The impact of high cortisol level in increasing incidence of infection cases among acute stroke patients

Background: Infection in the stroke was a treatment major problem, because it determines the prognosis. In the acute phase of stroke, high level cortisol may lead to a decreased immune system and patients tend to be more susceptible to infection. The correlation of serum cortisol level among acute stroke patients with incidence of infection was not fully investigated.Objective: The aim of this study was to determine the relationship between initial serum cortisol levels and the incidence of infection in acute stroke patients.Method: A prospective cohort study was conducted on 32 of acute stroke patients who admitted in RSUD Dr. Soetomo Surabaya during the period December 2015 to February 2016. Total of 2 cc to the venous blood within 48 hours in onset of stroke being examined of serum cortisol. During the 7 days of hospitalization, the patient was observed for signs of infection, both clinically and the investigation in accordance with the operational definition.Results: In the infected group there were 8 people (50%) with high cortisol levels (p = 0.015; RR 15,000; 95% IK 1.583-143,171); 6 people were (50%) using urine catheter (p = 0.049; RR 6,667; 95% IK 1.067-30.085); And 6 people were (54.5%) using NGT (p = 0,035; RR 7,200; 95% IK 1.311-39,557). In multivariate analysis obtained that Odds Ratio (OR) 15,468 based on high cortisol and OR 7,469 based on NGT usage.Conclusion: High cortisol levels and the use of NGT had the effect on the incidence of infection in acute stroke.