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Abstract：
BACKGROUND: Pneumonia, the most common post-acute ischemic stroke (AIS) infection, accounts for up to 30% of deaths after a stroke. Multiple chronic inflammatory diseases, such as rheumatoid arthritis, psoriasis, and inflammatory bowel disease, are associated with increased risk of stroke and stroke morbidity. This study assessed the relationship between chronic inflammatory diseases and stroke-associated pneumonia (SAP).
METHODS: Using data from the 2015-2017 National Inpatient Sample, we classified hospital discharges with a diagnosis of AIS as having ulcerative colitis, Crohn\'s disease, rheumatoid arthritis, psoriasis, systemic lupus erythematosus, other chronic inflammatory diseases, multiple chronic inflammatory diseases, or none. With multivariable logistic regression, we assessed for associations between chronic inflammatory disease and in-hospital SAP or death.
RESULTS: Among AIS discharges, there was a decreased risk of SAP among those with psoriasis or other chronic inflammatory diseases (adjusted odds ratio (aOR) 0.70, 95%CI 0.63-0.99; aOR 0.64, 95%CI, 0.46-0.89, respectively), compared to those without psoriasis and without other chronic inflammatory disease, respectively. Rheumatoid arthritis, psoriasis, and other chronic inflammatory diseases were associated with reduced in-hospital mortality (aOR 0.89, 95%CI 0.78-1.00; aOR 0.77, 95%CI 0.59-1.00; aOR 0.69, 95%CI 0.50-0.94, respectively).
CONCLUSIONS: The risk of SAP and in-hospital mortality varies by chronic inflammatory disease - psoriasis and other chronic inflammatory diseases are associate with reduced rates of SAP, whereas rheumatoid arthritis, psoriasis and other chronic inflammatory disease were associated with reduced in-hospital mortality. Further investigations are needed to determine a relationship between the potential role of immunomodulation and the reduction in SAP and mortality in chronic inflammatory diseases.
METHODS: Using data from the 2015-2017 National Inpatient Sample, we classified hospital discharges with a diagnosis of AIS as having ulcerative colitis, Crohn\'s disease, rheumatoid arthritis, psoriasis, systemic lupus erythematosus, other chronic inflammatory diseases, multiple chronic inflammatory diseases, or none. With multivariable logistic regression, we assessed for associations between chronic inflammatory disease and in-hospital SAP or death.
RESULTS: Among AIS discharges, there was a decreased risk of SAP among those with psoriasis or other chronic inflammatory diseases (adjusted odds ratio (aOR) 0.70, 95%CI 0.63-0.99; aOR 0.64, 95%CI, 0.46-0.89, respectively), compared to those without psoriasis and without other chronic inflammatory disease, respectively. Rheumatoid arthritis, psoriasis, and other chronic inflammatory diseases were associated with reduced in-hospital mortality (aOR 0.89, 95%CI 0.78-1.00; aOR 0.77, 95%CI 0.59-1.00; aOR 0.69, 95%CI 0.50-0.94, respectively).
CONCLUSIONS: The risk of SAP and in-hospital mortality varies by chronic inflammatory disease - psoriasis and other chronic inflammatory diseases are associate with reduced rates of SAP, whereas rheumatoid arthritis, psoriasis and other chronic inflammatory disease were associated with reduced in-hospital mortality. Further investigations are needed to determine a relationship between the potential role of immunomodulation and the reduction in SAP and mortality in chronic inflammatory diseases.
摘要：
背景：肺炎，最常见的急性缺血性卒中后（AIS）感染，占中风后死亡人数的30%。多种慢性炎症性疾病,比如类风湿性关节炎，牛皮癣,和炎症性肠病，与卒中风险和卒中发病率增加相关。这项研究评估了慢性炎症性疾病与卒中相关性肺炎（SAP）之间的关系。
方法：使用来自2015-2017年全国住院患者样本的数据，我们将诊断为AIS的出院分类为溃疡性结肠炎，克罗恩病,类风湿性关节炎,牛皮癣,系统性红斑狼疮,其他慢性炎症性疾病，多种慢性炎症性疾病，或者没有。利用多变量逻辑回归，我们评估了慢性炎症性疾病与住院SAP或死亡之间的关联.
结果：在AIS放电中，银屑病或其他慢性炎症性疾病患者的SAP风险降低(调整比值比(aOR)0.70,95CI0.63-0.99;aOR分别为0.64,95CI,0.46-0.89),与没有牛皮癣和其他慢性炎症性疾病的患者相比，分别。类风湿性关节炎,牛皮癣,和其他慢性炎症性疾病与住院死亡率降低相关(分别为aOR0.89,95CI0.78-1.00;aOR0.77,95CI0.59-1.00;aOR0.69,95CI0.50-0.94).
结论：SAP的风险和院内死亡率因慢性炎症性疾病而异——银屑病和其他慢性炎症性疾病与SAP发病率降低相关，而类风湿关节炎，银屑病和其他慢性炎症性疾病与住院死亡率降低相关.需要进一步的研究来确定免疫调节的潜在作用与慢性炎症性疾病中SAP和死亡率的降低之间的关系。
方法：使用来自2015-2017年全国住院患者样本的数据，我们将诊断为AIS的出院分类为溃疡性结肠炎，克罗恩病,类风湿性关节炎,牛皮癣,系统性红斑狼疮,其他慢性炎症性疾病，多种慢性炎症性疾病，或者没有。利用多变量逻辑回归，我们评估了慢性炎症性疾病与住院SAP或死亡之间的关联.
结果：在AIS放电中，银屑病或其他慢性炎症性疾病患者的SAP风险降低(调整比值比(aOR)0.70,95CI0.63-0.99;aOR分别为0.64,95CI,0.46-0.89),与没有牛皮癣和其他慢性炎症性疾病的患者相比，分别。类风湿性关节炎,牛皮癣,和其他慢性炎症性疾病与住院死亡率降低相关(分别为aOR0.89,95CI0.78-1.00;aOR0.77,95CI0.59-1.00;aOR0.69,95CI0.50-0.94).
结论：SAP的风险和院内死亡率因慢性炎症性疾病而异——银屑病和其他慢性炎症性疾病与SAP发病率降低相关，而类风湿关节炎，银屑病和其他慢性炎症性疾病与住院死亡率降低相关.需要进一步的研究来确定免疫调节的潜在作用与慢性炎症性疾病中SAP和死亡率的降低之间的关系。
