Correlation Analysis Of Neutrophil To Albumin Ratio Combined With A~2DS~2 In Stroke-associated Pneumonia

Objective:This study was conducted to explore the independent risk factors for Stroke-Associated Pneumonia(SAP)in patients with Acute Ischemic Stroke(AIS)through a retrospective study,and whether Neutrophil count albumin ratio(NAR),a novel inflammatory index,can predict the occurrence of SAP,reduce the probability of SAP,improve the prognosis of AIS patients,and combine with A~2DS~2 score to form a new scoring model,whether the predictive ability of SAP is better than the original model.Method:204 patients with acute cerebral infarction who attended the Department of Neurology of the Affiliated Hospital of Guilin Medical College from August 2020 to August 2022 and had onset within 72 hours were collected with baseline data(including age,sex,history of alcohol consumption,history of smoking,history of previous stroke,hypertension,type 2 diabetes,coronary artery disease,atrial fibrillation,and whether they used acid-suppressing drugs such as proton pump inhibitors)and corresponding clinical data(e.g.,admission time,NIHSS score[National Institute of Health Scale],infarct site,swallowing dysfunction)and post-admission imaging data(cranial CT,CT brain perfusion,MRI),post-admission laboratory data(e.g.,neutrophil count)Laboratory data(e.g.neutrophil count,white blood cell count,LDL,lymphocyte count,albumin,HDL,triglycerides,glucose,homocysteine,calculation of NLR,NAR values)after admission.They were divided into SAP and non-SAP groups according to whether SAP occurred after admission,and the data differences between SAP and non-SAP groups were compared using one-way analysis,and the data differences between the two groups were statistically significant(P<0.05),and logistic regression was included to analyze the independent risk factors for SAP.The predictive value of NAR was analyzed by the Receiver Operating Characteristic(ROC)curve,and the best cut-off values of NAR and NLR were combined with the A~2DS~2 scoring model to form a new scoring model to compare whether the predictive value of the new model was better than the original model.Results:There were 204 acute stroke patients attending the Department of Neurology of the Affiliated Hospital of Guilin Medical College,of which 68patients(mean age 69.3 years)were in the SAP group and 135 patients(32.4%)were in the non-SAP group,with a mean age of 61.5 years.inhibitors,gastric tube placement,white blood cell count,neutrophil count,lymphocyte count,albumin,HDL,triglycerides,glucose,NLR,and NAR were statistically different from the non-SAP group(P<0.05).In multifactor logistic regression analysis,the p values corresponding to the variables admission NIHSS score,diastolic blood pressure,acid suppressant,and NLR were less than 0.05 by multifactor binary logistic regression analysis at the test level ofα=0.05 and were statistically significant,and the new models NAR-A~2DS~2,NLR-A~2DS~2 and the original scoring model with univariate typing were statistically different(p<0.05),and the new model had elevated sensitivity in comparison with the original scoring model.Conclusions:1.Admission NIHSS score,use of proton pump inhibitors or not,NLR,NAR,A~2DS~2 are independent risk factors for the development of stroke-associated pneumonia.2.NAR and NLR can be used as one of the predictors for the development of SAP in stroke patients.3.The combined scoring model A~2DS~2 of NAR and NLR forms the new models NAR-A~2DS~2,NLR-A~2DS~2 may have better predictive value for the occurrence of SAP.