Objective To investigate the influencing factors and etiological characteristics of stroke-associated pneumonia(SAP)in the patients with acute cerebral stroke(ACS).Methods A total of 214 patients with ACS were divided into two groups of A(with SAP,95 cases)and B(without SAP,119 cases).The relevant data,including NIHSS score,APACHE Ⅱ score,GCS score and laboratory indexes were compared between the two groups.The influencing factors for SAP in the patients with ACS were analyzed by multivariate logistic regression.The diagnostic value of NLR and APACHE Ⅱ score in SAP was analyzed by ROC curve.The pathogenic bacteria in the sputum culture and clinical outcome of SAP patients were analyzed.Results Compared with group B,the age,APACHEⅡ score,NIHSS score,WBC,neutrophil count,neutrophil percentage,NLR,homocysteine level and proportions of admitting ICU,atrial fibrillation,disturbance of consciousness,dysphagia,indwelling urinary catheter,indwelling gastric tube,deep vein catheterization,emergency operation and using proton pump inhibitor were increased,while GCS score,lymphocyte count and levels of hemoglobin and albumin were decreased in group A(P＜0.05).The multivariate logistic regression analysis showed that the increased albumin level was the independent protective factor(P＜0.05),while the indwelling urinary catheter,indwelling gastric tube and increased APACHE Ⅱ score and NLR were the independent risk factors for SAP in the patients with ACS(P＜0.05).Compared with NLR or APACHE Ⅱ score alone,the AUC value of combined detection of them in the diagnosis of SAP in the patients with ACS was higher(P＜0.05).The pathogen analysis showed that the pathogenic bacteria was found in 30 cases(31.58％)in group A,which included 18 cases of Gram-negative bacilli,mainly Klebsiella pneumoniae.The mortality rate in group A was higher than that in group B(27.37％vs.1.68％)(P＜0.05).Conclusion The indwelling catheter,indwelling gastric tube,decreased albumin level,and increased APACHE Ⅱ score and NLR are the independent risk factors for SAP in the patients with ACS.The combined detection of APACHE Ⅱ score and NLR may improve the diagnosis of SAP.
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