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

SYKORA, Marek, Pavel SIARNIK, Jozef SZABO, Peter TURCANI, Stefan KREBS, Wilfried LANG, Stanislava JAKUBÍČEK, Marek CZOSNYKA and Peter SMIELEWSKI. Baroreflex sensitivity is associated with post-stroke infections. An open, prospective study. Journal of the neurological sciences. Amsterdam: Elsevier, 2019, vol. 406, NOV 15 2019, p. 1-5. ISSN 0022-510X. Available from: https://dx.doi.org/10.1016/j.jns.2019.116450.

Basic information

Original name

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

Authors

SYKORA, Marek (40 Austria, guarantor), Pavel SIARNIK (703 Slovakia), Jozef SZABO (703 Slovakia), Peter TURCANI (703 Slovakia), Stefan KREBS (40 Austria), Wilfried LANG (40 Austria), Stanislava JAKUBÍČEK (703 Slovakia, belonging to the institution), Marek CZOSNYKA (616 Poland) and Peter SMIELEWSKI (616 Poland)

Edition

Journal of the neurological sciences, Amsterdam, Elsevier, 2019, 0022-510X

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Other information

Language

English

Type of outcome

Článek v odborném periodiku

Field of Study

30103 Neurosciences

Country of publisher

Netherlands

Confidentiality degree

není předmětem státního či obchodního tajemství

References:

URL

Impact factor

Impact factor: 3.115

RIV identification code

RIV/00216224:14110/19:00112623

Organization unit

Faculty of Medicine

DOI

http://dx.doi.org/10.1016/j.jns.2019.116450

UT WoS

000499766400015

Keywords in English

Baroreflex; Stroke; Infection; Pneumonia; Autonomic

Tags

14110127, rivok

Tags

International impact, Reviewed

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Abstract

V originále

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<.001) higher initial NIHSS (median 15 vs 5, p<.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.