Stroke-associated pneumonia (SAP) constitutes a clinically relevant complication of stroke, because it increases the mortality and has a negative impact on the neurological prognosis of the patient. An early identification of patients at risk for SAP allowing an early initiation of antiinfective therapy may improve the prognosis. To date, no reliable prediction models or clinical scores for stroke-associated pneumonia exist. Recently, it was shown that parameters indicating an impaired immune function are associated with the subsequent occurrence of SAP and could therefore be used as predictors for SAP. This study will develop and prospectively validate a prognostic score to predict SAP based on clinical parameters. Furthermore, the study examines the prognostic properties of selected immune and infectious parameters for the prediction and diagnosis of SAP. The study will further address the question whether these infectious and immune parameters predict the 3-month-outcome. In a subgroup of patients, MRI parameters on stroke size and localization will be assessed to investigate whether these parameters might allow prediction of SAP or the 3-month-outcome.
Study Type
OBSERVATIONAL
Enrollment
486
Charite University (Center for Stroke Research Berlin CSB & NeuroCure Clinical Research Center NCRC)
Berlin, Germany
Unfallkrankenhaus Berlin, Neurologie
Berlin, Germany
Vivantes Auguste Viktoria Klinikum Neurologie
Berlin, Germany
Vivantes Klinikum im Friedrichshain Neurologie
Berlin, Germany
Vivantes Klinikum Spandau Neurologie
Berlin, Germany
Vivantes Neukölln Neurologie
Berlin, Germany
Sankt Josefs Krankenhaus Potsdam Neurologie
Potsdam, Germany
Hospital Vall d'Hebron
Barcelona, Spain
Predictive score for SAP based on clinical parameters assessed within 36h after stroke onset
To establish a predictive score for SAP based on clinical parameters assessed within 36h after stroke onset
Time frame: SAP within 7 days after onset of symptoms (stroke)
Predictive properties of immune parameters (IL6, IL10, mHLA-DR) or infection parameters (PCT) for the occurrence of a SAP within 7 days after stroke onset
To evaluate of the predictive properties of immune parameters (IL6, IL10, mHLA-DR) or infection parameters (PCT) for the occurrence of a SAP within 7 days after stroke onset
Time frame: SAP within 7 days after onset of symptoms (stroke)
Predictive properties of immune parameters (IL6, IL8, IL10, mHLA-DR, MBL, monocytic cytokine secretion after ex vivo stimulation, C5a) and infection parameters (PCT, LBP) for the neurological outcome
To evaluate of the predictive properties of immune parameters (IL6, IL8, IL10, mHLA-DR, MBL, monocytic cytokine secretion after ex vivo stimulation, C5a) and infection parameters (PCT, LBP) for the neurological outcome
Time frame: Neurological outcome 3 months after onset of symptoms (stroke)
Plasma levels of acetylcholinesterase
To investigate the parasympathetic influence on the immune function after stroke by measuring plasma levels of acetylcholinesterase
Time frame: within 7 days after onset of symptoms (stroke)
Localization and stroke volume analysis
To investigate the influence of the localization and stroke volume on the occurrence of a SAP and on neurological outcome
Time frame: SAP within 7 days and neurological outcome after 3 months after onset of symptoms (stroke)
Predictive properties of immune parameters (IL6, IL8, IL10, mHLA-DR, MBL, monocytic cytokine secretion after ex vivo stimulation, C5a) and infection parameters (PCT, LBP) for the occurence of a SAP
To evaluate of the predictive properties of immune parameters (IL6, IL8, IL10, mHLA-DR, MBL, monocytic cytokine secretion after ex vivo stimulation, C5a) and infection parameters (PCT, LBP) for the occurence of a SAP
Time frame: SAP within 7 days after onset of symptoms (stroke)
Influence of insular cortex involvement and infarct volume on the occurrence of a SAP within 7 days and and on the neurological outcome after 3 months
To investigate the influence of insular cortex involvement and infarct volume on the occurrence of a SAP within 7 days after stroke onset and on the neurological outcome after 3 months
Time frame: SAP within 7 days after onset of symptoms (stroke) and neurological outcome after 3 months
Transcriptome analyses
To perform transcriptome analyses to identify new biomarkers which may predict the occurence of a SAP or the 3-month neurological outcome
Time frame: SAP within 7 days and neurological outcome after 3 months after onset of symptoms (stroke)
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