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Bacterial pneumonia following acute ischemic stroke
Li-Fu Chen1, Cheng-Yu Chang, Li-Cho Hsu
1Department of Emergency Medicine, National Yang-Ming University Hospital, Yilan, Taiwan, ROC.
Journal of the Chinese Medical Association : JCMA
|January 29, 2013
Summary
Pneumonia following acute ischemic stroke is a severe complication. A low Glasgow Coma Scale (GCS) score (<9) on pneumonia onset predicts 30-day mortality in stroke patients.
Area of Science:
- Neurology
- Infectious Diseases
- Critical Care Medicine
Background:
- Pneumonia is a frequent and serious complication of acute ischemic stroke.
- This complication is associated with increased mortality and poorer clinical outcomes.
- Identifying predictors of mortality is crucial for managing these patients.
Purpose of the Study:
- To investigate predictors of 30-day mortality in patients who develop pneumonia after acute ischemic stroke.
Main Methods:
- Retrospective analysis of 51 patients with pneumonia post-acute ischemic stroke (June 2006 - May 2011).
- Analysis included clinical features, microbiological data, and outcomes.
- Univariate and multivariate analyses were used to identify mortality predictors.
Main Results:
- Large-artery atherosclerosis was the cause of stroke in 72.5% of patients.
- Klebsiella pneumoniae was the most common pathogen, followed by Pseudomonas aeruginosa and Escherichia coli.
- The 30-day mortality rate was 23.5%. Higher NIH Stroke Scale, CURB-65 scores, hemodynamic instability, and lower Glasgow Coma Scale (GCS) scores were associated with mortality.
- A GCS score <9 on the day of pneumonia onset was a significant predictor of 30-day mortality (HR, 6.72; 95% CI, 2.12-21.30; p=0.001).
Conclusions:
- Pneumonia is a severe complication after acute ischemic stroke.
- Neurologic assessment (GCS score), CURB-65 score, and shock are important for predicting prognosis in stroke-related pneumonia.
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