{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T04:28:30Z","timestamp":1787027310468,"version":"build-2736575974"},"reference-count":18,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,2,17]],"date-time":"2026-02-17T00:00:00Z","timestamp":1771286400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Stroke"],"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Stroke may result in dysphagia, which can subsequently lead to stroke-associated pneumonia (SaP). This condition has been shown to exert a significant negative impact on patient outcome. Early diagnosis and prevention are therefore desirable.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This retrospective study compared inflammatory markers during the first 4 days after stroke in 515 patients from 2015 and 2021, analyzing associations with dysphagia, year of treatment, dietary adjustments, stroke-associated pneumonia, and antibiotic use. Data entry and descriptive analyses were performed using Microsoft Excel\n                      <jats:sup>\u00ae<\/jats:sup>\n                      . Datasets from 2015 and 2021 were analyzed in SPSS\n                      <jats:sup>\u00ae<\/jats:sup>\n                      (IBM SPSS Statistics 27).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>This retrospective analysis demonstrates that dysphagia significantly influences C-reactive protein (CRP) levels within the first 4 days after stroke. Dysphagia and elevated CRP are early markers of emergence of stroke-associated pneumonia, whereas leukocyte count and temperature show limited forewarning value. The combination of post-stroke inflammatory response, dysphagia (PAS &amp;gt; 5), and elevated CRP may serve as an early indicator of SaP and support timely FEES-based assessment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>Early elevated CRP levels in dysphagic stroke patients are indicative of aspiration-related inflammation and may serve as a sensitive early biomarker for stroke-associated pneumonia. The combined assessment of dysphagia severity and CRP supports improved early risk stratification and preventive management.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fstro.2026.1742758","type":"journal-article","created":{"date-parts":[[2026,2,17]],"date-time":"2026-02-17T05:18:43Z","timestamp":1771305523000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Role of C-reactive protein and fibreoptic endoscopic evaluation of swallowing as early markers of stroke-associated pneumonia"],"prefix":"10.3389","volume":"5","author":[{"given":"Svetlana","family":"Politz Geleva","sequence":"first","affiliation":[{"name":"Klinik f\u00fcr Neurologie, Cantonal Hospital of M\u00fcnsterlingen","place":["M\u00fcnsterlingen, Switzerland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ludwig D.","family":"Schelosky","sequence":"additional","affiliation":[{"name":"Klinische Neurologie, District Hospital Rohrbach","place":["Rohrbach-Berg, Austria"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,2,17]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"287","DOI":"10.1007\/978-3-662-46500-4_20","article-title":"\u201cNosokomiale Pneumonie - Antibiotikatherapie und hygienische Interventionsstrategien,\u201d","author":"Abele-Horn","year":"2015","journal-title":"NeuroIntensiv"},{"key":"B2","doi-asserted-by":"publisher","first-page":"282","DOI":"10.1186\/s12883-019-1499-8","article-title":"Adjustment of oral diet based on flexible endoscopic evaluation of swallowing (FEES) in acute stroke patients: a cross-sectional hospital-based registry study","volume":"19","author":"Braun","year":"2019","journal-title":"BMC Neurol."},{"key":"B3","doi-asserted-by":"publisher","first-page":"93","DOI":"10.1016\/S0165-5728(03)00134-6","article-title":"An early and sustained peripheral inflammatory response in acute ischaemic stroke: relationships with infection and atherosclerosis","volume":"139","author":"Emsley","year":"2003","journal-title":"J. Neuroimmunol."},{"key":"B4","doi-asserted-by":"publisher","first-page":"127","DOI":"10.1186\/s12974-021-02177-0","article-title":"Stroke-induced immunosuppression: implications for the prevention and prediction of post-stroke infections","volume":"18","author":"Faura","year":"2021","journal-title":"J. Neuroinflammation"},{"key":"B5","doi-asserted-by":"publisher","first-page":"430","DOI":"10.1159\/000350199","article-title":"Stroke-associated pneumonia: major advances and obstacles","volume":"35","author":"Hannawi","year":"2013","journal-title":"Cerebrovasc. Dis."