Analysis Of Risk Factors Of Pulmonary Infection In Patients With Acute Ischemic Cerebral Infarction

Purpose:With the rapid development of China's economy and the continuous improvement of people's living standards,cerebrovascular diseases in China have become one of the most common diseases threatening human life and health,in which cerebral infarction accounts for 70% and there is a high rate of disability and mortality.Pulmonary infection is one of the most common complications in patients with acute cerebral infarction.This study explored the risk factors of pulmonary infection after acute cerebral infarction in clinical practice.Through the retrospective analysis of the clinical data of patients with acute cerebral infarction in the real world,it provides the relevant basis for the prediction of pulmonary infection in patients with acute cerebral infarction,improvement of prognosis and reduction of hospitalization cost.Method:1.This study is a single-center,real-world,retrospective analysis study.Detailed clinical data of 280 patients with acute cerebral infarction who were hospitalized in chengdu shuangliu district first people's hospital on January 1,2017 and December 30,2017 were collected.Detailed record patients' age,gender,hospitalization days,hospitalization expenses,history of smoking,history of basic diseases,(eg:diabetes,hypertension,chronic obstructive pulmonary disease(copd),cerebrovascular accident history,history of coronary heart disease,organ dysfunction),with or without respiratory tractinvasive operation,aspiration and difficulty swallowing,placing nasogastric tube,nutritional status,nutritional risk screening score,Acute physiology and chronic health evaluation II,Glasgow coma scale(GCS),white blood cell count,lymphocyte count,lymphocyte ratio,Random blood glucose,brain CT/MRI scan,cerebral infarction volume,etc.2.Patients with pulmonary infection after acute cerebral infarction were classified as pulmonary infection group,while those without pulmonary infection were classified as non-pulmonary infection group.After referring to relevant literatures,18 factors that may be related to pulmonary infection after acute cerebral infarction were selected for study.To patients' age,history of smoking,history of basic diseases(chronic obstructive pulmonary disease(COPD),history of coronary heart disease),history of cerebrovascular accident,organ dysfunction,with or without respiratory tract invasive operation,aspiration and difficulty swallowing,placing nasogastric tube,nutritional status,nutritional risk screening score,Acute physiology and chronic health evaluation II,Glasgow coma scale(GCS),white blood cell count,lymphocyte count,lymphocyte ratio,random blood glucose,the respect such as cerebral infarction volume comparing single factor and multiple factors Logistic regression analysis.3.In this study,SPSS 25.0 statistical software was used for data entry and analysis.For the measurement data,the Shapiro-Wilk test was used for the normal distribution test,and the Levene test was used for the measurement data that followed the normal distribution.If the variance is equal,the t test is used for comparison between the two groups.The results are expressed as mean ± standard deviation(??± s).The count datais represented by the composition ratio.The two sets of count data were compared using the chi-square test of the two-table data,P < 0.05 was considered statistically significant.Results:1.A total of 280 patients with acute cerebral infarction were included in this study,including 77 patients with pulmonary infection.Through comparative analysis of the differences between the pulmonary infection group and the non-pulmonary infection group,Counting data were found by univariate analysis: chronic obstructive pulmonary disease(COPD),history of coronary heart disease,organ dysfunction,nutritional status,cerebral infarction volume,aspiration,difficulty swallowing,respiratory tract invasive operation,placing nasogastric tube,and patients with acute,ischemic cerebral infarction is related lung infection(P <0.05).History of smoking,previous history of cerebrovascular disease and the occurrence of pulmonary infection were not significantly correlated,and the difference was not statistically significant(P > 0.05).2.Single factor analysis results of measurement data show that: There were significant differences in age,APACHE II score at admission,GCS score at admission,nutritional risk screening score,white blood cell count and lymphocyte ratio in the presence or absence of pulmonary infection(P < 0.05).In the infected group,Age,APACHE II score at admission,GCS score at admission,WBC count and nutritional risk screening score were all higher than those in the non-infected group,while the ratio of lymphocytes was lower than that in the non-infected group.There was no significant difference in lymphocyte count and glucose at admission between the two groups(P > 0.05).3.The independent variableswere age,basic disease history,organ dysfunction,APACHE II score,GCS score,nutritional status,nutritional risk screening score,white blood cell count lymphocyte ratio,aspiration,difficulty swallowing,Invasive airway operation,placing the tube and GCS score at admission.and whether lung infection was the dependent variable.Multivariate Logistic regression analysis was performed.The results showed that: Basic disease history(chronic obstructive pulmonary disease and coronary heart disease),APACHE II score,nutritional risk screening score,cerebral infarction volume,white blood cell count,lymphocyte ratio,aspiration,dysphagia and GCS score at admission were risk factors for pulmonary infection in patients with acute cerebral infarction(P <0.05).Conclusions: 1.lung infection after acute cerebral infarction is caused by multiple factors,Single factor analysis was found that age,basic disease history,(history of chronic obstructive pulmonary disease,COPD,and coronary heart disease),organ dysfunction,nutritional status,cerebral infarction volume,aspiration,difficulty swallowing,respiratory tract invasive operation,placing nasogastric tube,APACHE II score,GCS score on admission,admission nutritional risk screening score,leukocyte count,The proportion of lymphocyte,cerebral infarction volume associated with lung infection in the aftermath of the acute cerebral infarction.2.Multivariate analysis showed that the high risk factors of pulmonary infection in patients with acute cerebral infarction were: basic disease history(COPD,history of coronary heart disease),admission APACHE II score,dysphagia,aspiration,cerebral infarction volume,nutritional risk screening score,lymphocyte ratio,GSC score at admission and white blood cell count;3.This study is the first to find that APACHE II score on admission and nutritional risk screening score are related to pulmonary infection occurs after acute cerebral infarction.