Incidence and Predictors of Aspiration Pneumonia Among Stroke Patients in Western Amhara Region, North-West Ethiopia: A Retrospective Follow Up Study

Lidetu, Tadios; Muluneh, Essey Kebede; Wassie, Gizachew Tadesse

doi:10.2147/ijgm.s400420

Cited by 11 publications

(3 citation statements)

References 53 publications

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“…The control group exhibited the highest proportion of AP cases (21.1%), while the ACEi + BB group had the lowest proportion (12.1%). These findings suggest that the control group, representing individuals receiving neither ACEi nor BB therapy, may be more predisposed to develop AP, as supported by related studies [ 37 , 38 ]. Further, patients diagnosed with AP rather than non-AP were found to have significantly higher PSI and CURB-65 scores across all four treatment groups, emphasising greater disease severity with AP compared to non-AP, irrespective of the treatment regimen.…”

Section: Discussionsupporting

confidence: 75%

The Potential Role of Angiotensin-Converting Enzyme Inhibitors and Beta-Blockers in Reducing Pneumonia Severity in Older Adults

Thomas,

Yoshimatsu,

Thompson

et al. 2024

Cureus

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Background Understanding the impact of pharmacological therapy on pneumonia severity is crucial for effective clinical management. The impact of angiotensin-converting enzyme inhibitors (ACEis) and beta-blockers (BBs) on pneumonia severity remains unknown, warranting further investigation. Methodology This retrospective study examined the hospital records of inpatients (≥75 years) admitted with community-acquired pneumonia in 2021. Pneumonia severity associated with the use of pre-established ACEi and BB therapy was documented using CURB-65 (confusion, uraemia, respiratory rate, blood pressure, age ≥65 years) and pneumonia severity index (PSI) scores. Descriptive statistics and multivariable linear regression were used to analyse differences across BB therapy, ACEi therapy, their combination, or neither (control group). Results A total of 803 patient records were examined, of whom 382 (47.6%) were male and 421 (52.4%) were female. Sample sizes for each group were as follows: control (n = 492), BB only (n = 185), ACEi only (n = 68), and BB + ACEi (n = 58). Distribution of aspiration pneumonia (AP) versus non-AP for each group, respectively, was control (21.1% vs. 78.9%), BB only (9.7% vs. 90.3%), ACEi only (7.3% vs. 92.7%), and ACEi + BB (12.1% vs. 87.9%). No significant differences in PSI and CURB-65 scores were found between intervention groups even after controlling for patient characteristics and irrespective of AP or non-AP aetiology. Patients with AP had significantly higher CURB-65 (p = 0.026) and PSI scores (p = 0.044) compared to those with non-AP. Conclusions Pre-prescribed ACEi or BB therapy did not appear to be associated with differences in pneumonia severity. There were no differences in pneumonia severity scores with ACEi and BB monotherapy or combined ACEi and BB therapy.

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Section: Discussionsupporting

confidence: 75%

The Potential Role of Angiotensin-Converting Enzyme Inhibitors and Beta-Blockers in Reducing Pneumonia Severity in Older Adults

Thomas,

Yoshimatsu,

Thompson

et al. 2024

Cureus

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“…According to the data obtained, inhibition of cholinergic signaling by vagotomy or the use of mice with nicotinic acetylcholine receptor deficiency stimulated an increased immune response and prevented pneumonia after stroke. These results showed an association between the cholinergic pathway and the risk of developing pneumonia (15). Due to reduced chewing, salivation, swallowing and oral hygiene, patients with acute stroke are particularly vulnerable to disruption of the microbial ecology of the oral cavity.…”

Section: Pathogenesis and Risk Factors Of Sapmentioning

confidence: 90%

Etiopathogenesis, diagnosis and treatment strategies for stroke-associated pneumonia