},{"key":"B6","doi-asserted-by":"publisher","first-page":"167","DOI":"10.1177\/1747493018798527","article-title":"Elevated C-reactive protein increases diagnostic accuracy of algorithm-defined stroke-associated pneumonia in afebrile patients","volume":"14","author":"Kalra","year":"2019","journal-title":"Int. J. Stroke"},{"key":"B7","doi-asserted-by":"publisher","first-page":"2849","DOI":"10.1161\/STROKEAHA.109.549618","article-title":"The spectrum of systemic immune alterations after murine focal ischemia: immunodepression versus immunomodulation","volume":"40","author":"Liesz","year":"2009","journal-title":"Stroke"},{"key":"B8","doi-asserted-by":"publisher","first-page":"42","DOI":"10.1016\/j.neuint.2018.01.002","article-title":"Research progress in stroke-induced immunodepression syndrome (SIDS) and stroke-associated pneumonia (SAP)","volume":"114","author":"Liu","year":"2018","journal-title":"Neurochem. Int."},{"key":"B9","doi-asserted-by":"publisher","first-page":"429","DOI":"10.12788\/jhm.3154","article-title":"Aspiration pneumonia in older adults","volume":"14","author":"Makhnevich","year":"2019","journal-title":"J. Hosp. Med."},{"key":"B10","doi-asserted-by":"publisher","first-page":"2756","DOI":"10.1161\/01.STR.0000190056.76543.eb","article-title":"Dysphagia after stroke: incidence, diagnosis, and pulmonary complications","volume":"36","author":"Martino","year":"2005","journal-title":"Stroke"},{"key":"B11","doi-asserted-by":"publisher","first-page":"1941","DOI":"10.1016\/S0140-6736(17)30866-8","article-title":"Idiopathic pulmonary fibrosis","volume":"389","author":"Richeldi","year":"2017","journal-title":"Lancet"},{"key":"B12","doi-asserted-by":"publisher","first-page":"2318","DOI":"10.1161\/STROKEAHA.107.510362","article-title":"Variables associated with 7-day, 30-day, and 1-year fatality after ischemic stroke","volume":"39","author":"Saposnik","year":"2008","journal-title":"Stroke"},{"key":"B13","doi-asserted-by":"publisher","first-page":"3052","DOI":"10.1080\/07853890.2022.2138529","article-title":"Community-acquired pneumonia in hospitalised patients: changes in aetiology, clinical presentation, and severity outcomes in a 10-year period","volume":"54","author":"Sellar\u00e8s-Nadal","year":"2022","journal-title":"Ann. Med."},{"key":"B14","doi-asserted-by":"publisher","first-page":"2335","DOI":"10.1161\/STROKEAHA.115.009617","article-title":"Diagnosis of stroke-associated pneumonia: recommendations from the pneumonia in stroke consensus group","volume":"46","author":"Smith","year":"2015","journal-title":"Stroke"},{"key":"B15","doi-asserted-by":"publisher","first-page":"4289","DOI":"10.2174\/138161212802481200","article-title":"Inflammation in ischemic stroke subtypes","volume":"18","author":"Tuttolomondo","year":"2012","journal-title":"Curr. Pharm. Des."},{"key":"B16","doi-asserted-by":"publisher","first-page":"547","DOI":"10.1016\/j.jocn.2013.06.015","article-title":"C-reactive protein and long-term ischemic stroke prognosis","volume":"21","author":"VanGilder","year":"2014","journal-title":"J. Clin. Neurosci."},{"key":"B17","doi-asserted-by":"publisher","first-page":"2073","DOI":"10.1089\/neu.2013.3060","article-title":"Traumatic brain injury in rats induces lung injury and systemic immune suppression","volume":"30","author":"Vermeij","year":"2013","journal-title":"J. Neurotrauma"},{"key":"B18","doi-asserted-by":"publisher","first-page":"110","DOI":"10.1186\/1471-2377-11-110","article-title":"Post-stroke infection: a systematic review and meta-analysis","volume":"11","author":"Westendorp","year":"2011","journal-title":"BMC Neurol."}],"container-title":["Frontiers in Stroke"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fstro.2026.1742758\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,17]],"date-time":"2026-02-17T05:18:43Z","timestamp":1771305523000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fstro.2026.1742758\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2,17]]},"references-count":18,"alternative-id":["10.3389\/fstro.2026.1742758"],"URL":"https:\/\/doi.org\/10.3389\/fstro.2026.1742758","relation":{},"ISSN":["2813-3056"],"issn-type":[{"value":"2813-3056","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2,17]]},"article-number":"1742758"}}