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Men Experience Higher Risk of Pneumonia and Death After Intracerebral Hemorrhage.
Neurocrit Care. 2018 02; 28(1):77-82.NC

Abstract

BACKGROUND

Infectious complications worsen outcome after intracerebral hemorrhage (ICH). We investigated the impact of sex on post-ICH infections and mortality.

METHODS

Consecutive ICH patients (admitted to a single hospital between 1994 and 2015) were retrospectively assessed via chart review to ascertain the following in-hospital infections: urinary tract infection (UTI), pneumonia, and sepsis. Adjusted logistic regression was performed to identify associations between sex, infection, and mortality at 90 days.

RESULTS

Two thousand and four patients were investigated, 1071 (53.7%) males. Men were more likely to develop pneumonia (21.9 vs 15.5% p < 0.001) and sepsis (3.4 vs 1.6%, p = 0.009), whereas women had higher risk of UTI (19.9 vs 11.7% p < 0.001). Multivariate analyses confirmed association between male sex and pneumonia (Odds Ratio (OR) 1.37, 95% confidence interval (CI) 1.08-1.74, p = 0.011). Male sex (OR 1.40; CI 1.07-1.85; p = 0.015) and infection (OR 1.56; CI 1.11-1.85; p = 0.011) were independently associated with higher 90-day mortality.

CONCLUSIONS

Types and rates of infection following ICH differ by sex. Male sex independently increases pneumonia risk, which subsequently increases 90-day mortality. Sex-specific preventive strategies to reduce the risk of these complications may be one strategy to improve ICH outcomes.

Authors+Show Affiliations

Center for Genomic Medicine, Massachusetts General Hospital, 185 Cambridge Street, Boston, MA, 02114, USA. smarini1@mgh.harvard.edu. J. P. Kistler Stroke Research Center, Massachusetts General Hospital, Boston, MA, USA. smarini1@mgh.harvard.edu.Center for Genomic Medicine, Massachusetts General Hospital, 185 Cambridge Street, Boston, MA, 02114, USA. J. P. Kistler Stroke Research Center, Massachusetts General Hospital, Boston, MA, USA. Stroke Unit and Department of Emergency Neurology, C. Mondino National Neurological Institute, Pavia, Italy.Center for Genomic Medicine, Massachusetts General Hospital, 185 Cambridge Street, Boston, MA, 02114, USA.J. P. Kistler Stroke Research Center, Massachusetts General Hospital, Boston, MA, USA. Division of Neurocritical Care and Emergency Neurology, Department of Neurology, Massachusetts General Hospital, Boston, MA, USA.J. P. Kistler Stroke Research Center, Massachusetts General Hospital, Boston, MA, USA. Division of Neurocritical Care and Emergency Neurology, Department of Neurology, Massachusetts General Hospital, Boston, MA, USA.Center for Genomic Medicine, Massachusetts General Hospital, 185 Cambridge Street, Boston, MA, 02114, USA. J. P. Kistler Stroke Research Center, Massachusetts General Hospital, Boston, MA, USA. Division of Neurocritical Care and Emergency Neurology, Department of Neurology, Massachusetts General Hospital, Boston, MA, USA.Center for Genomic Medicine, Massachusetts General Hospital, 185 Cambridge Street, Boston, MA, 02114, USA. J. P. Kistler Stroke Research Center, Massachusetts General Hospital, Boston, MA, USA. Division of Neurocritical Care and Emergency Neurology, Department of Neurology, Massachusetts General Hospital, Boston, MA, USA.

Pub Type(s)

Journal Article
Observational Study
Research Support, N.I.H., Extramural

Language

eng

PubMed ID

28730561

Citation

Marini, Sandro, et al. "Men Experience Higher Risk of Pneumonia and Death After Intracerebral Hemorrhage." Neurocritical Care, vol. 28, no. 1, 2018, pp. 77-82.
Marini S, Morotti A, Lena UK, et al. Men Experience Higher Risk of Pneumonia and Death After Intracerebral Hemorrhage. Neurocrit Care. 2018;28(1):77-82.
Marini, S., Morotti, A., Lena, U. K., Goldstein, J. N., Greenberg, S. M., Rosand, J., & Anderson, C. D. (2018). Men Experience Higher Risk of Pneumonia and Death After Intracerebral Hemorrhage. Neurocritical Care, 28(1), 77-82. https://doi.org/10.1007/s12028-017-0431-6
Marini S, et al. Men Experience Higher Risk of Pneumonia and Death After Intracerebral Hemorrhage. Neurocrit Care. 2018;28(1):77-82. PubMed PMID: 28730561.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Men Experience Higher Risk of Pneumonia and Death After Intracerebral Hemorrhage. AU - Marini,Sandro, AU - Morotti,Andrea, AU - Lena,Umme K, AU - Goldstein,Joshua N, AU - Greenberg,Steven M, AU - Rosand,Jonathan, AU - Anderson,Christopher D, PY - 2017/7/22/pubmed PY - 2019/10/1/medline PY - 2017/7/22/entrez KW - Infections KW - Intracerebral hemorrhage KW - Mortality KW - Pneumonia KW - Sepsis KW - Sex SP - 77 EP - 82 JF - Neurocritical care JO - Neurocrit Care VL - 28 IS - 1 N2 - BACKGROUND: Infectious complications worsen outcome after intracerebral hemorrhage (ICH). We investigated the impact of sex on post-ICH infections and mortality. METHODS: Consecutive ICH patients (admitted to a single hospital between 1994 and 2015) were retrospectively assessed via chart review to ascertain the following in-hospital infections: urinary tract infection (UTI), pneumonia, and sepsis. Adjusted logistic regression was performed to identify associations between sex, infection, and mortality at 90 days. RESULTS: Two thousand and four patients were investigated, 1071 (53.7%) males. Men were more likely to develop pneumonia (21.9 vs 15.5% p < 0.001) and sepsis (3.4 vs 1.6%, p = 0.009), whereas women had higher risk of UTI (19.9 vs 11.7% p < 0.001). Multivariate analyses confirmed association between male sex and pneumonia (Odds Ratio (OR) 1.37, 95% confidence interval (CI) 1.08-1.74, p = 0.011). Male sex (OR 1.40; CI 1.07-1.85; p = 0.015) and infection (OR 1.56; CI 1.11-1.85; p = 0.011) were independently associated with higher 90-day mortality. CONCLUSIONS: Types and rates of infection following ICH differ by sex. Male sex independently increases pneumonia risk, which subsequently increases 90-day mortality. Sex-specific preventive strategies to reduce the risk of these complications may be one strategy to improve ICH outcomes. SN - 1556-0961 UR - https://www.unboundmedicine.com/medline/citation/28730561/Men_Experience_Higher_Risk_of_Pneumonia_and_Death_After_Intracerebral_Hemorrhage_ L2 - https://dx.doi.org/10.1007/s12028-017-0431-6 DB - PRIME DP - Unbound Medicine ER -