London, United Kingdom 2013 Poster Session Blue Cerebrovasc Dis 2013; 35 (suppl 3)1-854 665 603 Acute stroke: emergency management, stroke units and complications Lifestyle factors and the risk of post stroke pneumonia and urinary tract infection A. Ingeman1, G. Andersen2, R.W. Thomsen3, H.H. Rasmussen4, S.P. Johnsen5 Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, DENMARK1, De-partment of Neurology, Aarhus University Hospital, Aarhus, DENMARK2, Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, DENMARK3, Centre for Nutrition and Bowel Disease, Aalborg University Hospital, Aalborg, DENMARK4, Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, DENMARK5 Background: It is well established that early intervention during the acute phase of stroke, in partic-ular early mobilization, is associated with a lower risk of post stroke infections. Less is known about the role of patient-related factors including lifestyle factors. We therefore examined the association among stroke unit patients. Methods: Using population-based Danish medical registries we identified 13,721 patients admitted for stroke to stroke units in two Danish counties in 2003-2009. Data regarding pneumonia and uri-nary tract infection (UTI) were prospectively registered, and the individual and joint effects of life-style factors were investigated. Lifestyle factors were measured in terms of Body Mass Index (BMI) (kg/m2), alcohol intake and smoking habits. Results: Overall, 20.9 % (n=2,861) of the patients experienced either pneumonia, UTI or both during hospitalization. A total of 15.4% (n=2,107) of the patients experienced UTI, 9% (n=1.235), pneumonia and 3.5% (n=481) experienced both. We found no indications of a relationship between neither the individual nor the joint effects of life-style factors and the risk of either pneumonia or UTI (i.e., adjusted odds ratios (OR) ranged from 1.02 95% confidence interval (CI): 0.90–1.16 for moderate healthy lifestyle (1 lifestyle factor) to 1.11 95% CI: 0.79–1.55 for unhealthy lifestyle (smoker, alcohol intake >21/14 drinks per week men and women, respectively and BMI <18.5 kg/m2 or >24.9 kg/m2). Of the individual lifestyle factors severe obesity (BMI >/=35 kg/m2) was associated with the highest non-significant risk of in-fection adjusted OR 1.11 95% CI: 0.77–1.60. Conclusions: Lifestyle factors at admission for acute stroke care were not associated with an in-creased risk of post stroke infections. The apparent minor role of these patient-related factors un-derlines the important role of the health care professionals and the need for a high overall quality of care in preventing infections in patients with stroke. TABLE 1. Pneumonia or urinary tract infection after admission for stroke according to lifestyle fac-tors present at admission Lifestyle factors Pneumonia or urinary tract infection N (%) Unadjusted OR (95% CI) Adjusted OR* (95% CI) Healthy lifestyle: - Non smoker, alcohol intake <= 21/14, bmi >18.5 and < 24.9 kg/m2 290/1,183(24.5) Ref ref Moderate healthy: - 1 lifestyle factor present 1042/4,739 (22.0) 0.80 (0.72– 0.89) 1.02 (0.90–1.16) Moderate unhealthy: - 2 lifestyle factors present 861/4,965 (17.3) 0.62 (0.56– 0.68) 1.02 (0.88–1.18) Unhealthy: - Smoker, alcohol intake > 21/14, and bmi <18.5 and > 24.9 kg/m2 99/686 (14.4) 0.53 (0.42– 0.67) 1.11 (0.79–1.55) Body Mass Index: - Normal weight:18.5 -24.9 kg/m2 1102/4,536 (24.3) ref ref Body Mass Index - Underweight: <18.5 kg/m2 186/566 (32.9) 1.42 (1.15– 1.74) 1.04 (0.81–1.33) Body Mass Index: - Overweight: 25 - 29.9 kg/m2 589/3,139 (18.8) 0.73 (0.68– 0.78) 0.94 (0.86–1.04) Body Mass Index: - Moderate obesity: 30.0 - 34.9 kg/m2 206/1,079 (19.1) 0.72 (0.62– 0.83) 1.01 (0.83–1.22) Body Mass Index: - Severe obesity: >= 35 kg/m2 72/381 (17.6) 0.71 (0.53– 0.95) 1.11 (0.77–1.60) Alcohol intake**: - ≤21/14 drinks per week† 2099/10,350 (20.3) ref ref Alcohol intake**: - >21/14 drinks per week† 193/1,223 (15.8) 0.73 (0.68– 0.79) 1.06 (0.92–1.22) Smoking habits**: Never smoker 859/3,821 (22.5) ref ref Smoking habits**: Current smoker 827/4,859 (17.0) 0.71 (0.64– 0.79) 1.05 (0.93–1.18) Smoking habits**: Former smoker 551/2,679 (20.6) 0.89 (0.76– 1.05) 1.04 (0.89–1.21) *All analyses are corrected for clustering of patients by stroke unit and age, sex, marital status, housing, profession, alcohol intake(except for lifestyle and alcohol intake),, smoking habits (except for lifestyle and smoking), atrial fibrillation, previous stroke, hypertension, Charlson comorbidity index, Scandinavian stroke scale score on admission, type of stroke, and proportion of relevant pro-cesses of care received. **Also corrected for Body Mass Index †Drinks per week for men and women, respectively
Karger_ESC London_2013
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