Procalcitonin related to stroke-associated pneumonia and clinical outcomes of acute ischemic stroke after IV rt-PA treatment

Shi, Guomei; Li, Minghao; Zhou, Rujuan; Wang, Xiaorong; Xu, Wu; Yang, Feng; Xue, Shouru

doi:10.1007/s10571-020-01031-w

Cited by 14 publications

(15 citation statements)

References 40 publications

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“…The results of our study also revealed that patients with SAP had elevated levels of Hs-CRP, leucocyte, and a higher proportion of dysphagia as well as higher baseline NIHSS, which were consistent with previous studies. 15 , 17 Additionally, our present study found that SAP is associated with diastolic blood pressure, which has never been reported and is warranted to be investigated in future study.…”

Section: Discussionsupporting

confidence: 42%

“…During the pathogenesis and progression of brain ischemic, neuroinflammation may be extraordinarily critical. 6 , 7 , 18 Several inflammatory biomarkers were evaluated in our previous studies, 15 , 16 suggesting that inflammatory biomarkers could be considered as prognosticators and indicators in ischemic stroke. In recent years, YKL-40, a novel biomarker of inflammation, has attracted attention as a valuable tool to predict diseases that are characterized by inflammation, fibrosis and tissue remodeling.…”

Section: Discussionmentioning

confidence: 99%

“…The diagnosis of SAP was based on the modified Centers for Disease Control and Prevention criteria of hospitalacquired pneumonia, according to clinical and laboratory parameters of acute lower respiratory tract infection, and was confirmed by chest X-ray or CT. 14,15 SAP was diagnosed by two trained clinicians after onset of AIS. If there is disagreement about the diagnosis of SAP, we will invite a third neurologist to make a final decision.…”

Section: Definition Of Sapmentioning

confidence: 99%

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The Relationship Between Serum YKL-40 Levels on Admission and Stroke-Associated Pneumonia in Patients with Acute Ischemic Stroke

Shi

Chen

Gong

et al. 2021

JIR

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Background Stroke-associated pneumonia (SAP) is a standout complication after acute ischemic stroke (AIS), with a prevalence of 7–38%. The aim of this prospective study was to investigate the relationship between serum YKL-40 levels at admission and SAP. Methods Between August 2020 and February 2021, consecutive AIS patients from two centers were enrolled prospectively. Serum YKL-40 concentrations were measured via enzyme-linked immunosorbent assay. We performed logistic regression analyses to explore the relationship between YKL-40 and SAP. Receiver operating characteristic curve was also used to assess the predictive ability of YKL-40 in predicting SAP. Results Ultimately, a total of 511 AIS patients were recruited. Multivariate logistic regression analysis showed that YKL-40 was independently related to SAP, whether as a continuous variable or as quartiles ( P =0.001). The area under curve of YKL-40 to predict SAP was 0.765. The optimal cutoff value of YKL-40 as a predictor of SAP was determined to be 206.4 ng/mL, where the sensitivity was 63.1% and the specificity was 82.0%. Conclusion Our study demonstrated that YKL-40 might be considered as a useful biomarker to predict SAP in AIS patients.

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Section: Discussionsupporting

confidence: 42%

Section: Discussionmentioning

confidence: 99%

Section: Definition Of Sapmentioning

confidence: 99%

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The Relationship Between Serum YKL-40 Levels on Admission and Stroke-Associated Pneumonia in Patients with Acute Ischemic Stroke

Shi

Chen

Gong

et al. 2021

JIR

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“…In addition, dynamic change process of biomarkers (e.g., CRP and PCT) reflect the progression and prognosis of the disease. PCT was considered to have higher diagnostic and prognostic accuracy of SAP than CRP in recent studies ( Wang et al, 2016 ; Shi et al, 2021 ). Interestingly, PCT-guided antimicrobial strategies in ICU attracted a lot of attention, and PCT-guided cessation of antibiotics was found to reduce both antibiotic exposure and mortality ( Huang et al, 2017 ; Lam et al, 2018 ).…”

Section: Discussionmentioning

confidence: 99%

Microbiology and Outcomes of Institutionalized Patients With Stroke-Associated Pneumonia: An Observational Cohort Study

Zhao

Zhen

et al. 2021

Front. Microbiol.

