Hoffmann-Urlaub, Sarah

[["dc.bibliographiccitation.artnumber","153"],["dc.bibliographiccitation.journal","Frontiers in Neurology"],["dc.bibliographiccitation.volume","8"],["dc.contributor.author","Ulm, Lena"],["dc.contributor.author","Hoffmann, Sarah"],["dc.contributor.author","Nabavi, Darius"],["dc.contributor.author","Hermans, Marcella"],["dc.contributor.author","Mackert, Bruno-Marcel"],["dc.contributor.author","Hamilton, Frank"],["dc.contributor.author","Schmehl, Ingo"],["dc.contributor.author","Jungehuelsing, Gerhard-Jan"],["dc.contributor.author","Montaner, Joan"],["dc.contributor.author","Bustamante, Alejandro"],["dc.contributor.author","Katan, Mira"],["dc.contributor.author","Hartmann, Andreas"],["dc.contributor.author","Ebmeyer, Stefan"],["dc.contributor.author","Dinter, Christiane"],["dc.contributor.author","Wiemer, Jan C."],["dc.contributor.author","Hertel, Sabine"],["dc.contributor.author","Meisel, Christian"],["dc.contributor.author","Anker, Stefan-D."],["dc.contributor.author","Meisel, Andreas"],["dc.date.accessioned","2018-11-07T10:24:50Z"],["dc.date.available","2018-11-07T10:24:50Z"],["dc.date.issued","2017"],["dc.description.abstract","Background: Pneumonia is among the most common acute complications after stroke and is associated with poor long-term outcome. Biomarkers may help identifying stroke patients at high risk for developing stroke-associated pneumonia (SAP) and to guide early treatment. AIMS: This trial investigated whether procalcitonin (PCT) ultrasensitive (PCTus)-guided antibiotic treatment of SAP can improve functional outcome after stroke. METHODS: In this international, multicenter, randomized, controlled clinical trial with blinded assessment of outcomes, patients with severe ischemic stroke in the middle cerebral artery territory were randomly assigned within 40 h after symptom onset to PCTus-based antibiotic therapy guidance in addition to stroke unit care or standard stroke unit care alone. The primary endpoint was functional outcome at 3 months, defined according to the modified Rankin Scale (mRS) and dichotomized as acceptable (<= 4) or unacceptable (>= 5). Secondary endpoints included usage of antibiotics, infection rates, days of fever, and mortality. The trial was registered with http://ClinicalTrials.gov (Identifier NCT01264549). RESULTS: In the intention-to-treat-analysis based on 227 patients (112 in PCT and 115 in control group), 197 patients completed the 3-month follow-up. Adherence to PCT guidance was 65%. PCT-guided therapy did not improve functional outcome as measured by mRS (odds ratio 0.79; 95% confidence interval 0.45-1.35, p = 0.47). Pneumonia rate and mortality were similar in both groups. Days with fever tended to be lower (p = 0.055), whereas total number of days treated with antibiotics were higher (p = 0.004) in PCT compared to control group. A post hoc analysis including all PCT values in the intention-to-treat population demonstrated a significant increase on the first day of infection in patients with pneumonia and sepsis compared to patients with urinary tract infections or without infections (p < 0.0001). CONCLUSION: PCTus-guided antibiotic therapy did not improve functional outcome at 3 months after severe ischemic stroke. PCT is a promising biomarker for early detection of pneumonia and sepsis in acute stroke patients."],["dc.identifier.doi","10.3389/fneur.2017.00153"],["dc.identifier.isi","000399981200001"],["dc.identifier.pmid","28484421"],["dc.identifier.purl","https://resolver.sub.uni-goettingen.de/purl?gs-1/14463"],["dc.identifier.uri","https://resolver.sub.uni-goettingen.de/purl?gro-2/42736"],["dc.notes.intern","Merged from goescholar"],["dc.notes.status","zu prüfen"],["dc.notes.submitter","PUB_WoS_Import"],["dc.publisher","Frontiers Media Sa"],["dc.relation.issn","1664-2295"],["dc.rights","CC BY 4.0"],["dc.rights.uri","https://creativecommons.org/licenses/by/4.0"],["dc.title","The Randomized Controlled STRAWINSKI Trial: Procalcitonin-Guided Antibiotic Therapy after Stroke"],["dc.type","journal_article"],["dc.type.internalPublication","yes"],["dc.type.peerReviewed","yes"],["dc.type.status","published"],["dc.type.version","published_version"],["dspace.entity.type","Publication"]]