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| Name | Class |
|---|---|
| Siemens Health Care | UNKNOWN |
| NeuroCure Clinical Research Center, Charite, Berlin | OTHER |
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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.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| ischemic stroke patients | patients with an ischemic stroke in the anterior (ACA, MCA) and posterior flow area (PCA, BA) of any severity in the last 36h |
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| Measure | Description | Time Frame |
|---|---|---|
| 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 | 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 | SAP within 7 days after onset of symptoms (stroke) |
| Measure | Description | Time Frame |
|---|---|---|
| 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 |
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Inclusion Criteria:
Exclusion Criteria:
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ischemic stroke in the anterior (ACA, MCA) and posterior cerebral circulation (PCA, BA) of any severity in the last 36h
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| Name | Affiliation | Role |
|---|---|---|
| Andreas Meisel, MD | Charite University Berlin (Center for Stroke Research Berlin CSB & NeuroCure Clinical Research Center NCRC) | Principal Investigator |
| Peter Heuschmann, MD | Charité University Berlin (Center for Stroke Research Berlin CSB) | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Charite University (Center for Stroke Research Berlin CSB & NeuroCure Clinical Research Center NCRC) | Berlin | 10117 | Germany | |||
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 27733675 | Result | 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. | |
| 33280547 |
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| ID | Term |
|---|---|
| D000083242 | Ischemic Stroke |
| ID | Term |
|---|---|
| D020521 | Stroke |
| D002561 | Cerebrovascular Disorders |
| D001927 | Brain Diseases |
| D002493 | Central Nervous System Diseases |
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Blood sample (serum, plasma)
| 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 | 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 | 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 | 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 | 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 | SAP within 7 days and neurological outcome after 3 months after onset of symptoms (stroke) |
| 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 |
| Result |
| 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. |
| 30828313 | Result | 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. |
| 32098866 | Result | 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. |
| 31269910 | Result | 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. |
| 33288717 | Result | 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. |
| D009422 |
| Nervous System Diseases |
| D014652 | Vascular Diseases |
| D002318 | Cardiovascular Diseases |