Kadyrov,

Mamytova,

Mamytova

et al. 2024

HVT

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The stroke-associated pneumonia (SAP) is considered an important risk factor for death following a stroke. It is important for clinicians to be able to recognize the causes of its occurrence, characteristic clinical and radiological signs and to be aware of treatment and prophylaxis in the early post-stroke period. This review article is devoted to the analysis and presentation of modern data on etiopathogenesis, modern strategies for early diagnosis and management of patients with stroke-associated pneumonia in the early post-stroke period. Design: Review of observational studies. Methods: We used following databases: PubMed, Web of Science, Scopus for the period of time 2019-2023 for studies search. Data from selected studies were extracted, including study design, data source, outcome definition, sample size, etiopathogenesis, diagnostic criteria and treatment strategies for stroke-associated pneumonia. Results: Totally 354 studies were reviewed, and after the selection process, 37 studies were included in this article. The incidence of stroke-associated pneumonia in patients with acute stroke ranged from 6.7 % to 37.98 %. Despite the abovementioned practical statements, there is currently no «gold standard» or generally accepted criteria for the diagnosis and treatment of SAP. As a rationale, detection of patients with the highest risk of SAP facilitates both prevention and treatment. The highest risks are associated with the age over 65, brain stem infarction with dysphagia, decreased throat and cough reflexes, impaired consciousness. Conclusion:The identification of high-risk patients requires knowledge of the modern criteria for diagnosing SAP. Since most SAP consists of aspiration pneumonia, hospital-acquired pneumonia, healthcare-associated pneumonia, pneumonia caused by artificial ventilation, partial diagnosis, treatment, rehabilitation, are related to the provision of medical care.

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“… 52 , 53 Aspiration pneumonia is one of the most important complications among hospitalized stroke patients. 54 Lidetu et al 55 found that the risk of developing aspiration pneumonia in patients with vomiting and dysphagia was higher than in patients without vomiting and dysphagia. For these reasons, it is considered natural for caregivers to associate nausea and vomiting with aspiration.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of aspiration risk by relatives of inpatients in the neurology service: A metaphor analysis

Kaş,

Çakır,

Kocatürk

2023

Health Expectations

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BackgroundThe risk of aspiration is high in stroke patients due to dysphagia/loss of swallowing. This problem can cause problems affecting the nutrition of patients. Due to the possible risk of aspiration during feeding, patient relatives are hesitant to feed their patients. Because of this fear, malnutrition and hospital readmissions may increase. It is important to evaluate the fear of aspiration risk of relatives of patients hospitalized in the neurology service. The aim of this study is to determine the views of the relatives of patients treated in the neurology service about the risk of aspiration through metaphors.MethodThis article analyzed metaphors of patients' relatives' about the risk of aspiration. The analysis uses metaphor identification and analysis. The research sample consisted of 31 patients. First of all, in the study, evaluation of the data was conducted by performing content analysis, as a result of which it was divided into metaphors and conceptual categories, and the relevant field was associated with the text (event, thought, feelings, related in speech or writing). In the reporting of research, the Consolidated Criteria for Reporting Qualitative Research (COREQ) checklist was used.ResultsIt was seen that the patients' relatives produced 31 different metaphors in response to the statement ‘Aspiration risk is like …, because it is …’ The patients' relatives mostly compared the concept of ‘fear of aspiration’ to the concept of ‘fear’ (n: 24).ConclusionsIn this study, relatives mostly described the concept of fear related to the risk of aspiration. According to this result, patients' relatives have a great fear of aspiration increasing the risk of readmission to hospital and of malnutrition. This result shows that informing patients' relatives will increase awareness and will allow them to provide informed care.Patient and Public ContributionCollaborated with patients and their relatives regarding the risk of aspiration and contributed to the planning of care for the risk of aspiration.

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Incidence and Predictors of Aspiration Pneumonia Among Stroke Patients in Western Amhara Region, North-West Ethiopia: A Retrospective Follow Up Study

Cited by 11 publications

References 53 publications

The Potential Role of Angiotensin-Converting Enzyme Inhibitors and Beta-Blockers in Reducing Pneumonia Severity in Older Adults

The Potential Role of Angiotensin-Converting Enzyme Inhibitors and Beta-Blockers in Reducing Pneumonia Severity in Older Adults

Etiopathogenesis, diagnosis and treatment strategies for stroke-associated pneumonia

Evaluation of aspiration risk by relatives of inpatients in the neurology service: A metaphor analysis

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