Baroreflex sensitivity is associated with post-stroke infections. An open, prospective study

Kód výsledku v IS VaVaI

<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F00159816%3A_____%2F19%3A00071710" target="_blank" >RIV/00159816:_____/19:00071710 - isvavai.cz</a>

Nalezeny alternativní kódy

RIV/00216224:14110/19:00112623

Výsledek na webu

<a href="https://www.sciencedirect.com/science/article/abs/pii/S0022510X1930382X?via%3Dihub" target="_blank" >https://www.sciencedirect.com/science/article/abs/pii/S0022510X1930382X?via%3Dihub</a>

DOI - Digital Object Identifier

<a href="http://dx.doi.org/10.1016/j.jns.2019.116450" target="_blank" >10.1016/j.jns.2019.116450</a>

Jazyk výsledku

angličtina

Název v původním jazyce

Baroreflex sensitivity is associated with post-stroke infections. An open, prospective study

Popis výsledku v původním jazyce

Background and purpose: Autonomic nervous system (ANS) seems to play an important role in the post-stroke immunosuppression syndrome with increased susceptibility to infections. The aim of this study was to investigate if ANS activity measured at admission is associated with post-stroke infections. Methods: We prospectively analyzed patients with acute ischemic stroke. ANS was measured using the cross-correlational baroreflex sensitivity (BRS) at admission. The occurrence and cause of in-hospital infections was assessed based on the clinical and laboratory examination. Demographic and clinical variables including initial stroke severity, dysphagia, procedures as nasogastric tubes, central venous and urinary catheters and mechanical ventilation were included in the analysis. Results: We included 161 patients with ischemic stroke, of those 49 (30.4%) developed a nosocomial infection during the first 7 days of hospital stay. Patients with infections had significantly lower BRS (median 3 vs 5 ms/mmHg, p&lt;.001) higher initial NIHSS (median 15 vs 5, p&lt;.001), had more often non-lacunar etiology and underwent more invasive procedures. In the multivariable regression model decreased BRS (adjusted OR 1.21, 95% CI 1.03-1.41, p=.02), admission NIHSS (adjusted OR 1.10, 95% CI 1.02-1.19, p=.02) and invasive procedures (adjusted OR 1.46, 95% CI 1.03-2.06, p=.03) were independently associated with infection after ischemic stroke. Conclusions: Decreased BRS was independently associated with infections after ischemic stroke. Autonomic shift may play an important role in increased susceptibility to infections after stroke. The possible diagnostic and therapeutic relevance of this finding deserves further research.

Název v anglickém jazyce

Baroreflex sensitivity is associated with post-stroke infections. An open, prospective study

Popis výsledku anglicky

Background and purpose: Autonomic nervous system (ANS) seems to play an important role in the post-stroke immunosuppression syndrome with increased susceptibility to infections. The aim of this study was to investigate if ANS activity measured at admission is associated with post-stroke infections. Methods: We prospectively analyzed patients with acute ischemic stroke. ANS was measured using the cross-correlational baroreflex sensitivity (BRS) at admission. The occurrence and cause of in-hospital infections was assessed based on the clinical and laboratory examination. Demographic and clinical variables including initial stroke severity, dysphagia, procedures as nasogastric tubes, central venous and urinary catheters and mechanical ventilation were included in the analysis. Results: We included 161 patients with ischemic stroke, of those 49 (30.4%) developed a nosocomial infection during the first 7 days of hospital stay. Patients with infections had significantly lower BRS (median 3 vs 5 ms/mmHg, p&lt;.001) higher initial NIHSS (median 15 vs 5, p&lt;.001), had more often non-lacunar etiology and underwent more invasive procedures. In the multivariable regression model decreased BRS (adjusted OR 1.21, 95% CI 1.03-1.41, p=.02), admission NIHSS (adjusted OR 1.10, 95% CI 1.02-1.19, p=.02) and invasive procedures (adjusted OR 1.46, 95% CI 1.03-2.06, p=.03) were independently associated with infection after ischemic stroke. Conclusions: Decreased BRS was independently associated with infections after ischemic stroke. Autonomic shift may play an important role in increased susceptibility to infections after stroke. The possible diagnostic and therapeutic relevance of this finding deserves further research.

Druh

J_imp - Článek v periodiku v databázi Web of Science

CEP obor

—

OECD FORD obor

30210 - Clinical neurology

Projekt

—

Návaznosti

I - Institucionalni podpora na dlouhodoby koncepcni rozvoj vyzkumne organizace

Rok uplatnění

2019

Kód důvěrnosti údajů

S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů

Název periodika

Journal of the Neurological Sciences

ISSN

0022-510X

e-ISSN

—

Svazek periodika

406

Číslo periodika v rámci svazku

NOV 15

Stát vydavatele periodika

US - Spojené státy americké

Počet stran výsledku

5

Strana od-do

"UNSP 116450"

Kód UT WoS článku

000499766400015

EID výsledku v databázi Scopus

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