Pneumonia in acute ischemic stroke patients requiring invasive ventilation: Impact on short and long-term outcomes
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Bourenne, J. | Brule, N. | Bretonniere, C. | Cheval, C. | Carvelli, J. | Coupez, E. | Cour, M. | Dopeux, L. | Dumenil, A. S. | Dupuis, C. | Forel, J. M. | Garret, C. | Gros, A. | Haouache, A. | Hissem, T. | Ha, V. H. T. | Jochmans, S. | Joffredo, J. B. | Kallel, H. | Lacave, G. | Lautrette, A. | Lemiale, V. | Lermuzeaux, M. | Lebut, J. | Lugosi, M. | Magalhaes, E. | Merceron, S. | Mourvillier, B. | Misset, B. | Neuville, M. | Nicolet, L. | Oziel, J. | Papazian, L. | Planquette, B. | Quenot, J. P. | Radjou, A. | Simon, M. | Reignier, J. | Souweine, B. | Smonig, R. | Troche, G. | Thuong, M. | Thierry, G. | Toledano, D. | van Der Meersch, G. | Venot, M. | Zambon, O. | Fournier, J. | Tournegros, C. | Bagur, S. | Adda, M. | Vindrieux, V. | Salle, S., de La | Enguerrand, P. | Ferrand, L. | Gobert, V. | Guessens, S. | Merle, H. | Kaddour, N. | Berthe, B. | Bekkhouche, S. | Mellouk, K. | Lebrazic, M. | Ouisse, C. | Maugars, D. | Aparicio, C. | Theodose, I. | Nouacer, M. | Deiler, V. | Moussa, M. | Mouaci, A. | Viguier, N. | Lamara, F. | Letrou, S. | Siami, S. | Grp, Outcomerea Study | Montmollin, E., De | Ruckly, S. | Schwebel, C. | Philippart, F. | Adrie, C. | Mariotte, E. | Marcotte, G. | Cohen, Y. | Sztrymf, B. | Silva, D., Da | Bruneel, F. | Gainnier, M. | Garrouste-Orgeas, M. | Sonneville, R. | Timsit, J. F. | Azoulay, E. | Zahar, J. R. | Darmon, M. | Clec'H, C. | Alberti, C. | Francais, A. | Vesin, A. | Bailly, S. | Lecorre, F. | Nakache, D. | Van-Nieuwenhuyze, A. | Hernu, R. | Agasse, C. | Allaouchiche, B. | Andremont, O. | Andreu, P. | Argaud, L. | Ara-Somohano, C. | Barbier, F. | Boyer, D. | Bedos, J. P. | Baudry, T. | Bedel, J. | Bohe, J. | Bouadma, L.
Edité par
CCSD ; Elsevier -
International audience.
Objectives: To describe the epidemiology and prognostic impact of pneumonia in acute ischemic stroke patients requiring invasive mechanical ventilation. Methods: Retrospective analysis from a prospective multicenter cohort study of critically ill patients with acute ischemic stroke requiring invasive mechanical ventilation at admission. Impact of pneumonia was investigated using Cox regression for 1-year mortality, and competing risk survival models for ICU mortality censored at 30-days. Results: We included 195 patients. Stroke was supratentorial in 62% and 64% of patients had a Glasgow coma scale score \textless8 on admission. Mortality at day-30 and 1 year were 56%, and 70%, respectively. Post-stroke pneumonia was identified in 78 (40%) patients, of which 46/78 (59%) episodes were present at ICU admission. Post-stroke pneumonia was associated with an increase in 1-year mortality (adjusted HR 1.49, 95% CI [1.01-2.20]). Post-stroke pneumonia was not associated with ICU mortality but was associated with a 1.6-fold increase in ICU length of stay (CSHR 0.62 [0.39-0.99], p = 0.06). Conclusions: In ischemic stroke patients requiring invasive ventilation, pneumonia occurred in 40% of cases and was associated with a 49% increase in 1-year mortality. Post-stroke pneumonia did not impact day-30 mortality but increased ICU length of stay. (C) 2019 The British Infection Association. Published by Elsevier Ltd. All rights reserved.
