Analysis of clinical characteristics and early prognosis in acute cerebral infarction patients complicated with pneumonia in areas of Xi'an city

ZHANG Na; WU Songdi; LIN Xuemei; LIU Zhongzhong

doi:10.7619/jcmp.201920002

Journal of Clinical Medicine in Practice > 2019 > 23(20): 6-10, 14. > DOI: 10.7619/jcmp.201920002

ZHANG Na, WU Songdi, LIN Xuemei, LIU Zhongzhong. Analysis of clinical characteristics and early prognosis in acute cerebral infarction patients complicated with pneumonia in areas of Xi'an city[J]. Journal of Clinical Medicine in Practice, 2019, 23(20): 6-10, 14. DOI: 10.7619/jcmp.201920002

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Analysis of clinical characteristics and early prognosis in acute cerebral infarction patients complicated with pneumonia in areas of Xi'an city

Department of Neurology, Xi′an First Hospital, Xi′an, Shaanxi, 710002

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Received Date: August 09, 2019
Accepted Date: September 24, 2019
Available Online: February 28, 2021
Published Date: October 27, 2019

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Abstract

Abstract

Objective To investigate the clinical characteristics and the early prognosis of acute cerebral infarction (ACI) complicated with pneumonia in areas of Xi′an city.
Methods Clinical data of acute cerebral infarction (ACI) patients complicated with pneumonia who were consecutively admitted to four tertiary grade and class A hospitals from January to December 2015 in Stroke Data Bank of Xi′an city were collected, and the clinical characteristics of ACI patients who complicated with and without pneumonia were comparatively analyzed. The outcome events of 90 d follow-up including recurrence of stroke, death and poor prognosis were recorded. Multivariate logistic regression analysis was used to investigate the early prognosis of acute cerebral infarction (ACI) complicated with pneumonia in Xi'an district within 90 d of follow-up.
Results A total of 2 137 ACI patients were enrolled in our study, including 104 patients (4.87%) complicated with pneumonia. Compared with the ACI patients without pneumonia, the ACI patients who complicated with pneumonia had elder age, higher proportions in patients with National Institute Health Stroke Scale (NIHSS) score≥14 at admission and in those with a history of stroke, dysphagia by swallowing evaluation results as well as atrial fibrillation, lower proportion in those receiving swallow rehabilitation, and higher fasting blood glucose level, aspartate transaminase, urea nitrogen levels, and leucocyte count levels, there were significant differences between the two groups (P < 0.05 or P < 0.01). The ACI patients who complicated with pneumonia had worse prognosis of 90 d followed-up than that in patients without pneumonia. After adjustment for therelated confounders, multivariate Logistic regression analysis showed that the risk of 90 d death of followed-up in the ACI patients who complicated with pneumoniwas significantly increased (OR=3.88; 95%CI: 1.46~10.30, P < 0.01), the risk of early poor prognosis was significantly increased (OR=5.45; 95%CI: 2.60~11.42, P < 0.01). There were no obvious differences in early recurrence of stroke between two groups (P>0.05).
Conclusion Physicians should focus on the primary prevention of stroke in the elderly. According to the clinical characteristics of this district, it is of great significance to treating the post-stroke pneumonia in ACI patients to reduce early unfavorable prognosis.
- acute cerebral infarction,
- pneumonia,
- clinical features,
- early prognosis,
- recurrence of stroke

