The risk factors for stroke-associated pneumonia

Abstract

Objective The incidence and prognosis of stroke-associated pneumonia (SAP) among stroke patients during recovery stage have not been thoroughly investigated.We performed a retrospective evaluation to explore the risk factors of SAP.Methods One hundred and sixty-eight patients with ischemic stroke admitted to rehabilitation unit between January 2010 and July 2011 were divided into SAP group (34 cases) and non-SAP group (134 cases) according to whether SAP occured within 4 weeks of admission.The data on age,sex,level of consciousness,dysarthria,dysphagia,nasogastric feeding,pneumonia,diabetes,atrial fibrillation,modified Barthel index,ischemic stroke subtype,lymphocyte counts were retrospectively collected and used for a logistic regression analysis.Results The mean age (mean ± standard deviation) of SAP group was elder than non-SAP group (73.5 ±10.0 years vs.67.8±10.4 years,P=0.006,P＜0.05).It was shown that the incidence of SAP was associated with age ≥ 75 years,nasogastric feeding,dysarthria,modified Barthel index ＜ 40,Kubota Toshio's drinking tests at Ⅲ or Ⅳ ～ Ⅴ levels and lower lymphocyte counts.In a multivariate analysis,lymphocyte counts showed the strongest association with SAP with a significant independent protect value (odds ration [OR] 0.16195％ confidence interval [CI] 0.059-0.438 P =0.000).Swallowing function (OR =5.471 95％ CI 2.773-10.794 P =0.000) and atrial fibrillation (OR 5.373 95 ％ CI 1.470-19.639,P =0.011) were significant independent risk factors of SAP.Conclusion Low lymphocyte counts,poor swallowing and atrial fibrillation were significant risk factors of SAP in stroke patients.Close monitoring of these factors can help prevent SAP and improve the prognosis of stroke patients at risk. Key words: Cerebrovascular accident; Pneumonia; Dysphagia