Background and Purposes: Inflammatory factors play an important role in the pathogenesis of ischemic stroke. They may influence circulation during the acute phase of stroke and enhance the ischemic region. Materials and Methods: We examined 51 patients – 36 patients in the early stage of stroke, i.e. the first 24 h after onset. Of these, 15 patients had infection and 21 had no infection during the week preceding stroke. There were 15 patients with noninflammatory diseases in the control group. We analyzed parameters of inflammation such as: activity of serum chitotriosidase by fluorimetric assay, C-reactive proteins (CRP), number of white body cells (WBCs), IgG and fibrinogen. We also assessed the neurological stage according to the Scandinavian Stroke Scale (SSS). Results: In our study, we observed a statistically significant difference (p < 0.05) in the activity of most parameters of inflammation. This difference could be seen in the levels of CRP, number of WBCs and the activity of chitotriosidase, apart from IgG and fibrinogen, between the control group and groups with versus without infection. A significantly increased level of CRP (p < 0.0005) and fibrinogen (p > 0.01) was found on the first day in the stroke group as compared to the control group. The neurological stage on day 4 after stroke, assessed according to the SSS, was significantly worse in the group of patients with infection before stroke than in stroke patients without infection (p < 0.008). Conclusion: These results suggest the importance of active inflammatory processes in the pathogenesis of stroke. We observed increased activity of chitotioridase, a parameter of the inflammatory process, in stroke. This study is one more proof that inflammatory processes caused by infection may influence the occurrence of stroke and worsen its outcome. It could be another step towards understanding immunological processes during the acute phase of stroke. The study may also help establish new diagnostic and therapeutic strategies and could be a useful tool for prophylaxis.

In a prospective population-based study, analyses were performed to evaluate the 30-day case fatality in stroke as related to the following factors: hematocrit (HCT), hemoglobin (Hgb), red blood cells (RBC), mean cell volume (MCV), platelet count, erythrocyte sedimentation rate (ESR), white blood cells (WBC) and glucose concentration. We studied 345 patients with stroke, 170 men and 175 women, mean age 68.4 +/- 14.2 years, admitted within 72 h of stroke onset. Patients who died had significantly higher mean values of ESR, WBC, HCT and glucose concentration than the patients who survived. Logistic regression analysis revealed that ESR, HCT and WBC are independent factors predicting 30-day case fatality. The odds ratio (OR) for ESR was 1.006 (95% CI 1.0002-1.011), for HCT 1.04 (95% CI 1.01-1.07), for WBC 1.03 (95% CI 1.01-1.05). Glucose concentration after adjusting for the severity of neural deficit did not become an independent predictor.

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Case fatality rates for stroke were ascertained prospectively in two regional catchment hospitals in Poland and 36 teaching hospitals in the US University Hospital Consortium. Case fatality rates in Poland (23.9%) were higher than in the United States (7.5%). Angina, atrial fibrillation, and congestive heart failure were more frequent in Polish stroke patients (40%, 26%, and 25%, respectively) than in US patients (17%, 12%, and 10%). Stroke severity as indicated by higher frequencies of hemiplegia, disordered consciousness, dysphagia, and aphasia was greater in Poland (19%, 39%, 28%, and 42%, respectively) than the United States (11%, 13%, 14%, and 26%).