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[1]	Kammersgaard L P, Jørgensen H S, Reith J, et al. Early infection and prognosis after acute stroke: the Copenhagen stroke study[J]. J Stroke Cerebrovasc Dis, 2001, 10(5): 217-221. doi: 10.1053/jscd.2001.30366
[2]	Sellars C, Bowie L, Bagg J, et al. Risk factors for chest infection in acute stroke: a prospective cohort study[J]. Stroke, 2007, 38(8): 2284-2291. doi: 10.1161/STROKEAHA.106.478156
[3]	Katzan I L, Cebul R D, Husak S H, et al. The effect of pneumonia on mortality among patients hospitalized for acute stroke[J]. Neurology, 2003, 60(4): 620-625. doi: 10.1212/01.WNL.0000046586.38284.60
[4]	Heuschmann P U, Kolominsky-Rabas P L, Misselwitz B, et al. Predictors of in-hospital mortality and attributable risks of death after ischemic stroke: the German stroke registers study group[J]. Arch Intern Med, 2004, 164(16): 1761-1768. doi: 10.1001/archinte.164.16.1761
[5]	Koennecke H C, Belz W, Berfelde D, et al. Factors influencing in-hospital mortality and morbidity in patients treated on a stroke unit[J]. Neurology, 2011, 77(10): 965-972. doi: 10.1212/WNL.0b013e31822dc795
[6]	Vargas M, Horcajada J P, Obach V, et al. Clinical consequences of infection in patients with acute stroke: is it prime time for further antibiotic trials[J]. Stroke, 2006, 37(2): 461-465. doi: 10.1161/01.STR.0000199138.73365.b3
[7]	邹芳, 田晔, 吴卫国, 等. 基于非结构化电子病历的脑卒中数据挖掘管理系统设计和实现[J]. 中国数字医学, 2015, 10(3): 41-44. https://www.cnki.com.cn/Article/CJFDTOTAL-YISZ201503017.htm
[8]	Asplund K, Tuomilehto J, Stegmayr B, et al. Diagnostic criteria and quality control of the registration of stroke events in the MONICA project[J]. Acta Med Scand Suppl, 1988, 728: 26-39. http://www.ncbi.nlm.nih.gov/pubmed/3202029
[9]	Wang Y J, Zhao X Q, Liu L P, et al. Prevalence and outcomes of symptomatic intracranial large artery stenoses and occlusions in China: the Chinese intracranial atherosclerosis (CICAS) study[J]. Stroke, 2014, 45(3): 663-669. doi: 10.1161/STROKEAHA.113.003508
[10]	Vermeij F H, Scholte op Reimer W J, de Man P, et al. Stroke-associated infection is an independent risk factor for poor outcome after acute ischemic stroke: data from the Netherlands Stroke Survey[J]. Cerebrovasc Dis, 2009, 27(5): 465-471. doi: 10.1159/000210093
[11]	李慎军, 胡怀强, 王晓玲, 等. 急性脑梗死患者卒中后肺炎与预后的关系[J]. 中华医学杂志, 2016, 96(35): 2796-2801. doi: 10.3760/cma.j.issn.0376-2491.2016.35.007
[12]	Ovbiagele B, Hills N K, Saver J L, et al. Frequency and determinants of pneumonia and urinary tract infection during stroke hospitalization[J]. J Stroke Cerebrovasc Dis, 2006, 15(5): 209-213. doi: 10.1016/j.jstrokecerebrovasdis.2006.05.004
[13]	Chumbler N R, Williams L S, Wells C K, et al. Derivation and validation of a clinical system for predicting pneumonia in acute stroke[J]. Neuroepidemiology, 2010, 34(4): 193-199. doi: 10.1159/000289350
[14]	Popovic N, Stefanovic-Budimkic M, Mitrovic N, et al. The frequency of poststroke infections and their impact on early stroke outcome[J]. J Stroke Cerebrovasc Dis, 2013, 22(4): 424-429. doi: 10.1016/j.jstrokecerebrovasdis.2013.03.003
[15]	Maeshima S, Osawa A, Hayashi T, et al. Elderly age, bilateral lesions, and severe neurological deficit are correlated with stroke-associated pneumonia[J]. J Stroke Cerebrovasc Dis, 2014, 23(3): 484-489. doi: 10.1016/j.jstrokecerebrovasdis.2013.04.004
[16]	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. doi: 10.1161/01.STR.0000063373.70993.CD
[17]	Joundi R A, Martino R, Saposnik G, et al. Predictors and outcomes of dysphagia screening after acute ischemic stroke[J]. Stroke, 2017, 48(4): 900-906. doi: 10.1161/STROKEAHA.116.015332
[18]	Ho C H, Lin W C, Hsu Y F, et al. One-year risk of pneumonia and mortality in patients with poststroke dysphagia: A nationwide population-based study[J]. J Stroke Cerebrovasc Dis, 2018, 27(5): 1311-1317. doi: 10.1016/j.jstrokecerebrovasdis.2017.12.017
[19]	黄振华, 曾庆理, 肖孝勇, 等. 糖尿病合并急性脑卒中并发医院获得性肺炎的临床特征和危险因素[J]. 热带医学杂志, 2018, 18(2): 177-180, 220. https://www.cnki.com.cn/Article/CJFDTOTAL-RDYZ201802011.htm
[20]	Castellanos M R, Szerszen A, Saifan, et al. Fasting hyperglycemia upon hospital admission is associated with higher pneumonia complication rates among the elderly[J]. Int Arch Med, 2010, 3: 16-16. doi: 10.1186/1755-7682-3-16
[21]	Suda S, Aoki J, Shimoyama T, et al. Stroke-associated infection independently predicts 3-month poor functional outcome and mortality[J]. J Neurol, 2018, 265(2): 370-375. doi: 10.1007/s00415-017-8714-6
[22]	郝俊杰, 郑天衡, 王少石. 急性卒中后肺炎的早期风险识别和预防[J]. 中国卒中杂志, 2010, 5(2): 157-163. https://www.cnki.com.cn/Article/CJFDTOTAL-ZUZH201002018.htm

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