Risk Factors Of Stroke-Associated Pneumonia

Objective:Stroke-associated pneumonia(SAP) is one of the most frequent complications in acute stroke patients.The purpose of this study is to explore the risk factors of stroke-associated pneumonia and to abtain a father understanding of SAP.Metheds :A retrospective analysis was carried out to invesgate the stroke patients admitted to the neurological intensive care unit at our hospital during January 1st, 2005 to January 1st 2oo7.Three main aspects of stroke patients were observed:basic state(including age,sex,smoking history,diabetes history,heart disease history) , related factors of stroke(including apoplexy position,category of cerebral stoke and conscious state),treatment after admission(including tube feeding,use of dehydrant,gastric mucosal protective drugs and prophylatic antibiotic).All the stroke patients were divided into two or more groups by different factors as followings:age,sex,smoking history,diabetes history,heart disease history,apoplexy position,category of cerebral stoke,conscious state,tube feeding,whether use dehydrant and gastric mucosal protective drugs,and whether prophylactic use of antibiotic. Comparison in incidence of SAP between different groups use chi square test.Multivariable logistic regression analysis was used after univariate analysis.Results:1,SAP occurred in 310(52.1﹪)of 595 patients,early-onset pneumonia developed in 225(72.6﹪)of SAP and late-onset pneumonia developed in 85(27.4﹪).2,The totle number of hospital stay more than 3 weeks was 113 (50.3﹪)in early-onset pneumonia patients.3,The incidencr of 1week onset was 70.6﹪in late-onset pneumonia patients.4,In single factor analysis there was statistical difference between the two groups divided by agae,history of heart disease,diabetes,apoplexy position,category of cerebral stoke,conscious state,tube feeding,and use of dehydrant,gastric mucosal protective drugs,prophylatic antibiotic.5,Multiple factor analysis indicated that when age increases one year,the incidence of SAP increases 1.037 times; the incidence of SAP in diabetes patients is 1.724 times than non-dibetes; when GCS score raises one point, the incidence decreases 0.908 times; the incidence rate in tube feeding patients is 6.640 times than non-nasal feeding patients; the incidence rate in patients who use gastric mucosal protective drugs is 3.581 times than those who not use; and the incidence rate in patients who use antibiotic preventively is 2.433 times than those who not use.Conclusions:1,SAP could make patients stay longer in hospital.2,Most stroke patients get SAP earlier .3,SAP is closed related to the following risk factors: patients age,diabetes,conscious state,tube feeding,and use of gastric mucosal protective drugs,antibiotic prophylaxis.