Lower peak expiratory flow rate is associated with a higher risk of pneumonia in patients with stroke.

IF 3.3 3区 医学 Q1 REHABILITATION
Wenxiu Wu, Jingjing Lin, Xuezhen Zhou, Suzhen Ye, Mengmeng Shao, Jiangying Yu, Chengye Zhou, Haiyan Li
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Abstract

Background: Low peak expiratory flow (PEF) rate is common in patients with stroke. Studies on changes in PEF rates in patients with stroke often have small sample sizes, limiting the generalizability of their findings.

Aim: This study aimed to compare the PEF rates between patients who were post-stroke with or without pneumonia and age- and sex-matched healthy controls and explore the PEF-pneumonia association among stroke survivors.

Design: Prospective observational study.

Setting: Department of Rehabilitation, the First Affiliated Hospital of Wenzhou Medical University.

Population: Initially, 809 patients with stroke undergoing inpatient rehabilitation were recruited.

Methods: Data collected included the demographics, stroke history, the presence of dysphagia, and the PEF rates on admission. Logistic regression analysis was conducted to identify the PEF threshold as predictive of pneumonia after adjusting for confounders.

Results: Patients with stroke had a mean PEF rate of 243.89±139.38 L/min, significantly lower than that of the normal control group. The PEF rate was significantly lower in the pneumonia group than in the non-pneumonia group (P<0.001). Within the stroke cohort, the PEF rates were lower than the predicted rates (P<0.001). Older age, lower PEF(%),and dysphagia were associated with a higher pneumonia risk post-stroke per stepwise multivariate logistic regression analysis. Furthermore, the combination of these three significant predictors (PEF(%), swallowing function, and age) yielded an area under the curve of 0.857 .Regarding age, the cut-off point of ≥65.5 years was the optimal level to discriminate the presence of pneumonia among patients with stroke. For PEF%,the cut-off point of <60% was the optimal level to discriminate the presence of pneumonia among patients with stroke. For screening dysphagia, the patients with impaired safety only and those with impaired safety and efficacy faced a higher pneumonia risk.

Conclusions: Patients with stroke exhibited significantly lower peak expiratory flow rates compared to healthy controls after adjusting for age and sex and when compared to their reference values. Decreased PEF rates were independently associated with pneumonia development during inpatient rehabilitation in post-stroke patients.

Clinical rehabilitation impact: This study suggests that low PEF rates may predict pneumonia and that the prevention of PEF rate decline may prevent pneumonia development.

较低的呼气峰流速与中风患者较高的肺炎风险有关。
背景:低呼气峰流速(PEF)在中风患者中很常见。目的:本研究旨在比较卒中后合并或不合并肺炎的患者与年龄和性别匹配的健康对照组之间的呼气峰流速,并探讨卒中幸存者的呼气峰流速与肺炎之间的关系:前瞻性观察研究:地点:温州医科大学附属第一医院康复科:初步招募809名接受住院康复治疗的脑卒中患者:收集的数据包括人口统计学、脑卒中病史、是否存在吞咽困难以及入院时的 PEF 率。在调整了混杂因素后,进行了逻辑回归分析,以确定 PEF 临界值对肺炎的预测作用:结果:脑卒中患者的平均 PEF 为 243.89±139.38 L/min,明显低于正常对照组。肺炎组的 PEF 率明显低于非肺炎组(PC 结论:脑卒中患者的呼气峰值明显低于正常对照组:在调整年龄和性别后,与健康对照组相比,脑卒中患者的呼气峰流速明显较低,与参考值相比也是如此。PEF率的降低与中风后患者住院康复期间肺炎的发生有独立关联:这项研究表明,低呼气流速可能预示着肺炎的发生,而防止呼气流速下降则可预防肺炎的发生。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
8.50
自引率
4.40%
发文量
162
审稿时长
6-12 weeks
期刊介绍: The European Journal of Physical and Rehabilitation Medicine publishes papers of clinical interest in physical and rehabilitation medicine.
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