Evaluation of a novel scoring system based on thrombosis and inflammation for predicting stroke-associated pneumonia: A retrospective cohort study

Abstract

BackgroundInflammation and thrombosis are involved in the development of stroke-associated pneumonia (SAP). Our aim was to evaluate the predictive value of a novel, simplified, thrombo-inflammatory prognostic score (TIPS) that combines both inflammatory and thrombus biomarkers in the early phase of ischemic stroke (IS).MethodsThe study population consisted of 897 patients with a first diagnosis of IS admitted to the emergency department of five tertiary hospitals in China. Of these, the data from 70% of patients was randomly selected to derive the model and the other 30% for model validation. A TIPS of “2” was indicative of high inflammation and thrombosis biomarkers and “1” of one biomarker, with “0” indicative of absence of biomarkers. Multivariate logistic regression analyses were used to identify the association between TIPS and SAP.ResultsThe TIPS was an independent predictor of SAP and 90-day mortality, with the incidence of SAP being significantly higher for patients with a high TIPS. The TIPS provided superior predictive value for SAP than clinical scores (A2DS2) and biomarkers currently used in practice, for both the derivation and validation sets. Mediation analysis revealed that TIPS provided a predictive value than either thrombotic (NLR) and inflammatory (D-dimer) biomarkers alone.ConclusionThe TIPS score may be a useful tool for early identification of patients at high-risk for SAP after IS.

Thrombo-inflammatory prognostic score can predict the outcome of stroke: a retrospective cohort study

“…Notably, the implementation of TIPS based on D-dimer and PCT levels has improved the risk stratification of patients with sepsis ( Li et al, 2018 ). Moreover, TIPS has proven to be a valuable tool for the early identification of high-risk patients for SAP after IS ( Li et al, 2023 ).…”

“…However, the current biomarkers and assessment tools fall short of their required clinical value. Our preliminary study showed that the combined use of thrombo-inflammatory markers can provide more prognostic information than a single thrombus or validated marker does ( Li et al, 2023 ). The thrombo-inflammatory prognostic score (TIPS) stands out as an emerging risk assessment tool with unique advantages.…”