Analysis Of Risk Factors And The Etiology Feature In Patients With Acute Stroke-Associated Pneumonia

ObjectiveTo ascertain the incidence ? risk factors ? microorganism of stroke-associated pneumonia(SAP) and mortality in acute stroke patients.MethodsWe retrospectively investigate clinical date of 649 patients of acute stroke treated in the general ward of the First Affiliated Hospital of Ji-nan University between Aug 2012 and Jul 2015.They were divided into SAP and non-SAP.Univariate analysis and multivariate logistic regression analysis were used to analyze the related risk factors for SAP,and analyze the pathogens.ResultsThe incidence of SAP in 649 patients of acute stroke was 14.6%,in which early-onset pneumonia(EOP) accounted for 73.7%.In different types of stroke,the incidence of SAP in cerebral infarct group was 13.5%,in cerebral hemorrhage group was 15.0%,in subarachnoid hemorrhage group was 36.4%(P=0.016).In different locations of stroke,the incidence of SAP in anterior circulation group was 9.1%,in posterior circulation group was 28.2%(P<0.05).The mortality of SAP was 26.3%,and the mortality of non-SAP was 11.2%,the mortality of SAP was significantly higher than non-SAP(P<0.05).The risk factors of SAP include age?65?locations and types of stroke?diabetes?smoking?disturbance of consciousness?hypoproteinemia?dysphagia?ventilator supporting ? antibiotic prophylaxis ? dehydrant ? inhibitors of proton pump,nasal feeding.There were 58 strains obtained by sputum culture.The percentage of the Gram-negative bacteria was 72.4%,the major strain was A.baumannii.The percentage of the Gram-postive was 22.4%,the major strains was Enterococcus.The percentage of the fungi was 5.2%,the major strains was Candida albicans.ConclusionsThe most SAP was occurred in the first 72 hours of admissions,of which Gram-negative bacteria play the most important role.The mortality of SAP was quite high in acute stroke.The incidence rate of SAP is different between different types and locations.