Analysis of clinical characteristics and early prognosis in acute cerebral infarction patients complicated with pneumonia in areas of Xi'an city

  Objective  To investigate the clinical characteristics and the early prognosis of acute cerebral infarction (ACI) complicated with pneumonia in areas of Xi′an city.

  Methods  Clinical data of acute cerebral infarction (ACI) patients complicated with pneumonia who were consecutively admitted to four tertiary grade and class A hospitals from January to December 2015 in Stroke Data Bank of Xi′an city were collected, and the clinical characteristics of ACI patients who complicated with and without pneumonia were comparatively analyzed. The outcome events of 90 d follow-up including recurrence of stroke, death and poor prognosis were recorded. Multivariate logistic regression analysis was used to investigate the early prognosis of acute cerebral infarction (ACI) complicated with pneumonia in Xi'an district within 90 d of follow-up.

  Results  A total of 2 137 ACI patients were enrolled in our study, including 104 patients (4.87%) complicated with pneumonia. Compared with the ACI patients without pneumonia, the ACI patients who complicated with pneumonia had elder age, higher proportions in patients with National Institute Health Stroke Scale (NIHSS) score≥14 at admission and in those with a history of stroke, dysphagia by swallowing evaluation results as well as atrial fibrillation, lower proportion in those receiving swallow rehabilitation, and higher fasting blood glucose level, aspartate transaminase, urea nitrogen levels, and leucocyte count levels, there were significant differences between the two groups (P < 0.05 or P < 0.01). The ACI patients who complicated with pneumonia had worse prognosis of 90 d followed-up than that in patients without pneumonia. After adjustment for therelated confounders, multivariate Logistic regression analysis showed that the risk of 90 d death of followed-up in the ACI patients who complicated with pneumoniwas significantly increased (OR=3.88; 95%CI: 1.46~10.30, P < 0.01), the risk of early poor prognosis was significantly increased (OR=5.45; 95%CI: 2.60~11.42, P < 0.01). There were no obvious differences in early recurrence of stroke between two groups (P>0.05).

  Conclusion  Physicians should focus on the primary prevention of stroke in the elderly. According to the clinical characteristics of this district, it is of great significance to treating the post-stroke pneumonia in ACI patients to reduce early unfavorable prognosis.