BRIEF RESEARCH REPORT article
Front. Stroke
Sec. Preventative Health and Stroke Complications
Role of C-reactive protein and fibreoptic endoscopic evaluation of swallowing as early markers of stroke-associated pneumonia
Provisionally accepted
- 1Kantonsspital Munsterlingen, Münsterlingen, Switzerland
- 2Klinische Neurologie, District Hospital Rohrbach, Rohrbach-Berg, Austria
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Introduction: 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. Methods: This retrospective study compared inflammatory markers during the first four 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®. Datasets from 2015 and 2021 were analyzed in SPSS® (IBM SPSS Statistics 27). Results: This retrospective analysis demonstrates that dysphagia significantly influences C-reactive protein (CRP) levels within the first four 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 > 5), and elevated CRP may serve as an early indicator of SaP and support timely FEES-based assessment. Discussion: 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.
Keywords: aspiration pneumonia, dysphagia, fees, post-stroke infection, prevention, Speech language therapy, Stroke, Stroke-associated pneumonia
Received: 09 Nov 2025; Accepted: 28 Jan 2026.
Copyright: © 2026 Politz and Schelosky. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Ludwig D. Schelosky
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