, Volume 33, Issue 5, pp 716–724 | Cite as

Cilostazol is Effective to Prevent Stroke-Associated Pneumonia in Patients Receiving Tube Feeding

  • Shizuka Netsu
  • Atsushi MizumaEmail author
  • Masaki Sakamoto
  • Sachiko Yutani
  • Eiichiro Nagata
  • Shunya Takizawa
Original Article


Stroke-associated pneumonia (SAP) is a frequent complication in acute ischemic stroke (IS) patients, especially those receiving tube feeding (TF). In this retrospective study, we investigated whether or not cilostazol, a pluripotent phosphodiesterase III-specific inhibitor with anti-platelet and vasculogenic effects, can prevent SAP in these patients and reduce their duration of stay in intensive care unit/hospitalization. We recruited 158 IS patients receiving TF. Patients’ characteristics (including age, gender, past history), National Institute of Health Stroke Scale and serum albumin level on admission, concomitant medications associated with SAP prevention (including cilostazol), and stroke characteristics (bilateral subcortical white matter lesion, brainstem involvement, large infarction, and asymptomatic hemorrhagic infarction) were compared between the SAP(−) and SAP(+) groups. Cilostazol was more frequently used in the SAP(−) group (20.8% vs. 6.1%, p < 0.05). Duration of intensive care unit was longer in patients with SAP (9 ± 8 vs. 6 ± 6 days, p < 0.05). However, the length of stay in an intensive care unit and duration of hospitalization were not reduced due to the prevention of SAP by cilostazol treatment. Cilostazol administration was associated with reduced SAP incidence in acute IS patients receiving TF.


Cilostazol Stroke-associated pneumonia Ischemic stroke Aspiration pneumonia Tube feeding Nutrition 



We thank M. Takada for helping to obtain approval from the ethics committee and M. Mizuma for awarding “incentive award” to us at the 21st annual meeting of Japanese Society of Dysphagia Rehabilitation.

Author contributions

SN and AM wrote the article and prepared the figures and tables. Data collection was performed by SN, AM, MS, and SY. Data analysis was performed by AM. EN and ST developed the study design, and revised the manuscript. All authors approved the final version.

Compliance with Ethical Standards

Conflict of interest

The authors state that they have no conflict of interest.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

Supplementary material

455_2018_9897_MOESM1_ESM.docx (79 kb)
Supplementary material 1 (DOCX 79 kb)


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Shizuka Netsu
    • 1
  • Atsushi Mizuma
    • 1
    Email author
  • Masaki Sakamoto
    • 2
  • Sachiko Yutani
    • 1
  • Eiichiro Nagata
    • 1
  • Shunya Takizawa
    • 1
  1. 1.Department of NeurologyTokai University School of MedicineIseharaJapan
  2. 2.Department of Nursing DepartmentTokai University HospitalIseharaJapan

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