Analysis Of Outcome And Risk Factors Of Stroke-associated Pneumonia After Thrombectomy In Patients With Acute Ischemic Stroke

【Objective】Stroke-associated pneumonia(SAP)is one of the common complications of acute ischemic stroke(AIS),and closely related to poor prognosis of acute ischemic stroke.Acute large vascular occlusive stroke is the most serious type of ischemic stroke,which has the characteristics of critical condition and high mortality.Endovascular therapy is the most effective method for patients with acute large vessel occlusion of stroke within the treatment time window.But the rate of poor outcome remains high in patients with large vessel occlusion.To our best knowledge,whether SAP affects outcome of acute larger artery occlusion of stroke is uncertain.This study mainly analyzed the effect of SAP on the prognosis of acute larger artery occlusion of stroke treated with endovascular thrombectomy and assessed the predictive factors of SAP in patients with larger artery occlusion undergoing endovascular thrombectomy.【Methods】A total of 152 patients with acute larger artery occlusion in the anterior circulation reveiving mechanical thrombectomy were retrospectively enrolled at the Departments of Neurology,Zhongshan Hospital,Xiamen University between March2016 and April 2020.According to modified Rankin scale(MRS)at 3 months from onset,all patients were divided into a good prognosis group(MRS<3)and a poor prognosis group(MRS≥3).Logistic regression was used to analyze whether SAP affected the prognosis at 3 months after mechanical thrombectomy.All patients were divided into two groups according to whether they had SAP(SAP group and non-SAP group).Logistic regression was used to analyze the predictors of SAP following thrombectomy.The goodness-of-fit of the model was tested by Hosmer-Lemeshow test.【 Results 】 SAP is an independent risk factor for poor outcome at 3 months after thrombectomy(OR=2.58,95% CI 1.13-5.87,P=0.024).In addition,advanced age(OR=1.07,95% CI 1.04-1.11,P=0.000),baseline NIHSS score(OR=1.09,95% CI1.02-1.17,P=0.018)and symptomatic intracranial hemorrhage(OR=22.19,95% CI2.34-210.5,P=0.007).Age(OR=1.05,95% CI 1.02-1.08,P=0.001)and disturbance of consciousness(OR=2.84,95% CI 1.41-5.73,p=0.004)were independently associated with SAP after intravascular thrombectomy in patients with acute anterior circulation of large vessel occlusion.【Conclusion】Stroke-associated pneumonia was an independent risk factor at 3 months adverse outcome after thrombectomy in acute ischemic stroke.Age and disturbance of consciousness at admission were independent predictors of SAP in patients with ischemic stroke undergoing mechanical thrombectomy.