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STRoke Adverse outcome is associated WIth NoSocomial Infections (STRAWINSKI): procalcitonin ultrasensitive-guided antibacterial therapy in severe ischaemic stroke patients - rationale and protocol for a randomized controlled trial
- Source :
- International Journal of Stroke; Vol 8
- Publication Year :
- 2012
-
Abstract
- Rationale Stroke-associated pneumonia is one of the most common causes of poor outcome in stroke patients. Clinical signs and laboratory parameters of stroke-associated infections are often inconclusive. Biomarkers may help to identify stroke patients at high risk for pneumonia and to guide physicians in an early antibiotic treatment, thereby improving stroke outcome. Aim The aim of the present study is to investigate whether procalcitonin ultrasensitive-guided antibiotic treatment improves functional outcome after severe ischaemic stroke by early treatment of pneumonia. Design STRAWINSKI is an investigator-initiated, multicentre, randomized, controlled trial with blinded assessment of outcome comparing procalcitonin ultrasensitive-guided antibiotic treatment with standard care. Study 200 patients with ischaemic stroke in the middle cerebral artery territory and a score >9 on the National Institutes of Health Stroke Scale will be included and randomly assigned to two groups. One group will receive procalcitonin-based antibiotic therapy guidance; the other group will receive standard stroke unit care. Outcomes The primary endpoint is functional outcome at day 90 after stroke on the modified Rankin Scale, dichotomized as favourable (0–4) or unfavourable outcome ( 5 ,– 6 ). Secondary endpoints are time to first event of death, rehospitalization, or recurrent stroke; death rate, infection rate, and days with fever up to day 7; length of hospital stay and hospital discharge disposition; shift analysis of the modified Rankin Scale; Barthel Index and days alive and out of hospital at day 90; use of antibiotics until day 90; and modified Rankin Scale, Barthel Index, and infarct volume at day 180.
- Subjects :
- Calcitonin
medicine.medical_specialty
medicine.drug_class
Calcitonin Gene-Related Peptide
Antibiotics
030204 cardiovascular system & hematology
Procalcitonin
law.invention
03 medical and health sciences
0302 clinical medicine
Randomized controlled trial
law
Modified Rankin Scale
Internal medicine
medicine
Clinical endpoint
Humans
cardiovascular diseases
Protein Precursors
Intensive care medicine
Stroke
Cross Infection
business.industry
Mortality rate
Pneumonia
medicine.disease
3. Good health
Anti-Bacterial Agents
Neurology
Research Design
business
030217 neurology & neurosurgery
Biomarkers
Subjects
Details
- ISSN :
- 17474949
- Volume :
- 8
- Issue :
- 7
- Database :
- OpenAIRE
- Journal :
- International journal of stroke : official journal of the International Stroke Society
- Accession number :
- edsair.doi.dedup.....ec774641513632de41d24c1b29306a3e