Can a Urinary Tract Infection Provoke a Stroke?
Infections of the skin, blood stream, abdomen, and respiratory tract are associated with the later development of acute ischemic stroke, according to a new study. Urinary tract infections (UTIs), in particular, are associated with the stroke subtype.1
To assess the relationship between different infections and stroke subtypes, the researchers analyzed data from the New York State Inpatient Databases and Emergency Department Databases from 2006 to 2013.
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Using these databases and the definitions from validated International Classification of Diseases, Ninth Edition, the researchers identified index hospitalizations for acute ischemic stroke, intracerebral hemorrhage, and subarachnoid hemorrhage as well as emergency department visits and hospitalizations for the 5 types of infection.
The identified data included patients who were exposed to their respective infection either 7, 14, 30, 60, 90, or 120 days before their stroke hospitalization. The association between each infection type, stroke subtype, and time to stroke was compared with control periods 1 year before the case period.
The researchers determined that every infection type—skin, blood stream, abdominal, respiratory tract, and urinary tract—was associated with an increased likelihood of experiencing an acute ischemic stroke, with the greatest association among patients with UTIs. In fact, the participants who had UTIs were 3 times as likely to have an ischemic stroke within 30 days of infection.2
Across all infection types, as the time from infection to stroke grew, the risk for stroke decreased.
The researchers also found an association between urinary tract, blood stream, and respiratory infections and intracerebral hemorrhage, as well as between subarachnoid hemorrhage and respiratory infections.
“Healthcare providers need to be aware that stroke can be triggered by infections,” said senior study author Mandip Dhamoon, MD, DrPH, from the Icahn School of Medicine at Mount Sinai, in a press release. “Probing into the previous weeks or months of a patient’s life before the stroke can sometimes help to illuminate the possible causes of stroke if there was an infection during that time.”2
—Colleen Murphy
References:
1. Sebastian S, Stein LK, Dhamoon MS. Infection as a stroke trigger: associations between different organ system infection admissions and stroke subtypes [published online June 26, 2019]. Stroke. doi:10.1161/STROKEAHA.119.025872.
2. Urinary tract and other infections may trigger different kinds of stroke [press release]. Dallas, TX: American Stroke Association; June 27, 2019. https://newsroom.heart.org/news/urinary-tract-and-other-infections-may-trigger-different-kinds-of-stroke. Accessed June 27, 2019.