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Background: The attributable mortality and microbial etiology of stroke-associated pneumonia (SAP) vary among different studies and were inconsistent.Purpose: To determine the microbiology and outcomes of SAP in the lower respiratory tract (LRT) for patients with invasive mechanical ventilation (MV).Methods: In this observational study, included patients were divided into SAP and non-SAP based on a comprehensive analysis of symptom, imaging, and laboratory results. Baseline characteristics, clinical characteristics, microbiology, and outcomes were recorded and evaluated.Results: Of 200 patients, 42.5% developed SAP after the onset of stroke, and they had a lower proportion of non-smokers (p = 0.002), lower GCS score (p < 0.001), higher serum CRP (p < 0.001) at ICU admission, and a higher proportion of males (p < 0.001) and hypertension (p = 0.039) than patients with non-SAP. Gram-negative aerobic bacilli were the predominant organisms isolated (78.8%), followed by Gram-positive aerobic cocci (29.4%). The main pathogens included K. pneumoniae, S. aureus, H. influenzae, A. baumannii, P. aeruginosa, E. aerogenes, Serratia marcescens, and Burkholderia cepacia. SAP prolonged length of MV (p < 0.001), duration of ICU stay (p < 0.001) and hospital stay (p = 0.027), shortened MV-free days by 28 (p < 0.001), and caused elevated vasopressor application (p = 0.001) and 60-day mortality (p = 0.001). Logistic regression analysis suggested that patients with coma (p < 0.001) have a higher risk of developing SAP.Conclusion: The microbiology of SAP is similar to early phase of HAP and VAP. SAP prolongs the duration of MV and length of ICU and hospital stays, but also markedly increases 60-day mortality.

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“…The exclusion criteria were as follows: (1) active infection or pneumonia before admission; (2) patients treated with nonsteroidal anti-inflammatory drugs; (3) patients with incomplete clinical records. Besides, the diagnosis of SAP was performed by two experienced neurologists based on the modified Centers for Disease Control and Prevention criteria of hospital- acquired pneumonia ( 22 ), assisted with clinical and laboratory parameters of respiratory infection and was confirmed by chest X-ray or CT ( 23 ).…”

Section: Methodsmentioning

confidence: 99%

15-Hydroxyprostaglandin Dehydrogenase Is a Predictor of Stroke-Associated Pneumonia

Qiao

Yang

et al. 2022

Front. Neurol.

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Background and PurposeStroke is a serious fatal and disabling disease. Stroke-associated pneumonia (SAP) is the most common complication of stroke, which may further aggravate the stroke. The prevention and early prediction of SAP is a key clinical strategy. 15-hydroxyprostaglandin dehydrogenase (15-PGDH) is involved in pneumonia, while its relationship with SAP has yet to be determined. Therefore, we investigated the predictive value of 15-PGDH for SAP and visualized their relationship.MethodsStroke patients were recruited and divided into SAP group and Non-SAP group. Baseline demographic and clinical data were obtained from the medical record system, blood samples were collected to detect relevant variables and 15-PGDH levels. Patient characteristics were compared with a t-test. Binary logistic regression analysis was performed to determine the predictive value of 15-PGDH for SAP. Restricted cubic splines (RCS) were performed to visualize the relationship between 15-PGDH and SAP risk. Finally, the SAP patient characteristics between the severe group and mild group were compared.Results50 patients were enrolled and divided into SAP group (n = 26) and Non-SAP group (n = 24). 15-PGDH in the SAP group was lower than that in the Non-SAP group (0.258 ± 0.275 vs. 0.784 ± 0.615, p = 0.025). Binary logistic regression analysis revealed that the lower 15-PGDH, the higher the risk of SAP (OR = 0.04, 95%CI, 0.010–0.157, p < 0.001). The RCS model showed the L-shaped relationship between 15-PGDH and SAP.ConclusionsIn stroke patients, serum 15-PGDH is a valuable biomarker for predicting SAP. There is an L-shaped relationship between the level of 15-PGDH and the risk of SAP.

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Procalcitonin related to stroke-associated pneumonia and clinical outcomes of acute ischemic stroke after IV rt-PA treatment

Cited by 14 publications

References 40 publications

The Relationship Between Serum YKL-40 Levels on Admission and Stroke-Associated Pneumonia in Patients with Acute Ischemic Stroke

The Relationship Between Serum YKL-40 Levels on Admission and Stroke-Associated Pneumonia in Patients with Acute Ischemic Stroke

Microbiology and Outcomes of Institutionalized Patients With Stroke-Associated Pneumonia: An Observational Cohort Study

15-Hydroxyprostaglandin Dehydrogenase Is a Predictor of Stroke-Associated Pneumonia

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