The A2DS2 Score As A Predictor Of Pneumonia In Acute Ischemic Stroke

ABSTRACT

Background:Stroke is the second leading cause of death worldwide. In the acute phase, stroke patients are susceptible to complications like chest infections, cardiac dysfunction, and urinary tract infections. Globally, the incidence of pneumonia among stroke patients is e stimated to be around 14%. The A2DS2 score (age, atrial fibrillation [AF], dysphagia, sex, and stroke severity using the National Institutes of Health Stroke Scale[NIHSS] score) is a simple scoring system to find risk of stroke associated pneumonia (SAP). Here our aim is planned to assess the risk of SAP in patients with acute stroke using the A2DS2 score.Material And Methods:This prospective observational study was conducted on patients with Ischemic stroke, time from symptom onset within 7 days and Age > 18 years admitted in tertiary care hospital. NIHSS score and A2DS2 score were calculated on admission. Follow up of all thepatients was done during their hospital stay and those who fulfilled Mann’s diagnostic criteria for pneumonia were diagnosed as SAP. Result:Out of 110 patients (M60, F50, Mean age 60.37+7.07), the commonest comorbidity was Hypertension (85, 77.27%) andthe commonest symptom was Facial Asymmetry (73, 66.4%). Among these, 19 (18.8%) patients developed SAP. Patients with SAP had higher mean age, male preponderance, commonest symptom dysphagia, higher NIHSS score and higher A2DS2 score. Patients with acute ischemic stroke who had high A2DS2 scores (5-10) higher risk of developing SAP and worse outcome (P <0.05). Conclusion:In conclusion, patients in the high A2DS2 score group had higher incidence of SAP and non-favourable outcome compared to patients with low A2DS2 scores who had more favourable outcomes: