Predictors of pneumonia in patients with acute spontaneous intracerebral hemorrhage in Algarve, Southern Portugal

Soares, Rita; Fernandes, Adriana; Taveira, Isabel; Marreiros, Ana; Nzwalo, Hipólito

doi:10.1016/j.clineuro.2022.107387

Cited by 7 publications

(5 citation statements)

References 23 publications

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“…Screening for swallowing function may reduce pneumonia incidence. This demonstrates the importance of DS in patients with ICH and supports the inclusion of DS as a performance indicator for improving stroke quality 11 34. Among them, DS and management is part of the process of quality of care.…”

Section: Discussionsupporting

confidence: 53%

“…This demonstrates the importance of DS in patients with ICH and supports the inclusion of DS as a performance indicator for improving stroke quality. 11 34 Among them, DS and management is part of the process of quality of care. Nursing processes ensure the collection of complete and accurate information during evaluation, facilitate the development of personalised treatment plans and contribute to the continuous and coordinated long-term management, allowing for timely adjustments to meet the changing needs of patients.…”

Section: Discussionmentioning

confidence: 99%

“…The process of care, which should be in a concrete and organised manner and use multidisciplinary management, determines the frequency of several complications, including pneumonia in stroke patients 10. Therefore, intensification of preventive intervention in high-risk patients and improvement of the process of care can reduce pneumonia occurrence after ICH 11. Dysphagia is an important risk factor for pneumonia12 that affects 37%–78% of all patients with stroke 13 14.…”

Section: Introductionmentioning

confidence: 99%

“… 10 Therefore, intensification of preventive intervention in high-risk patients and improvement of the process of care can reduce pneumonia occurrence after ICH. 11 Dysphagia is an important risk factor for pneumonia 12 that affects 37%–78% of all patients with stroke. 13 14 Dysphagia can cause significant complications, including dehydration, malnutrition and respiratory infections.…”

Section: Introductionmentioning

confidence: 99%

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Predictors of dysphagia screening and pneumonia among patients with intracerebral haemorrhage in China: a cross-sectional hospital-based retrospective study

Deng,

Sun,

et al. 2024

BMJ Open

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ObjectivesThis study aimed to investigate factors associated with undergoing dysphagia screening (DS) and developing pneumonia, as well as the relationship between DS and pneumonia in patients with intracerebral haemorrhage (ICH).DesignOur study was a cross-sectional hospital-based retrospective study.Study design and settingsWe derived data from the China Stroke Centre Alliance, a nationwide clinical registry of ICH from 1476 participating hospitals in mainland China. To identify predictors for pneumonia, multivariable logistic regression models were used to identify patient characteristics that were independently associated with DS and pneumonia.ParticipantsWe included 31 546 patients in this study with patient characteristics, admission location, medical history, hospital characteristics and hospital grade from August 2015 to July 2019.Primary and secondary outcome measuresThe primary outcomes were DS and pneumonia during acute hospitalisation.ResultsIn total, 25 749 (81.6%) and 7257 (23.0%) patients with ICH underwent DS and developed pneumonia. Compared with patients without pneumonia, those who developed pneumonia were older and had severe strokes (Glasgow Coma Scale 9–13: 52.7% vs 26.9%). Multivariable analyses revealed that a higher pneumonia risk was associated with dysphagia (OR, 4.34; 95% CI, 4.02 to 4.68), heart failure (OR, 1.85; 95% CI, 1.24 to 2.77) and smoking (OR, 1.12; 95% CI, 1.12 to 0.20). DS was associated with lower odds of pneumonia (OR, 0.65; 95% CI, 0.44 to 0.95).ConclusionOur findings further confirm that dysphagia is an independent risk factor for pneumonia; one-fifth of patients with ICH did not undergo DS. However, comprehensive dysphagia evaluation and effective management are crucial. Nursing processes ensure the collection of complete and accurate information during evaluation of patients. There is a need to increase the rate of DS in patients with ICH, especially those with severe stroke or older. Further, randomised controlled trials are warranted to determine the effectiveness of DS on clinical outcomes.

