 554 Epidemiology of stroke Intracerebral haemorrhage in a population-based stroke registry (LuSSt) Incidence, case-fa-tality and predictors for long-term survival F. Palm1, N. Henschke2, K. Zimmer3, A. Safer4, P. Brenk5, H. Becher6, A.J. Grau7 Klinikum Ludwigshafen, Ludwigshafen, GERMANY1, Institute of Public Health, University of Heidelberg, Germany, Heidelberg, GERMANY2, Klinikum Ludwigshafen, Ludwigshafen, GER-MANY3, Institute of Public Health, University of Heidelberg, Germany, Heidelberg, GERMANY4, Dept. of Neurosurgery, University of Heidelberg, Universitätsklinikum Mannheim, Germany, Mann-heim, GERMANY5, Institute of Public Health, University of Heidelberg, Germany, Heidelberg, GERMANY6, Klinikum Ludwigshafen, Ludwigshafen, GERMANY7 Background and Purpose: Data on incidence of intracerebral haemorrhage (ICH) are conflicting. Population-based data on predictors of ICH mortality are rare. Methods: The Ludwigshafen Stroke Study (LuSSt) is a prospective population-based stroke regis-try which started in January 2006. All residents of the city of Ludwigshafen who suffer from acute stroke or TIA are registered. Patients with first-ever intracerebral haemorrhage (FE-ICH) between 2006 and 2010 were included for present analysis. Follow-up was performed up to July 2012. Results: Between January 1, 2006 and December 31st, 2010, 152 patients (age 71.3+13.6 years (mean + standard deviation; 75 (49.3%) women) suffered a FE-ICH. Crude and age-adjusted inci-dence rates per 100,000 for FE-ICH was 18.7 (95% CI 15.9-21.9) and 11.9 (95% CI 10.2-14.0) and remained stable over time. Case-fatality rates for FE-ICH were 27.0%, 34.9% and 44.1% at days 28, 90 and 365, respectively. After adjusting for age and gender, high GCS, low mRS, stroke unit treat-ment, reduction of blood pressure before admission, arterial hypertension, hypercholesterolemia, low hematoma volume, absence of intraventricular haemorrhage and low leucocyte count on admis-sion were associated with longer survival time. Conclusions: Incidence of FE-ICH is in the lower range of those reported from other registries and remained stable over the observation period. In addition to well known predictors for ICH related mortality, early reduction of blood pressure before admission and low leukocyte count on admission were associated with long time-survival. Acute stroke: emergency management, stroke units and complications (PO 555 - 647) 555 Acute stroke: emergency management, stroke units and complications Incidence and risk factors of stroke-induced infections D. Brämer1, M. Möller2, M. Schwab3, O.W. Witte4, A. Günther5 Department of Neurology Friedrich Schiller University of Jena, Jena, GERMANY1, Depart-ment of Neurology Friedrich Schiller University of Jena, Jena, GERMANY2, Department of Neurol-ogy Friedrich Schiller University of Jena, Jena, GERMANY3, Department of Neurology Friedrich Schiller University of Jena, Jena, GERMANY4, Department of Neurology Friedrich Schiller Univer-sity of Jena, Jena, GERMANY5 Background: Infections are the most relevant complication after acute ischemic stroke. They are caused by stroke-induced immunodepression and increased exposition to bacteria (e.g. aspiration mediated). Nevertheless, a general prophylactic antibiotic treatment could not show a benefit in large clinical trials. Therefore, it seems to be relevant to select risk patients for development of infections. Methods: In a retrospective analysis of medical records and cerebral images from 244 patients with acute isch-emic stroke admitted to our stroke unit (mean age 67,5, m:f 128:116), we documented the develop-ment of infections following stroke (pneumonia, urinary tract infection, other systemic infections), anamnestic and diagnostic data (pre-existing diseases, pre-medication, size and location of stroke, severity of neurological deficits). Statistic analysis was performed using multivariate logistic regres-sion models. Results: 80 (32%) of the 244 stroke-patients developed a clinically apparent infection. 64 (26.2%) had a uri-nary tract infection, 25 (10.2%) a pneumonia and 40 (16.4%) other systemic infections. Gender (es-pecially male in pneumonias and female in urinary tract infections), size of stroke, right-hemispheric stroke and severity of neurological deficits (NIHSS >8) were risk factors for development of infec-tions (p<0.05). Development of infections increased the mortality (p<0.05). Pre-existing diseases or pre-medication had no effect. Conclusion: The incidence of stroke-induced infections in our patients was similar to the literature. The low in-fection rate does not support the concept of a general prophylactic antibiotic treatment following stroke. The close monitoring of development of infections seems to be useful in patients with large stroke (> 1/3 of the media territory), right-hemispheric stroke or severe neurological deficits (NIHSS >8). Screening for urinary tract infections is advisable especially in female patients.
Karger_ESC London_2013
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