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PublishedObservational

Prediction of Stroke-associated Pneumonia

This is a registered study tracked in the Sterling IMRES research watch. It is sponsored by Charite University, Berlin, Germany and run by the investigators named in the registry, not by Sterling IMRES. Details come from ClinicalTrials.gov, last updated 4 January 2022.

Summary

This prospective observational cohort, led by Charité Berlin with sites in Germany and Spain, followed patients after acute ischaemic stroke. It combined clinical information with measurements of immune function and inflammation to see who goes on to develop pneumonia. Several papers on prediction scores and biomarkers such as IL-6 have come from the cohort.

Objectives

  • Develop and prospectively validate a clinical score to predict pneumonia in the first week after ischaemic stroke.
  • Evaluate immune and infection-related blood markers for predicting and diagnosing stroke-associated pneumonia.

Methodology

Study design
Case only observational study, prospective time perspective
Conditions
Ischemic Stroke
Primary outcome
Predictive score for SAP based on clinical parameters assessed within 36h after stroke onset
Sample size
486 participants (actual)
Locations
Germany, Spain

Team

  • Andreas Meisel, MDPrincipal investigatorCharite University Berlin (Center for Stroke Research Berlin CSB & NeuroCure Clinical Research Center NCRC)
  • Peter Heuschmann, MDPrincipal investigatorCharité University Berlin (Center for Stroke Research Berlin CSB)

Findings and resulting publications

  • Hoffmann S, Harms H, Ulm L, Nabavi DG, Mackert BM, Schmehl I, Jungehulsing GJ, Montaner J, Bustamante A, Hermans M, Hamilton F, Gohler J, Malzahn U, Malsch C, Heuschmann PU, Meisel C, Meisel A; PREDICT Investigators. Stroke-induced immunodepression and dysphagia independently predict stroke-associated pneumonia - The PREDICT study. J Cereb Blood Flow Metab. 2017 Dec;37(12):3671-3682. doi: 10.1177/0271678X16671964. Epub 2016 Oct 14. PubMed 27733675
  • Hotter B, Hoffmann S, Ulm L, Meisel C, Bustamante A, Montaner J, Katan M, Smith CJ, Meisel A. External Validation of Five Scores to Predict Stroke-Associated Pneumonia and the Role of Selected Blood Biomarkers. Stroke. 2021 Jan;52(1):325-330. doi: 10.1161/STROKEAHA.120.031884. Epub 2020 Dec 7. PubMed 33280547
  • Hotter B, Hoffmann S, Ulm L, Meisel C, Fiebach JB, Meisel A. IL-6 Plasma Levels Correlate With Cerebral Perfusion Deficits and Infarct Sizes in Stroke Patients Without Associated Infections. Front Neurol. 2019 Feb 15;10:83. doi: 10.3389/fneur.2019.00083. eCollection 2019. PubMed 30828313
  • Hotter B, Hoffmann S, Ulm L, Montaner J, Bustamante A, Meisel C, Meisel A. Inflammatory and stress markers predicting pneumonia, outcome, and etiology in patients with stroke: Biomarkers for predicting pneumonia, functional outcome, and death after stroke. Neurol Neuroimmunol Neuroinflamm. 2020 Feb 25;7(3):e692. doi: 10.1212/NXI.0000000000000692. Print 2020 May. PubMed 32098866
  • Mengel A, Ulm L, Hotter B, Harms H, Piper SK, Grittner U, Montaner J, Meisel C, Meisel A, Hoffmann S. Biomarkers of immune capacity, infection and inflammation are associated with poor outcome and mortality after stroke - the PREDICT study. BMC Neurol. 2019 Jul 3;19(1):148. doi: 10.1186/s12883-019-1375-6. PubMed 31269910
  • Winek K, Lobentanzer S, Nadorp B, Dubnov S, Dames C, Jagdmann S, Moshitzky G, Hotter B, Meisel C, Greenberg DS, Shifman S, Klein J, Shenhar-Tsarfaty S, Meisel A, Soreq H. Transfer RNA fragments replace microRNA regulators of the cholinergic poststroke immune blockade. Proc Natl Acad Sci U S A. 2020 Dec 22;117(51):32606-32616. doi: 10.1073/pnas.2013542117. Epub 2020 Dec 7. PubMed 33288717

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