Psychogios, Marios-Nikos

[["dc.bibliographiccitation.artnumber","e0196174"],["dc.bibliographiccitation.issue","4"],["dc.bibliographiccitation.journal","PLoS One"],["dc.bibliographiccitation.volume","13"],["dc.contributor.author","Maier, Ilko L."],["dc.contributor.author","Becker, Johannes C."],["dc.contributor.author","Leyhe, Johanna Rosemarie"],["dc.contributor.author","Schnieder, Marlena"],["dc.contributor.author","Behme, Daniel"],["dc.contributor.author","Psychogios, Marios-Nikos"],["dc.contributor.author","Liman, Jan"],["dc.date.accessioned","2019-07-09T11:45:41Z"],["dc.date.available","2019-07-09T11:45:41Z"],["dc.date.issued","2018"],["dc.description.abstract","BACKGROUND: Stroke-induced immunodepression is a well characterized complication of acute ischemic stroke. In experimental studies beta-blocker therapy reversed stroke-induced immunodepression, reduced infection rates and mortality. Recent, heterogeneous studies in stroke patients could not provide evidence of a protective effect of beta-blocker therapy. Aim of this study is to investigate the potential preventive effect of beta-blockers in subgroups of patients at high risk for stroke-induced immunodepression. METHODS: Data from a prospectively derived registry of major stroke patients receiving endovascular therapy between 2011-2017 in a tertiary stroke center (University Medical Center Göttingen. Germany) was used. The effect of beta-blocker therapy on pneumonia, urinary tract infection, sepsis and mortality was assessed using multivariate logistic regression analysis. RESULTS: Three hundred six patients with a mean age of 72 ± 13 years and a median NIHSS of 16 (IQR 10.75-20) were included. 158 patients (51.6%) had pre-stroke- and continued beta-blocker therapy. Beta-blocker therapy did not reduce the incidence of pneumonia (OR 0.78, 95% CI 0.31-1.92, p = 0.584), urinary tract infections (OR 1.51, 0.88-2.60, p = 0.135), sepsis (OR 0.57, 0.18-1.80, p = 0.334) or mortality (OR 0.59, 0.16-2.17, p = 0.429). Strokes involving the insula and anterio-medial cortex increased the risk for pneumonia (OR 4.55, 2.41-8.56, p<0.001) and sepsis (OR 4.13, 1.81-9.43, p = 0.001), while right hemispheric strokes increased the risk for pneumonia (OR 1.60, 0.92-2.77, p = 0.096). There was a non-significantly increased risk for urinary tract infections in patients with beta-blocker therapy and insula/anterio-medial cortex strokes (OR 3.12, 95% CI 0.88-11.05, p = 0.077) with no effect of beta-blocker therapy on pneumonia, sepsis or mortality in both subgroups. CONCLUSIONS: In major ischemic stroke patients, beta-blocker therapy did not lower post-stroke infection rates and was associated with urinary tract infections in a subgroup with insula/anterio-medial strokes."],["dc.identifier.doi","10.1371/journal.pone.0196174"],["dc.identifier.pmid","29694433"],["dc.identifier.purl","https://resolver.sub.uni-goettingen.de/purl?gs-1/15285"],["dc.identifier.uri","https://resolver.sub.uni-goettingen.de/purl?gro-2/59286"],["dc.language.iso","en"],["dc.notes.intern","Merged from goescholar"],["dc.relation.issn","1932-6203"],["dc.rights","CC BY 4.0"],["dc.rights.uri","https://creativecommons.org/licenses/by/4.0"],["dc.subject.ddc","610"],["dc.subject.mesh","Adrenergic beta-Antagonists"],["dc.subject.mesh","Aged"],["dc.subject.mesh","Aged, 80 and over"],["dc.subject.mesh","Death"],["dc.subject.mesh","Female"],["dc.subject.mesh","Humans"],["dc.subject.mesh","Incidence"],["dc.subject.mesh","Male"],["dc.subject.mesh","Middle Aged"],["dc.subject.mesh","Pneumonia"],["dc.subject.mesh","Prospective Studies"],["dc.subject.mesh","Registries"],["dc.subject.mesh","Sepsis"],["dc.subject.mesh","Stroke"],["dc.subject.mesh","Tertiary Care Centers"],["dc.subject.mesh","Urinary Tract Infections"],["dc.title","Influence of beta-blocker therapy on the risk of infections and death in patients at high risk for stroke induced immunodepression"],["dc.type","journal_article"],["dc.type.internalPublication","yes"],["dc.type.version","published_version"],["dspace.entity.type","Publication"]]