THE PREVALENCE AND PREDICTIVE FACTORS OF STROKE-ASSOCIATED PNEUMONIA IN ISCHEMIC STROKE PATIENTS AT THE NEUROLOGY DEPARTMENT, CHO RAY HOSPITAL
Main Article Content
Abstract
Objective: To determine the prevalence of stroke associated pneumonia in ischemic stroke patients and related factors at the Department of Neurology, Cho Ray Hospital.
Subjects and methods: A retrospective cohort study was conducted on 242 ischemic stroke patients admitted to the Department of Neurology from December 2023 to June 2025. Data on demographics, clinical, and outcome data were collected. Firth logistic regression with LASSO selection was used to identify independent predictors.
Results: The prevalence of stroke associated pneumonia was 16.53%. Compared to the non-stroke associated pneumonia group, the stroke associated pneumonia group had significantly worse clinical outcomes, including a higher rate of poor outcomes (mRS ≥ 3) (80% vs. 36.7%; p < 0.001) and a longer mean hospital stay (5.43 vs. 3.87 days; p < 0.001). The optimal LASSO model identified three robust independent predictors for stroke associated pneumonia: dysphagia (OR = 6.81; p = 0.001), aphasia (OR = 3.71; p = 0.022), and baseline NIHSS score (OR = 1.15; p = 0.007).
Conclusion: The prevalence of stroke associated pneumonia in ischemic stroke patients at Cho Ray Hospital is quite high, and is associated with poor outcomes. Dysphagia, aphasia, and stroke severity (NIHSS score) are important independent predictors, helping to identify high-risk patients early.
Article Details
Keywords
Stroke associated pneumonia, ischemic stroke, predictive factors.
References
[2] Hannawi Y, Hannawi B, Rao C.P et al. Stroke-associated pneumonia: major advances and obstacles. Cerebrovascular Diseases (Basel, Switzerland), 2013, 35 (5): 430-43. doi: 10.1159/000350199
[3] Wang Y.J, Chen Y.G, Lv C.Z, et al. An updated Chinese consensus statement on stroke-associated pneumonia 2019. Asian Pacific Journal of Tropical Medicine, 2019, 12 (Suppl 2).
[4] Faura J, Bustamante A, Miró-Mur F, Montaner J. Stroke-induced immunosuppression: implications for the prevention and prediction of post-stroke infections. Journal of Neuroinflammation, 2021, 18 (1): 127. doi: 10.1186/s12974-021-02177-0.
[5] Bệnh viện Chợ Rẫy. Dấu hiệu nhận biết cơn đột quỵ sắp đến, 5/3/2020. https://bvcrheci.vn/dau-hieu-nhan-biet-con-dot-quy-sap-den/
[6] Smith C.J, Kishore A.K, Vail A, et al. Diagnosis of stroke-associated pneumonia: recommendations from the Pneumonia in Stroke Consensus Group. Stroke, 2015, 46 (8): 2335-40. doi: 10.1161/STROKEAHA.115.009617.
[7] Westendorp W.F, Nederkoorn P.J, Vermeij J.D et al. Post-stroke infection: a systematic review and meta-analysis. BMC Neurol, 2011, 11: 110. doi: 10.1186/1471-2377-11-110.
[8] Awere-Duodu A, Darkwah S, Osman A.H, Donkor E. A systematic review and meta-analysis show a decreasing prevalence of post-stroke infections. BMC Neurology, 2024, 24 (1): 479. doi: 10.1186/s12883-024-03968-7.
[9] Do Quyet, Nguyen Minh Hien et al. Risk factors for stroke associated pneumonia. Open Access Maced J Med Sci, 2019, 7 (24): 4416-4419. doi: 10.3889/oamjms.2019.873
[10] Chang M.C, Choo Y.J et al. The relationship between dysphagia and pneumonia in acute stroke patients: a systematic review and meta-analysis. Front Neurol, 2022, 13: 834240. doi: 10.3389/fneur.2022.834240.
[11] Hoffmann S, Harms H, Ulm L et al. Stroke-induced immunodepression and dysphagia independently predict stroke-associated pneumonia - the PREDICT study. J Cereb Blood Flow Metab, 2017, 37 (12): 3671-3682. doi: 10.1177/0271678X16671964.