Priority 8 Stroke Prevention, Diagnosis, Pre-hospital and Hospital Care

UNCERTAINTY: How can complications of stroke be reduced (e.g. pneumonia)? (JLA PSP Priority 8)
Overall ranking 8
JLA question ID 0106/8a
Explanatory note

Complications occur frequently after stroke and have an adverse effect on outcomes. For example, patients with dysphagia are at an increased risk of stroke-associated pneumonia. A 2018 Cochrane review looked at the effectiveness of using antibiotics preventatively and although overall infections reduced there was no effect on functional outcome, mortality or pneumonia (see evidence). A 2020 review (see Evidence) looked at the effects of oral hygiene care on incidence of ventilatorā€associated pneumonia in critically ill patients. It concluded that there is insufficient evidence to determine whether any of the interventions evaluated in the studies are associated with adverse effects.

A new trial starting in 2021 may partially address this question. However evidence is needed on effective interventions to reduce complications in stroke patients to improve outcomes.

Evidence

https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD008530.pub3/full
https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD008367.pub4/full
https://karger.com/ced/article/46/3-4/97/77289/Impact-of-Dysphagia-Assessment-and-Management-on

Health Research Classification System category Stroke
Extra information provided by this PSP
Original uncertainty examples How can we reduce complications after stroke such as pneumonia?
Submitted by Health/Social Care professional x 1
PSP information
PSP unique ID 0106
PSP name Stroke prevention, diagnosis, pre-hospital and hospital care
Total number of uncertainties identified by this PSP. 93 (To see a full list of all uncertainties identified, please see the detailed spreadsheet held on the JLA website)
Date of priority setting workshop 30th April 2021