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
,
A. Haouache
,
T. Hissem
,
V. H. T. Ha
,
S. Jochmans
,
J. B. Joffredo
,
H. Kallel
(6)
,
G. Lacave
,
A. Lautrette
(7)
,
V. Lemiale
(8)
,
M. Lermuzeaux
,
J. Lebut
,
M. Lugosi
,
E. Magalhaes
,
S. Merceron
,
B. Mourvillier
(9, 10)
,
B. Misset
(11)
,
M. Neuville
(12)
,
L. Nicolet
,
J. Oziel
(13)
,
L. Papazian
(14)
,
B. Planquette
,
J. P. Quenot
(15, 16)
,
A. Radjou
,
M. Simon
(17)
,
J. Reignier
(18)
,
B. Souweine
(19)
,
R. Smonig
,
G. Troche
,
M. Thuong
,
G. Thierry
(20)
,
D. Toledano
,
G. van Der Meersch
,
M. Venot
,
O. Zambon
,
J. Fournier
(21)
,
C. Tournegros
,
S. Bagur
,
M. Adda
,
V. Vindrieux
,
S. de La Salle
,
P. Enguerrand
,
L. Ferrand
(22)
,
V. Gobert
(23)
,
S. Guessens
,
H. Merle
,
N. Kaddour
,
B. Berthe
,
S. Bekkhouche
,
K. Mellouk
,
M. Lebrazic
,
C. Ouisse
,
D. Maugars
,
C. Aparicio
,
I. Theodose
(8)
,
M. Nouacer
,
V. Deiler
,
M. Moussa
,
A. Mouaci
,
N. Viguier
,
F. Lamara
,
S. Letrou
,
S. Siami
,
Outcomerea Study Grp
,
E. De Montmollin
,
S. Ruckly
(24)
,
C. Schwebel
,
F. Philippart
,
C. Adrie
,
E. Mariotte
,
G. Marcotte
,
Y. Cohen
,
B. Sztrymf
,
D. Da Silva
,
F. Bruneel
(25)
,
M. Gainnier
,
M. Garrouste-Orgeas
,
R. Sonneville
,
J. F. Timsit
,
E. Azoulay
(24)
,
J. R. Zahar
,
M. Darmon
(26)
,
C. Clec'H
,
C. Alberti
(27)
,
A. Francais
,
A. Vesin
,
S. Bailly
(9)
,
F. Lecorre
,
D. Nakache
,
A. Van-Nieuwenhuyze
,
R. Hernu
,
C. Agasse
,
B. Allaouchiche
(28)
,
O. Andremont
,
P. Andreu
(16)
,
L. Argaud
(29, 1)
,
C. Ara-Somohano
,
F. Barbier
,
D. Boyer
(30)
,
J. P. Bedos
,
T. Baudry
,
J. Bedel
,
J. Bohe
(31)
,
L. Bouadma
(32)
1
CarMeN -
Cardiovasculaire, métabolisme, diabétologie et nutrition
2 Department of Geology and Applied Geology
3 M2S - Mécanique des Matériaux et des Structures
4 INSA Lyon - Institut National des Sciences Appliquées de Lyon
5 GEOMAS - Géomécanique, Matériaux et Structures
6 Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française]
7 CHU Gabriel Montpied [Clermont-Ferrand]
8 Medical Intensive Care Unit, APHP, Hôpital St-Louis, Paris, France.
9 IAME (UMR_S_1137 / U1137) - Infection, Anti-microbiens, Modélisation, Evolution
10 AP-HP - Hôpital Bichat - Claude Bernard [Paris]
11 Service d'Hépato-gastro-entérologie et Nutrition [CHU Dupuytren 1, Limoges]
12 ObAS - Observatoire astronomique de Strasbourg
13 CHU Avicenne
14 AMU - Aix Marseille Université
15 LIPNESS - Equipe LIPNESS (LNC - U1231)
16 Service de Réanimation Médicale (CHU de Dijon)
17 LCPMR - Laboratoire de Chimie Physique - Matière et Rayonnement
18 CHU Nantes - Centre hospitalier universitaire de Nantes
19 LMGE - Laboratoire Microorganismes : Génome et Environnement
20 ESI S.A.
21 SCDV - Service de Conditionnement des Déchets et Vitrification
22 CMI Green Line
23 LEFE - Laboratoire Ecologie Fonctionnelle et Environnement
24 UPD7 - Université Paris Diderot - Paris 7
25 CHV - Centre Hospitalier de Versailles André Mignot
26 CHU Pitié-Salpêtrière [AP-HP]
27 Département de Biostatistiques [Paris]
28 Hôpital Edouard Herriot, Service Anesthésie Réanimation
29 Hôpital Edouard Herriot, Service Anesthésie Réanimation
30 ICCF - Institut de Chimie de Clermont-Ferrand
31 CHLS - Centre Hospitalier Lyon Sud [CHU - HCL]
32 CIC - CHU Bichat
2 Department of Geology and Applied Geology
3 M2S - Mécanique des Matériaux et des Structures
4 INSA Lyon - Institut National des Sciences Appliquées de Lyon
5 GEOMAS - Géomécanique, Matériaux et Structures
6 Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française]
