International Journal of Molecular Sciences (Nov 2022)

Circulating Inflammatory Biomarkers in Early Prediction of Stroke-Associated Infections

  • Isabel M. C. Hasse,
  • Gerrit M. Grosse,
  • Ramona Schuppner,
  • Till Van Gemmeren,
  • Maria M. Gabriel,
  • Karin Weissenborn,
  • Ralf Lichtinghagen,
  • Hans Worthmann

DOI
https://doi.org/10.3390/ijms232213747
Journal volume & issue
Vol. 23, no. 22
p. 13747

Abstract

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(1) Background: Patients with acute ischaemic stroke (AIS) are at high risk for stroke-associated infections (SAIs). We hypothesised that increased concentrations of systemic inflammation markers predict SAIs and unfavourable outcomes; (2) Methods: In 223 patients with AIS, blood samples were taken at ≤24 h, 3 d and 7d after a stroke, to determine IL-6, IL-10, CRP and LBP. The outcome was assessed using the modified Rankin Scale at 90 d. Patients were thoroughly examined regarding the development of SAIs; (3) Results: 47 patients developed SAIs, including 15 lower respiratory tract infections (LRTIs). IL-6 and LBP at 24 h differed, between patients with and without SAIs (IL-6: p p = 0.042). However, these associations could not be confirmed after adjustment for age, white blood cell count, reduced consciousness and NIHSS. When considering the subgroup of LRTIs, in patients who presented early (≤12 h after stroke, n = 139), IL-6 was independently associated with LRTIs (OR: 1.073, 95% CI: 1.002–1.148). The ROC-analysis for prediction of LRTIs showed an AUC of 0.918 for the combination of IL-6 and clinical factors; (4) Conclusions: Blood biomarkers were not predictive for total SAIs. At early stages, IL-6 was independently associated with outcome-relevant LRTIs. Further studies need to clarify the use of biochemical markers to identify patients prone to SAIs.

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