Abstract
Background: Stroke-associated pneumonia (SAP) is associated with poor prognosis after acute ischemic stroke (AIS).Purpose: This study aimed to describe the parameters of coagulation function and evaluate the association between the fibrinogen-to-albumin ratio (FAR) and SAP in patients with AIS.Patients and methods: A total of 932 consecutive patients with AIS were included. Coagulation parameters were measured at admission. All patients were classified into two groups according to the optimal cutoff FAR point at which the sum of the specificity and sensitivity was highest. Propensity score matching (PSM) was performed to balance potential confounding factors. Univariate and multivariate logistic regression analyses were applied to identify predictors of SAP.Results: A total of 100 (10.7%) patients were diagnosed with SAP. The data showed that fibrinogen, FAR, and D-dimer, prothrombin time (PT), activated partial thromboplastin time (aPTT) were higher in patients with SAP, while albumin was much lower. Patients with SAP showed a significantly increased FAR when compared with non-SAP (P < 0.001). Patients were assigned to groups of high FAR (≥0.0977) and low FAR (<0.0977) based on the optimal cut-off value. Propensity score matching analysis further confirmed the association between FAR and SAP. After adjusting for confounding and risk factors, multivariate regression analysis showed that the high FAR (≥0.0977) was an independent variable predicting the occurrence of SAP (odds ratio =2.830, 95% CI = 1.654–4.840, P < 0.001). In addition, the FAR was higher in the severe pneumonia group when it was assessed by pneumonia severity index (P = 0.008).Conclusions: High FAR is an independent potential risk factor of SAP, which can help clinicians identify high-risk patients with SAP after AIS.
Highlights
Stroke-associated pneumonia (SAP) is one of the most common complications among patients with acute ischemic stroke (AIS), taking place most frequently within the first week of stroke onset [1,2,3]
After adjusting for confounding and risk factors, multivariate regression analysis showed that the high fibrinogen-to-albumin ratio (FAR) (≥0.0977) was an independent variable predicting the occurrence of SAP
The FAR was higher in the severe pneumonia group when it was assessed by pneumonia severity index (P = 0.008)
Summary
Stroke-associated pneumonia (SAP) is one of the most common complications among patients with acute ischemic stroke (AIS), taking place most frequently within the first week of stroke onset [1,2,3]. Numerous studies have discovered various risk factors for SAP such as old age, being male, stroke severity, dysphagia, and diabetes [5, 9, 13]. In a consecutive cohort of 1,569 patients with AIS, Gong et al proved that the A2DS2 score could effectively predict the development of SAP in the Chinese population [19]. Stroke-associated pneumonia (SAP) is associated with poor prognosis after acute ischemic stroke (AIS). Purpose: This study aimed to describe the parameters of coagulation function and evaluate the association between the fibrinogen-to-albumin ratio (FAR) and SAP in patients with AIS
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