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Understanding definitive and probable stroke-associated pneumonia: Risk factors and clinical outcomes
Munevver Ece Guven1, Ulgen Yalaz Tekan2, Betül Zehra Pirdal3
1University of Health Sciences Trabzon Kanuni Training and Research Hospital, Department of Pain Medicine, Trabzon, Turkey.
Stroke-associated pneumonia (SAP) affects 18.2% of stroke patients, with definitive SAP linked to poorer outcomes. Lymphopenia and higher white blood cell counts are associated with increased pneumonia risk and severity.
Area of Science:
- Neurology
- Infectious Diseases
- Critical Care Medicine
Background:
- Stroke-associated pneumonia (SAP) is a common complication impacting patient recovery.
- Identifying risk factors and understanding the impact of inflammatory markers are crucial for managing SAP.
Purpose of the Study:
- To identify risk factors for SAP.
- To investigate SAP's impact on functional outcomes.
- To examine the role of white blood cell (WBC) count, C-reactive protein (CRP), and lymphocyte count in SAP development.
Main Methods:
- Retrospective study of 481 adult stroke patients admitted between September 2018 and June 2019.
- Stroke diagnosis confirmed by CT or MRI; classification using ICD-10 and Bamford Classification.
- WBC, CRP, NIHSS, and mRS were recorded to assess stroke severity and functional outcomes.
Main Results:
- 18.2% of patients developed pneumonia (78 SAP, 4 HAP).
- Definitive SAP (d-SAP) occurred in 11% of patients, associated with higher stroke severity (NIHSS) and poorer discharge outcomes.
- Lymphopenia correlated with pneumonia frequency, lesion size, and worse functional outcomes.
Conclusions:
- Definitive SAP is linked to increased stroke severity, atrial fibrillation, lower ejection fraction, and elevated WBC counts.
- Poor functional outcomes at discharge are strongly associated with definitive SAP.
- Lymphopenia is a significant predictor of pneumonia and adverse functional outcomes post-stroke.
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