Application of different scoring systems in elderly patients with stroke-associated pneumonia
Objective To explore the values of applying the PLAN(problem,location,autonomy,number)and ASTRAL(age,sex,type of admission,risk factors,acuity of admission,length of stay)scoring systems in neurological nursing care for elderly patients with stroke-associated pneumonia(SAP).Methods Two hundred and ten patients with SAP treated at Department of Neurology,Central Hospital Affiliated to Jiangnan University from January 2020 to January 2022 were retrospectively analyzed,including 102 males and 108 females.They were(70.85±8.32)years old.According to their survival status three months later,the patients were divided into a good prognosis group(168 cases)and a poor prognosis group(42 cases).The clinical data and scores of PLAN and ASTRAL were compared between these two groups.The risk factors of poor prognosis in the patients were analyzed by the logistic regression analysis.The values of the PLAN and ASTRAL scoring systems in the evaluation of the patients'prognosis were analyzed by the receiver operating characteristic curves(ROC).t,x2,and rank sum tests were applied.Results There were statistical differences in gender,atrial fibrillation,hypertension,diabetes,coronary heart disease,and type of stroke between the two groups(all P＞0.05).The good prognosis group were younger than the poor prognosis group[(68.58±5.70)years vs.(73.33±10.38)years],with a statistical difference(t=-4.002;P＜0.05).The scores of PLAN and ASTRAL in the good prognosis group were lower than those in the poor prognosis group[11.2(8.3,13.1)vs.16.3(14.4,20.6)and 20.0(17.2,23.1)vs.28.1(25.2,32.1)],with statistical differences(Z=-5.536 and-5.576;both P＜0.05).The logistic regression analysis results showed that the high scores of PLAN and ASTRAL and the old age were independent risk factors of poor prognosis in the elderly patients with SAP(all P＜0.05).ROC was used to explore the values of the scores of PLAN and ASTRAL and their combination in the prediction of poor prognosis in the patients,and it found that their AUC's were 0.728,0.680,and 0.800,respectively.The scores of PLAN and ASTRAL and their combination had certain values in predicting poor prognosis in the patients(all P＜0.05).Conclusion The PLAN and ASTRAL scoring systems have certain predictive value for the poor prognosis of elderly patients with SAP,and their combination has higher predictive value.
万方数据
维普
