Construction Of Early Warning Score Of Pneumonia In The Patients With Acute Ischemic Stroke

Objective: Through the Meta-analysis to identify risk factors for acute ischemic stroke associated pneumonia; Based on the risk factors of moderate intensity in Meta-analysis to construct the early warning score of acute ischemic stroke associated pneumonia, clear the risk of pneumonia early, and screen high risk patients as the population of focusing by nurses.Methods: We searched literature published from Medline, Embase, Cochrane Library, China Biomedical Literature database(CBM) and Chinese Academic Degree Theses database,used Revman5.3 statistical software for quantitative analysis in data extraction literatures, count data using the OR and 95% CI as the effect of the amount of the merger; Retrospect acute ischemic stroke patients in a three level of first-class hospital in Shanxi Province during 2014.10-2014.12, the occurrence of stroke associated pneumonia as the dependent variable, 60 years of age or older, atrial fibrillation, coronary heart disease, tracheal invasive operation, dysphagia, hypoproteinemia as variables to establish logistic regression model. According to the regression coefficient of risk factors selected respectively to establish early warning score and to evaluate the risk of acute ischemic stroke associated pneumonia.Results: Based on the inclusion and exclusion criteria, 15 articles were screened for Meta–analysis. Including 9 cohort studies and 6 case-control studies. A total of 24472 cases, including pneumonia group and non-pneumonia group were 3049 and 21423 respectively, 60 years of age or older, male, diabetes atrial fibrillation,coronary heart disease, hypertension, trachea, invasive operation, dysphagia and hypoalbuminemia may increase the risk of associated pneumonia after acute ischemic stroke patients; According to multivariate logistic regression analysis to establish regression model y=1.304*age +1.736*atrial fibrillation +1.207*coronary heart disease +2.842*tracheal invasive operation +2.219* dysphagia +1.118*hypoalbuminemia.. Early warning score: Age more than or equal to 60 years old was 1.3 points, atrial fibrillation was 1.7 points,coronary heart disease(CHD) was 1.2 points, tracheal invasion operation was 2.8 points, dysphagia was 2.2 points and hypoproteinemia was 1.1 points. Scores of 10.3 points, which 0~4.9 points were divided into low- risk groups, 5~10.3 points were divided into high-risk groups. The area under the ROC curve of the score was 0.83, sensitivity and specificity was respectively 80.4% and 76.6%.Conclusion: The early warning score of acute ischemic stroke associated pneumonia is simple and practical. It can provide the basis for assessing risk of stroke associated pneumonia, and suggest that clinical nurses should give the patients at high-risk much closer observation and targeted nursing measures to reduce the occurrence of acute ischemic stroke associated pneumonia.