Pneumonia in acute ischemic stroke patients requiring invasive ventilation: Impact on short and long-term outcomes

J. Bourenne N. Brule C. Bretonniere C. Cheval J. Carvelli E. Coupez M. Cour 1 L. Dopeux A. S. Dumenil C. Dupuis 2 J. M. Forel C. Garret S. Grange 3, 4, 5 A. Gros 6 A. Haouache T. Hissem V. H. T. Ha S. Jochmans J. B. Joffredo H. Kallel 7 G. Lacave A. Lautrette 8 V. Lemiale 9 M. Lermuzeaux J. Lebut M. Lugosi E. Magalhaes S. Merceron B. Mourvillier 10, 11 B. Misset 12 M. Neuville 13 L. Nicolet J. Oziel 14 L. Papazian 15 B. Planquette J. P. Quenot 16, 17 A. Radjou M. Simon 18 J. Reignier 19 B. Souweine 20 R. Smonig G. Troche M. Thuong G. Thierry 21 D. Toledano G. van der Meersch M. Venot O. Zambon J. Fournier 22 C. Tournegros S. Bagur M. Adda V. Vindrieux S. Salle P. Enguerrand L. Ferrand 23 V. Gobert 24 S. Guessens H. Merle N. Kaddour B. Berthe S. Bekkhouche K. Mellouk M. Lebrazic C. Ouisse D. Maugars C. Aparicio I. Theodose 9 M. Nouacer V. Deiler M. Moussa A. Mouaci N. Viguier F. Lamara S. Letrou S. Siami Outcomerea Study Grp E. Montmollin S. Ruckly 25 C. Schwebel F. Philippart C. Adrie E. Mariotte G. Marcotte Y. Cohen 26 B. Sztrymf D. Silva F. Bruneel 27 M. Gainnier M. Garrouste-Orgeas R. Sonneville J. F. Timsit E. Azoulay 25 J. R. Zahar M. Darmon 28 C. Clec'H C. Alberti 29 A. Francais A. Vesin S. Bailly 10 F. Lecorre D. Nakache A. Van-Nieuwenhuyze R. Hernu C. Agasse B. Allaouchiche 30 O. Andremont P. Andreu 17 L. Argaud 31, 1 C. Ara-Somohano F. Barbier D. Boyer 32 J. P. Bedos T. Baudry J. Bedel J. Bohe 33 L. Bouadma 34
3 M2S - Mécanique des Matériaux et des Structures
GEOMAS - Géomécanique, Matériaux et Structures
16 LIPNESS - Equipe LIPNESS (LNC - U1231)
LNC - Lipides - Nutrition - Cancer [Dijon - U1231]
Abstract : 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.
Document type :
Journal articles
Complete list of metadatas

https://hal.archives-ouvertes.fr/hal-02466193
Contributor : Laboratoire Carmen <>
Submitted on : Tuesday, February 4, 2020 - 12:36:46 PM
Last modification on : Wednesday, February 19, 2020 - 2:40:29 PM

Identifiers

Citation

J. Bourenne, N. Brule, C. Bretonniere, C. Cheval, J. Carvelli, et al.. Pneumonia in acute ischemic stroke patients requiring invasive ventilation: Impact on short and long-term outcomes. Journal of Infection, WB Saunders, 2019, 79 (3), pp.220--227. ⟨10.1016/j.jinf.2019.06.012⟩. ⟨hal-02466193⟩

Share

Metrics

Record views

30