The Natural History of Procalcitonin in Hemorrhagic Stroke

Approximately 12% of strokes in the United States are hemorrhagic.1 Hemorrhagic stroke can lead to multiple complications including fever that is not infectious. Identifying the cause of fever can help physicians choose the best care for the patient to try and prevent further damage to the already injured brain. Bacterial infection is one possible cause of fever in the stroke patient; however an incorrect diagnosis of infection can lead to unnecessary antibiotic use. Better screening tools for infection are being developed to help fight the problem of antibiotic resistance and unnecessary antibiotic use. Unnecessary use of antibiotics in patients increases the risk of adverse events and overall healthcare costs. Procalcitonin (PCT) is one such screening tool which has been used previously to help tell apart bacterial and nonbacterial causes of infection in other disease states; however, PCT has not been studied in hemorrhagic stroke patients. The purpose of this study is to understand the progress of PCT in hemorrhagic stroke patients in order to see whether PCT can be a useful marker for infection in these patients.

Inclusion Criteria: * Hospitalization for an admitting diagnosis of hemorrhagic stroke admitted to the neurosurgical intensive care unit * Age greater than 18 years * No evidence of ischemic cerebrovascular injury Exclusion Criteria: * Concomitant traumatic brain injury * Antibiotics on admission to the NICU * Immunocompromised by chemotherapy or HIV positive or patient with neutropenia (ANC \