Risk factors for periodic breathing in acute stroke: tracheobronchial infection

Despite evidence from clinical and population studies, the aim of the present study was to suggest that multiple factors contribute to periodic breathing (PB). However, little information has been focused on episodes of tracheobronchial infections (TBI) preceding PB onset.

Thirty subjects with acute stroke who had PB and 41 subjects with acute stroke that of a sex- and age-matched control group without PB were retrospectively evaluated. Stroke location, extent of stroke (demonstrated on CT or MRI), and characteristics of TBI before PB were assessed. PB diagnosis was carried out using a portable device and a pulse oximeter. Risk factors for patients with PB were compared with those without PB by univariate and multivariate analysis.

Twenty-four TBI in 30 patients with PB and 11 TBI in 41 patients with non-PB were diagnosed. There was no significant difference in age, sex, body mass index, stroke type, stroke location, or underlying diseases between the two groups (P > 0.05). There was a significant difference in snoring, first recurrent stroke, Glasgow Coma Scale, congestive heart failure, TBI, and inflammatory responses between the PB and non-PB group (P < 0.05). Multiple logistic regression analyses showed a difference in the prevalence of snoring (OR = 10.813, CI = 2.131-54.866, P < 0.01), TBI (OR = 5.313, CI = 1.241-22.740, P < 0.05), and inflammatory responses (OR = 7.315, CI = 1.253-43.123, P < 0.05) between the two groups.

In addition to snoring, TBI and inflammatory responses are the two independent predictors for PB in patients with acute stroke. Clinicians should be encouraged to systematically evaluate TBI and inflammatory responses before PB in patients with acute stroke.