Risk Factors For Stroke In Patients With Acute Cerebral Infarction Associated Pneumonia And Prognostic Studes

Subject:We analyse the risk factors of the stroke-associated pneumonia in patientswith acute cerebral infarction, explore the relationship between these risk factorsassociated with stroke, pneumonia, and the impact on the prognosis of cerebralinfarction.Methods:(1)822hospitalized patients with acute cerebral infarction clinical datawere collected after one month, three month follow-up from July2011to July2013period in Liuzhou People’s Hospital, Department of Neurology.(2) the cases were invided into pneumonia and control groups(non-pneumonia group) after the onset of cerebral infarction by a merger intopneumonia.(3) observation Index:observation in patients with general information: gender, age, medicalhistory (hypertension, heart disease, diabetes, chronic lung disease, cancer, stroke,≥10years of smoking history, etc.)main clinical data: disturbance of consciousness, difficulty swallowing,vomiting, indwelling stomach tube, trachea invasive procedures, site ofinfarction 【cerebral hemisphere infarction, brainstem/cerebellar infarction】,admission GCS score, NIHSS score.prognostic assessment data: a month after the onset of cerebral infarction,3month NIHSS scores, the average length of stay, average hospital charges,mortality and so on.Results:(1) Age comparison:Pneumonia group and the control group mean age of patients was66.95±11.35and61.53±10.14years old years old, the average age of patients withpneumonia was significantly higher, the difference between the two groups wasstatistically significant (P <0.001). Pneumonia group of patients≥60years ofage accounted for74.66%, significantly higher than58.24%, the differencebetween the two groups was statistically significant (P <0.001).(2) previous illness comparison:Previous pneumonia patients suffering from heart disease, diabetes,chronic lung disease, cancer, stroke, smoking history of10years, the ratio wassignificantly higher (P <0.05~0.001).(3) The comparison of the main clinical data:The main clinical data of patients with pneumonia, the occurrence of consciousness, difficulty swallowing, vomiting, indwelling stomach tube, theratio of the trachea invasive procedures, brainstem (and/or)cerebellarinfarction was significantly higher (P <0.001), admission GCS score scoredsignificantly lower than the control group (P <0.001), NIHSS score score wassignificantly higher (P <0.001).(4) Analysis of risk factors:The univariate analysis showed statistically significant risk factors, such as:previous heart disease, diabetes, chronic lung disease, cancer, stroke, smokinghistory of10years, advanced age, unconsciousness, difficulty swallowing,vomiting, indwelling stomach tube, trachea invasive procedures, brainstem (and/or) cerebellar infarction, lower GCS score, higher NIHSS score, theintroduction of Logistic regression model to calculate, suggesting previous heartdisease, diabetes, chronic lung disease10-year smoking history, as well asadvanced age, unconsciousness, difficulty swallowing, indwelling stomach tube,brainstem (and/or) cerebellar infarction, lower GCS score, higher NIHSS scorefactor may be independent risk factors associated pneumonia of acute cerebralinfarction patients after stroke.(5) The comparison of NIHSS scores after treatment:After1month and3months of treatment, pneumonia group and thecontrol group compared with baseline NIHSS score score slightly improved, butafter1month of treatment NIHSS score between the two groups was notstatistically significant improvement in value (P>0.05); after3months of treatment pneumonia group NIHSS score improvement was significantly betterthan the control group, the difference between the two groups NIHSS scoreimprovement was statistically significant values (P <0.001).(6)The comparison of the average length of hospital stay, cost andmortality:The average length of stay, average hospital costs of the pneumoniagroup patients were significantly higher, the difference between the two groupswere statistically significant (P <0.001). After1month and3months oftreatment, the mortality of pneumonia group patients were significantly higher,the difference between the two groups were statistically significant (P <0.001).Conclusion:（1）previous heart disease, diabetes, chronic lung disease,10-year historyof smoking, as well as advanced age, unconsciousness, difficulty swallowing,indwelling stomach tube, brainstem (and/or) cerebellar infarction, lower GCSscore, higher NIHSS score may be an independent risk factor forstroke-associated pneumonia.（2）Stroke-associated pneumonia in patients with acute cerebral infarction,average length of time, the cost increase, poor prognosis, and high mortalityafter1months and3months treatment, the survivors serious loss of nervefunction.