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[Clinical research progress in stroke-associated pneumonia].

Fang Fang1, Yi Shu, Zhijie Xiao

  • 1Department of Neurology, the Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China. Corresponding author: Shu Yi,

Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
|January 4, 2020
PubMed
Summary

Stroke-associated pneumonia (SAP) is a common complication after stroke, linked to immune suppression. Early prediction and prevention are key, as antibiotics are not recommended preventively.

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Area of Science:

  • Neurology
  • Infectious Diseases
  • Immunology

Background:

  • Stroke-associated pneumonia (SAP) is a frequent complication in non-mechanical ventilation patients post-stroke, impacting prognosis.
  • Stroke-induced immune-depression syndrome (SIDS) is a key factor in SAP pathogenesis, involving complex neuro-immune interactions.
  • The precise lung-brain interaction in SAP development remains incompletely understood.

Purpose of the Study:

  • To elucidate the pathogenesis and identify predictive markers for stroke-associated pneumonia (SAP).
  • To review current risk factors, diagnostic criteria, and management strategies for SAP.
  • To highlight the importance of SAP prevention and appropriate antibiotic use.

Main Methods:

  • Review of existing clinical studies and consensus guidelines on SAP.
  • Analysis of potential biomarkers (e.g., mHLA-DR, NLR, HRV) for SAP prediction.
  • Examination of established risk factors and developed SAP risk scales (A2DS2, PANTHERIS, AIS-APS, ISAN).

Main Results:

  • SAP incidence ranges from 7% to 38%, significantly worsening stroke outcomes.
  • Clinical indicators like mHLA-DR, NLR, and HRV show potential for SAP prediction.
  • Old age, male gender, and diabetes are identified risk factors for SAP.

Conclusions:

  • SAP prevention is crucial; preventive antibiotics are not advised.
  • Diagnosis should follow modified CDC criteria; established antibiotic strategies apply post-diagnosis.
  • Neuroprotective and anti-inflammatory treatments require further investigation.