Effect of stroke-associated pneumonia on the prognosis of the elderly hospitalized for acute stroke in the intensive care unit / 中国综合临床

ABSTRACT

Objective To investigate the risk factors for death within 30 days of stroke associated pneumonia(SAP) in elderly patients of the intensive care unit (ICU).Methods Clinical data of 116 patients with SAP who were admitted to ICU were reviewed.The predicting factors of death within 30 days were analyzed through variable analysis method.Results The hospitalization periods of the SAP group and control group were (27±8) d and (12±5) d,the difference was statistically significant(t =1 1.30,P =0.002).The most common pathogenic bacteria in SAP were Klebsiella pneumoniae,Bauman Acinetobacter,Escherichia coli,and gram negative bacteria.There was significant difference between the two groups in term of mortality rate(37.9％(44/ 116) of SAP group,22.0％ (22/100) of control group,x2 =6.423,P =0.011).Logistic regression analysis showed that basic diseases(OR =2.778,95％ CI1.205-6.401),high CRUB-65 score (OR =1.978,95％ CI0.871-11.098),lower Glasgow coma score(GCS) (OR=3.601,95％CI0.244-9.477),bucking(OR=3.020,95％CI1.305-10.603),mechanical ventilation(OR=2.654,95％CI1.176-5.990),shock(OR=2.636,95％ CI1.164-5.969) and high plasma CRP level(OR=2.333,95％CI1.046-5.206) were risk factors for SAP (all P＜0.05).In Cox regression analysis,a GCS score of ＜ 9 was an independent risk factor for 30 d mortality of patientswithSAP(HR=7.23,95％Cl2.24-20.11,P=0.001).Conclusion SAP is one of the serious complications of the elderly hospitalized for the acute stroke in the ICU,which may affect the prognosis of the patients.