Abstract:
BACKGROUND AND PURPOSE:Pneumonia has been estimated to occur in about one third of patients after acute stroke. Only limited data are available on stroke-associated pneumonia (SAP) in specialized neurological intensive care units (NICUs). METHODS:We enrolled 124 patients with acute stroke who were treated at our university hospital NICU in a prospective observational study. Incidence rates and risk factors of SAP and long-term clinical outcome were determined. RESULTS:SAP incidence was 21% with a spectrum of pathogens, which is comparable to previously published data on general ICU patients. Mechanical ventilation, multiple location, and vertebrobasilar stroke, as well as dysphagia and abnormal chest x-ray findings, were identified as risk factors for the disease. SAP patients showed higher mortality rates than nondiseased subjects (acute, 26.9% versus 8.2%; long-term, 35.3% versus 14.3%) and a significantly poorer long-term clinical outcome (Barthel Index, 50.5+/-42.4 versus 81.5+/-27.8; Rankin Scale, 3.5+/-1.7 versus 2.2+/-1.6). CONCLUSIONS:Our data underline the considerable epidemiological and prognostic impact of SAP for the treatment of acute stroke patients in a specialized NICU setting. They demonstrate that the occurrence of SAP deteriorates clinical outcome in these patients. Our results allow us to identify high-risk stroke patients at time of NICU admission in whom the use of preventive treatment strategies is most promising.
journal_name
Strokejournal_title
Strokeauthors
Hilker R,Poetter C,Findeisen N,Sobesky J,Jacobs A,Neveling M,Heiss WDdoi
10.1161/01.STR.0000063373.70993.CDsubject
Has Abstractpub_date
2003-04-01 00:00:00pages
975-81issue
4eissn
0039-2499issn
1524-4628pii
01.STR.0000063373.70993.CDjournal_volume
34pub_type
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