Evidence map›Paper›PMID 41711398›Full record

ArticleCNS neuroscience & therapeutics2026

Prognostic Implications of Vancomycin Therapeutic Drug Monitoring for Critically Ill Stroke Patients: Evidence From a Subtype-Oriented Analysis.

Hongbo San, Jing Feng, Hongyu Zhang, Mengsi Zhan, Jiahao Yao, Jianheng Gu, Lang Li, Yihan Hu, Chenxing Liu, Haonan Chen and 3 more

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In one paragraph

Article in CNS neuroscience & therapeutics, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

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2 · The registry

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3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

13 authors.

Hongbo SanDepartment of Neurosurgery, The Fourth Affiliated Hospital of Harbin Medical University, Harbin, China.
Jing FengDepartment of Neurosurgery, The Fourth Affiliated Hospital of Harbin Medical University, Harbin, China.
Hongyu ZhangPlastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.ORCID https://orcid.org/0009-0004-4632-5174
Mengsi ZhanDepartment of Neurosurgery, The Fourth Affiliated Hospital of Harbin Medical University, Harbin, China.
Jiahao YaoDepartment of Neurosurgery, The Fourth Affiliated Hospital of Harbin Medical University, Harbin, China.
Jianheng GuDepartment of Neurosurgery, The Fourth Affiliated Hospital of Harbin Medical University, Harbin, China.
Lang LiDepartment of Neurosurgery, The Fourth Affiliated Hospital of Harbin Medical University, Harbin, China.
Yihan HuDepartment of Neurosurgery, The Fourth Affiliated Hospital of Harbin Medical University, Harbin, China.
Chenxing LiuDepartment of Neurosurgery, The Fourth Affiliated Hospital of Harbin Medical University, Harbin, China.
Haonan ChenDepartment of Neurosurgery, The Fourth Affiliated Hospital of Harbin Medical University, Harbin, China.
Jianing JiangSchool of Basic Medicine, Harbin Medical University, Harbin, China.
Shuang LiuDepartment of Neurosurgery, The Fourth Affiliated Hospital of Harbin Medical University, Harbin, China.
Xuefeng WangDepartment of Neurosurgery, The Fourth Affiliated Hospital of Harbin Medical University, Harbin, China.ORCID https://orcid.org/0009-0008-0646-8305

Funding

The Horizontal Research Project on the Role of LncRNAs and PAK7 in Brain Glioma Cell Proliferation and Temozolomide-Resistant Glioma (2020-2024)The Special Fund Research Projects of The Fourth Affiliated Hospital of Harbin Medical University No.HYDSYTB202232The Torch Plan Surface Project of The Fourth Affiliated Hospital of Harbin Medical University No.HYDSYHJ201902
6 · The paper itself

Abstract

backgroundPost-stroke infections, particularly those caused by Gram-positive pathogens, are frequent in neurocritical care and worsen outcomes. Vancomycin is widely used against severe Gram-positive infections, and therapeutic drug monitoring (TDM) is recommended to optimize efficacy and minimize toxicity. However, its prognostic value in critically ill stroke patients remains unclear.

methodsClinical data were obtained from the MIMIC-IV (v3.1) database. Adult patients with ischemic or hemorrhagic stroke receiving intravenous vancomycin were included. Patients were stratified by stroke subtype and TDM status. Propensity score matching (PSM) was performed to balance baseline characteristics. The primary outcome was 28-day mortality; secondary outcomes included ICU, hospital, 60-, 90-, and 365-day mortality.

resultsA total of 1266 patients were analyzed (543 hemorrhagic, 723 ischemic). In hemorrhagic stroke, 28-day mortality was lower in the TDM group (24.6% vs. 48.2%, p < 0.001), and the association persisted after PSM (23.3% vs. 40.8%, p = 0.007). Multivariable Cox analysis confirmed TDM as an independent predictor of reduced 28-day mortality (adjusted HR = 0.29, 95% CI 0.15-0.56, p < 0.001). No significant association was observed in ischemic stroke.

conclusionsVancomycin TDM was independently linked to improved survival in hemorrhagic but not ischemic stroke, supporting individualized antimicrobial optimization in neurocritical care.

Indexed as

Anti-Bacterial AgentsDrug MonitoringIschemic StrokeStrokeVancomycinAgedCritical IllnessFemaleHumansMaleMiddle AgedPrognosisRetrospective StudiesAnti-Bacterial AgentsVancomycinMIMIC‐IVmortalitystroketherapeutic drug monitoringvancomycin

Identifiers

PMID41711398
PMCPMC12918411

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