Stroke-associated infections in patients with and without cancer.

Background: Cancer in stroke patients is associated with higher levels of inflammatory biomarkers and unfavorable poststroke outcomes. We thus explored whether there is a link between cancer and stroke-associated infections.

Methods: Medical records of patients with ischemic stroke in 2014-2016 registered in the Swiss Stroke Registry of Zurich were retrospectively analyzed. Incidence, characteristics, treatment, and outcome of stroke-associated infections diagnosed within 7 days after stroke onset were tested for an association with cancer.

Results: Among 1181 patients with ischemic stroke, 102 patients with cancer were identified. Stroke-associated infections occurred in 179 and 19 patients (17% and 19%) without and with cancer ( = .60), respectively, among them pneumonia in 95 and 10 patients (9% and 10%) and urinary tract infections in 68 and 9 patients (6% and 9%) ( = .74 and = .32). Use of antibiotics was similar between groups. Levels of C-reactive protein (CRP) ( < .001), erythrocyte sedimentation rate (ESR) ( = .014) and procalcitonin ( = .015) were higher and levels of albumin ( = .042) and protein ( = .031) were lower in patients with cancer than without cancer. Among patients without cancer, higher CRP ( < .001), ESR ( < .001) and procalcitonin ( = .04) and lower albumin ( < .001) were associated with stroke-associated infections. Among cancer patients with or without infections, no significant differences in these parameters were observed. In-hospital mortality was associated with cancer ( < .001) and with stroke-associated infections ( < .001). However, among patients with stroke-associated infections, cancer was not associated with in-hospital mortality ( = .24) or 30-day mortality ( = .66).

Conclusions: Cancer does not represent a risk factor for stroke-associated infections in this patient cohort.