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Section: Discussionsupporting

confidence: 53%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Predictors of dysphagia screening and pneumonia among patients with intracerebral haemorrhage in China: a cross-sectional hospital-based retrospective study

Deng,

Sun,

et al. 2024

BMJ Open

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“…Therefore, as a rapidly progressive disease with high mortality, early identification and effective indicators of SAP prevention are essential. Several risk factors for pneumonia in stroke patients, namely age, immunosuppression, dysphagia, previous medical history (i.e., diabetes, atrial fibrillation, alcohol consumption, and COPD), and stroke severity, were highlighted (5)(6)(7)(8). However, these risk factors largely depend on clinical symptoms, and clinical monitoring of SAP remains imprecise.…”

Section: Introductionmentioning

confidence: 99%

Inflammatory response biomarkers nomogram for predicting pneumonia in patients with spontaneous intracerebral hemorrhage

Liu

et al. 2023

Front. Neurol.

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ObjectivesInflammatory response biomarkers are promising prognostic factors to improve the prognosis of stroke-associated pneumonia (SAP) after ischemic stroke. This study aimed to investigate the prognostic significance of inflammatory response biomarkers on admission in SAP after spontaneous intracerebral hemorrhage (SICH) and establish a corresponding nomogram.MethodsThe data of 378 patients with SICH receiving conservative treatment from January 2019 to December 2021 at Taizhou People's Hospital were selected. All eligible patients were randomized into the training (70%, 265) and validation cohorts (30%, 113). In the training cohort, multivariate logistic regression analysis was used to establish an optimal nomogram, including inflammatory response biomarkers and clinical risk factors. The area under the receiver operating characteristic (ROC) curve (AUC), calibration curve, and decision curve analysis (DCA) were used to evaluate the nomogram's discrimination, calibration, and performance, respectively. Moreover, this model was further validated in a validation cohort.ResultsA logistic regression analysis showed that intraventricular hemorrhage (IVH), hypertension, dysphagia, Glasgow Coma Scale (GCS), National Institute of Health Stroke Scale (NIHSS), systemic inflammation response index (SIRI), and platelet/lymphocyte ratio (PLR) were correlated with SAP after SICH (P < 0.05). The nomogram was composed of all these statistically significant factors. The inflammatory marker-based nomogram showed strong prognostic power compared with the conventional factors, with an AUC of 0.886 (95% CI: 0.841–0.921) and 0.848 (95% CI: 0.799–0.899). The calibration curves demonstrated good homogeneity between the predicted risks and the observed outcomes. In addition, the model has a significant net benefit for SAP, according to DCA. Also, internal validation demonstrated the reliability of the prediction nomogram. The length of hospital stay was shorter in the non-SAP group than in the SAP group. At the 3-month follow-up, clinical outcomes were worse in the SAP group (P < 0.001).ConclusionSIRI and PLR at admission can be utilized as prognostic inflammatory biomarkers in patients with SICH in the upper brain treated with SAP. A nomogram covering SIRI and PLR can more accurately predict SAP in patients' supratentorial SICH. SAP can influence the length of hospital stay and the clinical outcome.

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Elevated lactate dehydrogenase predicts pneumonia in spontaneous intracerebral hemorrhage

Xiao,

He,

Cheng

et al. 2024

Heliyon

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Predictors of pneumonia in patients with acute spontaneous intracerebral hemorrhage in Algarve, Southern Portugal

Cited by 7 publications

References 23 publications

Predictors of dysphagia screening and pneumonia among patients with intracerebral haemorrhage in China: a cross-sectional hospital-based retrospective study

Predictors of dysphagia screening and pneumonia among patients with intracerebral haemorrhage in China: a cross-sectional hospital-based retrospective study

Inflammatory response biomarkers nomogram for predicting pneumonia in patients with spontaneous intracerebral hemorrhage

Elevated lactate dehydrogenase predicts pneumonia in spontaneous intracerebral hemorrhage

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