Clinical analysis in risk factors of stroke-associated pneumonia in patients with acute cerebral infraction

doi:10.3877/cma.j.issn.1674-6902.2017.02.014

Abstract

Abstract:

Objective

To analyze the risk factors of stroke-associated pneumonia(SAP) in patients with acute cerebral infraction. For reducing the morbidity of SAP.

Methods

Collected case data of 380 inpatients with acute cerebral infraction in our department from January 2012 to June 2016. The patients were divided into two groups, 69 patients complicated with SAP were served as case group, and 311 patients did not complicated with SAP were served as control group. To analyze the risk factors of SAP after comparing the differences of case data between the two groups.

Results

The morbidity of SAP was 18.15% (69/380)in patients with acute cerebral infraction. Single factor analysis the clinical characteristics of two groups, the risk factors associated with SAP including age equal or over 65 years, disturbance of consciousness, dysphagia, lie in bed, diabetes mellitus, chronic bronchitis. The difference was statistically significant (P<0.05). OR value from high to low order: disturbance of consciousness, dysphagia, chronic bronchitis, diabetes mellitus, age equal or over 65 years, lie in bed. Multivariate unconditional logistic regression analyses, the result showed above the reasons are independent risk factors for SAP.

Conclusion

There were many reliated risk factors causing SAP. To control and improve these factors, SAP in patient with acute cerebral infraction could be prevented or cured, and the morbidity would be reduced.

Key words: Acute cerebral infraction, Stroke-associated pneumonia, Risk factors, Mobidity

Desheng Wang, Qingjie Su, Faqing Long, Xi Li, Xiangdong Zhou, Jie Wang. Clinical analysis in risk factors of stroke-associated pneumonia in patients with acute cerebral infraction[J]. Chinese Journal of Lung Diseases(Electronic Edition), 2017, 10(02): 183-186.

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https://zhfbjbzz.cma-cmc.com.cn/EN/Y2017/V10/I02/183

Figures/Tables 2

References 24

1	卒中相关性肺炎诊治中国专家共识组. 卒中相关性肺炎诊治中国专家共识[J]. 中华内科杂志，2010, 49(12): 1075-1078.
2	黄其密，惠俊兰，刘唯佳，等. 老年脑卒中患者上消化道出血与肺部感染的临床分析[J/CD]. 中华肺部疾病杂志(电子版), 2016, 9(3): 324-326.
3	Liu L, Wang D, Wong KS, et al. Stroke and stroke care in China: huge burden, significant workload，and a national priority[J]. Stroke, 2011, 42(12): 3651-3654.
4	Hamidon BB, Raymond AA. Risk factors and complications of acute ischemic stroke patients at Hospital University Kebangsaan Malaysia ( HUKM) [J]. Med J Malaysia, 2003, 58(4): 499-505.
5	Kstzan IL, Cebul RD, Husak SH, et al. The effect of pneumonia on morality among patients hospitalized for acute stroke[J]. Neurology, 2003, 60(4): 620-625.
6	Smith CJ, Kishore AK, Vail A, et al. Diagnosis of stroke-associated pneumonia: recommendations from the pneumonia in stroke consensus group[J]. Stroke, 2015, 46(8): 2335-2340.
7	Hilker R, Poetter C, Findeisen N, et al. Nosocomial pneumonia after acute stroke: implications for neurological intensive care medicine[J]. Stroke, 2003, 34(4): 975-981.
8	Walter U, Kolbaske S, Patejdl R, et al. Insular stroke is associated with acute sympathetic hyperactivation and immunodepression[J]. Eur J Neurol, 2013, 20(1): 153-159.
9	Kamel H, Iadecola C. Brain-immune interactions and ischemic stroke：clinical implications[J]. Arch Neurol, 2012, 69(5): 576-581.
10	Chamorro A, Meisel A, Planas AM, et al. The immunology of acute stroke[J]. Nat Rev Neurol, 2012, 8(7): 401-410.
11	Zhao H, Lin G, Shi M, et al. The mechanism of neurogenic pulmonary edema in epilepsy[J]. J Physiol Sci, 2014, 64(1): 65-72.
12	Martino R, Foley N, Bhogal S, et al. Dysphagia after stroke: Incidence，diagnosis，and pulmonary complications[J]. Stroke, 2005, 36(12): 2756-2763.
13	González-Fernández M, Ottenstein L, Atanelov L, et al. Dysphagia after stroke: an overview[J]. Curr Phys Med Rehabil Rep, 2013, 1(3): 187-196.
14	黄其密，惠俊兰，刘唯佳，等. 老年脑卒中患者上消化道出血与肺部感染的临床分析[J/CD]. 中华肺部疾病杂志(电子版), 2016, 9(3): 324-326.
15	陆媛，徐金富，梁兴伦，等. 老年卒中相关性肺炎患者病原菌分布与耐药性分析[J]. 中华医院感染学杂志，2015, 25(3): 537-539.
16	Ji R, Shen H, Pan Y, et al. Novel risk score to predict pneumonia after acute ischemic stroke[J]. Stroke, 2013, 44 (5): 1303-1309.
17	Li L, Zhang LH, Xu WP, et al. Risk assessment of ischemic stroke associated pneumonia[J]. World J Emerg Med, 2014, 5(3): 209-213.
18	张俞，葛晓麟，贡伟，等. 卒中相关性肺炎的临床特点及预测因子[J]. 中国现代医生，2012, 5(28): 24-25.
19	汪坚敏，吴莘，钱立，等. 卒中相关性肺炎危险因素的临床分析[J/CD]. 中华临床医师杂志(电子版), 2011, 5(19): 5829-5830.
20	张淑霞，潘晓华，刘国荣，等. 卒中相关性肺炎的发病机制及预测因素的研究进展[J]. 医学综述，2016, 22(23): 4637-4640.
21	刘淑媛，张永喜，袁娟，等. 老年脑卒中相关性肺炎多重耐药菌感染的危险因素及病原学分析[J]. 中国老年学，2014, 34(3): 599-600.
22	唐莉，金燕. 脑卒中患者合并肺部多重耐药菌感染的临床护理[J/CD]. 中华肺部疾病杂志(电子版), 2015, 8(5): 645-647.
23	温德良，李智博，温艺超，等. 重症监护病房脑卒中相关性肺炎多重耐药菌感染的危险因素及病原学分析[J]. 实用医学杂志，2016, 32(13): 2178-2181.
24	Dellinger RP, Levy MM, Carlet JM, et al. Surviving sepsis campaign：international guidelines for management of severe sepsis and septic shock: 2008[J]. Crit Care Med, 2008, 36(1): 296-327.