7 CHU Gabriel Montpied [Clermont-Ferrand]
8 Medical Intensive Care Unit, APHP, Hôpital St-Louis, Paris, France.
9 IAME (UMR_S_1137 / U1137) - Infection, Anti-microbiens, Modélisation, Evolution
10 AP-HP - Hôpital Bichat - Claude Bernard [Paris]
11 Service d'Hépato-gastro-entérologie et Nutrition [CHU Dupuytren 1, Limoges]
12 ObAS - Observatoire astronomique de Strasbourg
13 CHU Avicenne
14 AMU - Aix Marseille Université
15 LIPNESS - Equipe LIPNESS (LNC - U1231)
16 Service de Réanimation Médicale (CHU de Dijon)
17 LCPMR - Laboratoire de Chimie Physique - Matière et Rayonnement
18 CHU Nantes - Centre hospitalier universitaire de Nantes
19 LMGE - Laboratoire Microorganismes : Génome et Environnement
20 ESI S.A.
21 SCDV - Service de Conditionnement des Déchets et Vitrification
22 CMI Green Line
23 LEFE - Laboratoire Ecologie Fonctionnelle et Environnement
24 UPD7 - Université Paris Diderot - Paris 7
25 CHV - Centre Hospitalier de Versailles André Mignot
26 CHU Pitié-Salpêtrière [AP-HP]
27 Département de Biostatistiques [Paris]
28 Hôpital Edouard Herriot, Service Anesthésie Réanimation
29 Hôpital Edouard Herriot, Service Anesthésie Réanimation
30 ICCF - Institut de Chimie de Clermont-Ferrand
31 CHLS - Centre Hospitalier Lyon Sud [CHU - HCL]
32 CIC - CHU Bichat
J. Bourenne
- Function : Author
N. Brule
- Function : Author
C. Bretonniere
- Function : Author
C. Cheval
- Function : Author
J. Carvelli
- Function : Author
E. Coupez
- Function : Author
L. Dopeux
- Function : Author
A. S. Dumenil
- Function : Author
J. M. Forel
- Function : Author
C. Garret
- Function : Author
S. Grange
- Function : Author
- PersonId : 18316
- IdHAL : stephane-grange
- ORCID : 0000-0002-7766-0483
- IdRef : 137492464
A. Gros
- Function : Author
A. Haouache
- Function : Author
T. Hissem
- Function : Author
V. H. T. Ha
- Function : Author
S. Jochmans
- Function : Author
J. B. Joffredo
- Function : Author
G. Lacave
- Function : Author
M. Lermuzeaux
- Function : Author
J. Lebut
- Function : Author
M. Lugosi
- Function : Author
E. Magalhaes
- Function : Author
S. Merceron
- Function : Author
L. Nicolet
- Function : Author
B. Planquette
- Function : Author
J. P. Quenot
- Function : Author
- PersonId : 998462
- ORCID : 0000-0003-2351-682X
- IdRef : 079287654
A. Radjou
- Function : Author
M. Simon
- Function : Author
- PersonId : 173897
- IdHAL : simon-marsan
- ORCID : 0000-0003-4914-522X
R. Smonig
- Function : Author
G. Troche
- Function : Author
M. Thuong
- Function : Author
D. Toledano
- Function : Author
G. van Der Meersch
- Function : Author
M. Venot
- Function : Author
O. Zambon
- Function : Author
C. Tournegros
- Function : Author
S. Bagur
- Function : Author
M. Adda
- Function : Author
V. Vindrieux
- Function : Author
S. de La Salle
- Function : Author
P. Enguerrand
- Function : Author
S. Guessens
- Function : Author
H. Merle
- Function : Author
N. Kaddour
- Function : Author
B. Berthe
- Function : Author
S. Bekkhouche
- Function : Author
K. Mellouk
- Function : Author
M. Lebrazic
- Function : Author
C. Ouisse
- Function : Author
D. Maugars
- Function : Author
C. Aparicio
- Function : Author
M. Nouacer
- Function : Author
V. Deiler
- Function : Author
M. Moussa
- Function : Author
A. Mouaci
- Function : Author
N. Viguier
- Function : Author
F. Lamara
- Function : Author
S. Letrou
- Function : Author
S. Siami
- Function : Author
Outcomerea Study Grp
- Function : Author
E. De Montmollin
- Function : Author
C. Schwebel
- Function : Author
F. Philippart
- Function : Author
C. Adrie
- Function : Author
E. Mariotte
- Function : Author
G. Marcotte
- Function : Author
Y. Cohen
- Function : Author
B. Sztrymf
- Function : Author
D. Da Silva
- Function : Author
M. Gainnier
- Function : Author
M. Garrouste-Orgeas
- Function : Author
R. Sonneville
- Function : Author
J. F. Timsit
- Function : Author
J. R. Zahar
- Function : Author
C. Clec'H
- Function : Author
A. Francais
- Function : Author
A. Vesin
- Function : Author
F. Lecorre
- Function : Author
D. Nakache
- Function : Author
A. Van-Nieuwenhuyze
- Function : Author
R. Hernu
- Function : Author
C. Agasse
- Function : Author
O. Andremont
- Function : Author
C. Ara-Somohano
- Function : Author
F. Barbier
- Function : Author
J. P. Bedos
- Function : Author
T. Baudry
- Function : Author
J. Bedel
- Function : Author
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.
Origin : Files produced by the author(s)