Effekt der Beta-Blocker-Therapie auf die Infektionsrate nach einem ischämischen Schlaganfall
Influence of beta-blocker therapy on the risk of infections in patients with ischemic stroke
von Johannes Becker
Datum der mündl. Prüfung:2021-05-12
Erschienen:2021-04-30
Betreuer:Prof. Dr. Jan Liman
Gutachter:Prof. Dr. Jan Liman
Gutachter:Prof. Dr. Rolf Wachter
Dateien
Name:FinaleVersionDissertationJohannesBecker-Mai2...pdf
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Description:Dissertation
Zusammenfassung
Englisch
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. This study investigates the potential preventive effect of beta-blockers in subgroups of patients at high risk for stroke-induced immunodepression. Data from a prospectively derived registry of major stroke patients receiving endovascular therapy between 2011-2017 at the University Medical Center Göttingen was used. The effect of beta-blocker therapy on pneumonia, urinary tract infection, sepsis and mortality was assessed. In this cohort beta-blocker therapy did not reduce the incidence of pneumonia, urinary tract infections, sepsis or mortality. A subgroup of patients with strokes involving the insula and anterio-medial cortex showed an increased risk for pneumonia and sepsis. Patients with right hemispheric stroke had an increased risk for pneumonia. The results support the thesis of certain regions causing a stroke induced immunomodulation. But even in these subgroups beta-blocker therapy showed no significant impact.
Keywords: Stroke; Betablocker; Immunodepression; Infections