临床特征	SAP组(n＝69)	非SAP组(n＝311)	χ²值(t)值	OR值	P值
男性	51(73.91)	227(72.99)	0.024	1.048	>0.05
年龄≥65岁	30(43.48)	69(22.19)	13.288	2.698	<0.05
意识障碍	52(75.36)	18(5.79)	181.901	49.791	<0.05
吞咽困难	30(43.48)	10(3.22)	97.199	23.154	<0.05
卧床	15(21.74)	35(11.25)	5.433	2.19	<0.05
冠心病	34(49.28)	134(43.08)	0.877	1.283	>0.05
高血压	46(66.67)	220(70.73)	0.446	0.827	>0.05
心房纤颤	8(11.59)	32(10.29)	0.102	1.143	>0.05
糖尿病	50(72.46)	148(47.59)	14.002	2.898	<0.05
慢性支气管炎	37(53.62)	86(27.65)	17.399	3.025	<0.05

临床特征	SAP组(n＝69)	非SAP组(n＝311)	χ²值(t)值	OR值	P值
男性	51(73.91)	227(72.99)	0.024	1.048	>0.05
年龄≥65岁	30(43.48)	69(22.19)	13.288	2.698	<0.05
意识障碍	52(75.36)	18(5.79)	181.901	49.791	<0.05
吞咽困难	30(43.48)	10(3.22)	97.199	23.154	<0.05
卧床	15(21.74)	35(11.25)	5.433	2.19	<0.05
冠心病	34(49.28)	134(43.08)	0.877	1.283	>0.05
高血压	46(66.67)	220(70.73)	0.446	0.827	>0.05
心房纤颤	8(11.59)	32(10.29)	0.102	1.143	>0.05
糖尿病	50(72.46)	148(47.59)	14.002	2.898	<0.05
慢性支气管炎	37(53.62)	86(27.65)	17.399	3.025	<0.05

变　量	β	SE	Wald χ²(t)值	P值	Exp(β)
常数项	－13.923	3.737	13.884	.000	.000
龄≥65岁	6.435	1.717	14.042	.002	623.277
意识障碍	8.427	2.677	9.908	.000	4 569.799
吞咽困难	6.482	1.903	11.605	.001	653.056
卧床	3.913	1.503	6.783	.009	50.068
糖尿病	3.494	1.265	7.632	.006	32.915
慢性支气管炎	2.664	1.350	3.894	.048	14.347

变　量	β	SE	Wald χ²(t)值	P值	Exp(β)
常数项	－13.923	3.737	13.884	.000	.000
龄≥65岁	6.435	1.717	14.042	.002	623.277
意识障碍	8.427	2.677	9.908	.000	4 569.799
吞咽困难	6.482	1.903	11.605	.001	653.056
卧床	3.913	1.503	6.783	.009	50.068
糖尿病	3.494	1.265	7.632	.006	32.915
慢性支气管炎	2.664	1.350	3.894	.048	14.347

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