Risk factors of stroke-associated pneumonia in patients with acute ischemic stroke treated by endovascular thrombectomy.

Abstract

Background: Although there are a variety of risk factors and predictive models for stroke-associated pneumonia (SAP) in patients with acute ischemic stroke (AIS), the risk factors and predictive value for SAP in patients with AIS treated by endovascular thrombectomy (EVT) remain unclear. This study aimed to investigate the occurrence of SAP in acute ischemic stroke patients treated with EVT and identify independent predictors of SAP.

Methods: We enrolled patients with acute ischemic stroke who underwent endovascular thrombectomy (EVT) at the stroke center of Maoming People's Hospital between January 2021 and December 2023. The patients were categorized into the SAP group and Non-SAP group. Univariate analysis was performed to examine the correlation between each potential risk factor and SAP. Multivariate logistic regression analysis and receiver operating characteristic curve (ROC) were applied to identify independent predictors of SAP and evaluate their predictive value, respectively.

Results: A total of 233 participants were included in this study. Among them, 131 (56.22%) patients were identified with SAP. The univariate analysis showed significant differences in the following variables between groups: admission National Institute of Health Stroke Scale score (NIHSS) (P = 0.005), procedural time (P = 0.000), dysphagia (P = 0.004), white blood cell (WBC) (P = 0.044), neutrophils (P = 0.019), and neutrophil-lymphocyte ratio (NLR) (P = 0.002). The multivariable logistic analysis identified the following independent predictors of SAP: admission NIHSS score [OR = 1.078, 95% CI = 1.020-1.140, P = 0.008], procedural time [OR = 1.023, 95% CI = 1.014-1.032, P = 0.000], NLR [OR = 1.152, 95% CI = 1.005-1.320, P = 0.042], and dysphagia [OR = 0.340, 95% CI = 0.151-0.767, P = 0.009]. Furthermore, the receiver operating characteristic (ROC) curve analysis demonstrated that procedural time had the best predictive performance for SAP in AIS patients undergoing EVT.

Conclusion: Admission NIHSS score, procedural time, NLR, and dysphagia were associated with SAP in patients with AIS treated with EVT and can be an independent predictor for SAP.