Analysis of clinical characteristics and risk factors of stroke-associated pneumonia in patients with acute cerebral hemorrhage / 中华老年医学杂志

ABSTRACT

Objective To explore the clinical characteristics and risk factors of strokeassociated pneumonia (SAP) in patients with acute cerebral hemorrhage.Methods A total of 375 patients with acute cerebral hemorrhage were selected from the department of neurology and neurosurgery during January 2013 to December 2015 in our hospital.According to the incidence of SAP,they were divided into the observation group (complicated with SAP,n =79) and control group (not complicated with SAP,n =296).Clinical data were collected,and clinical characteristics and related risk factors of SAP complicated with acute cerebral hemorrhage were analyzed.Results Among all the 79 SAP patients in observation group,there were 38 cases with gram-negative bacterial infections,25 cases with gram-positive bacterial infections,16 cases with mixed infections.The SAP incidence in patients with massive hemorrhage was higher than that in patients with nonmasive hemorrhage (x2 =11.301,P＜ 0.01),and was higher in patients with cerebellum,brainstem,ventricle,thalamus and multifoeal hemorrhage than that in patients with basal ganglion and brain lobe hemorrhage(x2 =4.023,P＜0.05).The hospitalization days of the observation group was longer than that of the control group [(32.7 ± 16.2) versus (17.3 ± 6.7),t=2.93,P＜ 0.01].The mortality of the observation group was higher than that of the control group (24.1％ versus 3.7％),(x2 =8.720,P＜ 0.01).Multivariate Logistic regression analysis showed that age≥ 65 (OR =4.87),underlying lung diseases (OR =5.30),bulbar paralysis (OR =7.39),disorder of consciousness (OR=4.11),NIHSS score ＞ 4 (OR =3.96),invasive airway operations (OR=3.78),gastric tube (OR =4.37),H2-receptor blocking agents application (OR =2.09) were independent risk factors for SAP in acute intraerebral hemorrhage patients.Conclusions Gram-negative bacteria are the main pathogens of SAP in patients with acute cerebral hemorrhage.The patients complicated with SAP after acute cerebral hemorrhage have poor prognosis including prolonged hospitalization period and higher mortality.SAP in acute intraerebral hemorrhage patients is closely related to the following factorsage≥65,underlying lung diseases,bulbar paralysis,disorder of consciousness,NIHSS score ＞ 4,invasive airway operations,gastric tube,H2-receptor blocking agents.