Analysis of risk factors for pneumonia associated to elderly patients with cerebral stroke / 中华老年医学杂志

ABSTRACT

Objective To investigate the risk factors of pneumonia associated to elderly patients with cerebral stroke.Methods Totally 248 elderly patients with stroke were retrospectively analyzed on medical history,treatment and prognosis.Results In 248 cases of senile stroke patients,78 cases had an associated pneumonia,accounting for 31.5％.The onset with admission period ≥48 h was in majority (48 cases),less than 48 h in 30 cases (38.5％).12 patients (15.4％)were involved blood culture,38 cases sputum culture,accounting for 48.7％.In the univariate correlation analysis,older age,consciousness,basic diseases,stroke location,NIHSS score of nasal feeding therapy were associated with associated pneumonia (all P＜0.05).As compared to patients without no associated pneumonia,the patients with associated pneumonia had more aged and higher proportions of bulbar paralysis and impaired consciousness,more underlying diseases.At the time of admission,increased occurrences of National Institute of Health Stroke Scale (NIHSS) score,brainstem stroke and multiple feeding treatment appeared in most of patients.Multivariate Logtistic regression analysis showed that age≥ 65 years,history of pulmonary disease,bulbar paralysis,disturbance of consciousness,nasal treatment among older stroke were the associated pneumonia risk factors.The hospitalized time was prolonged [(31.3±20.4)d and(17.6±8.1)d,t＝7.57,P＝0.001] and fatality rate increased (41.0％ vs.4.1％) in patients with pneumonia than without pneumonia(x2＝ 54.96,P＝ 0.000).The independent factors of death were aged ≥ 75 years(OR＝1.6,95％CI1.0-2.6),NIHSS＞13 (OR＝5.0,95％CI1.7-24.6) and pulmonary infection(OR＝5.2,95％ CI1.8-17.3).Conclusions The occurrence of associated pneumonia in elderly patients with cerebral stroke is related with age,underlying disease,state of consciousness and NIHSS scores.The prevention and treatment of relevant factors can improve prognosis.