A novel risk score for predicting hospital acquired pneumonia in aneurysmal subarachnoid hemorrhage patients

Abstract

BackgroundPneumonia is a common complication in aneurysmal subarachnoid hemorrhage (aSAH) patients and has been confirmed associated with unfavorable outcome of aSAH patients. This study is designed to explore risk factors and develop predictive model of hospital acquired pneumonia in aSAH patients. Methods351 aSAH patients received treatments in the neuro-intensive care unit (NICU) of West China hospital were included. Univariate and multivariate logistic regression were performed to explore risk factors of hospital acquired pneumonia. And predictive model for pneumonia was also constructed using logistic regression. Area under the receiver operating characteristics curve (AUC) were calculated to evaluate the accuracy of the constructed model and single markers. Results96 aSAH patients developed hospital acquired pneumonia with incidence of 27.4%. Logistic regression analysis showed World Federation of Neurosurgical Societies (WFNS) score (0R = 1.677, p = 0.006), neutrophil count (0R = 1.300, p = 0.042), red blood cell transfusion (0R = 3.035, p = 0.030) and tracheostomy (0R = 7.645, p < 0.001) were independent risk factors of pneumonia in aSAH patients. Consisted of these four factors, the constructed model was valuable in predicting pneumonia with AUC of 0.808. The AUC of neutrophil to lymphocyte ratio and lactate dehydrogenase for predicting pneumonia was 0.671 and 0.613, respectively. ConclusionsWFNS, high neutrophil at admission, need of RBC transfusion and tracheostomy were independent risk factors of hospital acquired pneumonia in aSAH patients. The novel predictive model we constructed is efficient in evaluating possibility of pneumonia in aSAH patients during hospitalizations.