Table 3.
Characterization of the validation cohort (391 patients with ischemic stroke and stroke-associated infection)
| Baseline data | |
|---|---|
| Age, year, median (Q1-Q3) | 80 (71–86) |
| Sex, female | 220 (56.3) |
| Arterial hypertension | 335 (85.7) |
| Dyslipidemia | 265 (67.8) |
| Atrial fibrillation | 200 (51.2) |
| Smoking | 78 (19.9) |
| Diabetes mellitus | 125 (32.0) |
| Charlson comorbidity index score, median (Q1-Q3) | 2 (1–3) |
| Premorbid mRS, median (Q1-Q3) | 1 (0–3) |
| Stroke characteristics and treatment | |
| NIHSS score at admission, median (Q1-Q3) | 10 (5–17) |
| ASPECTS at admission, median (Q1-Q3) | 7 (5–9) |
| Occlusion of large intracranial arteries | 203 (51.9) |
| Middle cerebral artery, M1 segment | 88 (43.3) |
| Middle cerebral artery, M2 segment | 52 (25.6) |
| Intracranial internal carotid artery | 35 (17.2) |
| Basilar artery | 13 (6.4) |
| Other | 15 (7.4) |
| Stroke etiology | |
| Cardioembolism | 155 (39.6) |
| Large artery arteriosclerosis | 61 (15.6) |
| Small vessel disease | 19 (4.9) |
| Other determined etiology | 17 (4.3) |
| Undetermined etiology | 139 (35.5) |
| Intravenous thrombolysis | 97 (24.8) |
| Endovascular therapy | 145 (37.1) |
| General anesthesia for endovascular therapy | 137 (95.1) |
| Symptomatic intracranial hemorrhage after intravenous thrombolysis or endovascular therapy | 18 (9.5) |
| Treatment limitations | |
| DNR | 147 (37.6) |
| DNI | 132 (33.8) |
| Time from admission to DNR/DNI order, days, median (Q1-Q3) | 2 (1–5) |
| Further treatment limitations including comfort measures only | 79 (20.2) |
| Time from admission to further treatment limitations, days, median (Q1-Q3) | 7 (3–15) |
| Stroke-associated infection | |
| Time from admission to diagnosis of infection, days, median (Q1-Q3) | 3 (2–6) |
| Source of infection | |
| Pneumonia (clinical diagnosis) | 186 (47.6) |
| Pneumonia (according to PISCES criteria) | 135 (34.5) |
| Urinary tract infection (clinical diagnosis) | 170 (43.5) |
| Urinary tract infection (according to CDC criteria) | 18 (4.6) |
| Other | 31 (7.9) |
| Undetermined | 41 (10.5) |
| COVID-19 | 17 (4.3) |
| Evidence of a pathogenic organism in body fluid cultures | 198 (50.6) |
| Antibiotic therapy | 370 (94.6) |
| Time from diagnosis of infection to antibiotic therapy, hours, median (Q1-Q3) | 1.4 (0.13–4.12) |
| Sepsis (diagnosis according to Sepsis-3 definition) | 129 (33.0) |
| Clinical outcome at discharge | |
| NIHSS, median (Q1-Q3) | 5 (3–11) |
| mRS, median (Q1-Q3) | 4 (3–5) |
| Barthel index, median (Q1-Q3) | 25 (10-62.5) |
| Length of stay, d, median (Q1-Q3) | 13 (7–19) |
| ICU treatment | 95 (24.3) |
| Death | 72 (18.4) |
| Clinical outcome at 3 months | |
| mRS, median (Q1-Q3) | 5 (3–6) |
| mRS 0 | 4 (1.0) |
| mRS 1 | 21 (5.4) |
| mRS 2 | 20 (5.1) |
| mRS 3 | 56 (14.4) |
| mRS 4 | 87 (22.3) |
| mRS 5 | 60 (15.3) |
| Death (mRS 6) | 142 (36.3) |
| Functional independency (mRS 0–2) | 45 (11.5) |
| Unfavourable outcome (mRS 4–6) | 289 (74.1) |
| Poor outcome (mRS 5–6) | 202 (51.7) |
Results are presented as n (%) unless indicated otherwise for certain variables. Abbreviations: ASPECTS = Alberta Stroke Programme Early Computed Tomography Score, CDC = Centers for Disease Control and Prevention, COVID-19 = coronavirus disease 2019, DNI = Do not intubate, DNR = Do not resuscitate, ICU = intensive care unit. mRS = modified Rankin Scale, NIHSS = National Institutes of Health Stroke Scale, PISCES = Pneumonia in Stroke Consensus
Other occlusions of large intracranial arteries include vertebral artery, P1/2 segment of the posterior cerebral artery, and A1 segment of the anterior cerebral artery