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Abstract：
BACKGROUND: Hyperglycaemia (HG) during an acute ischemic stroke (AIS) is not only associated with unfavourable functional outcomes but also associated with stroke-associated pneumonia (SAP). This study aimed to determine the prevalence of SAP among Malaysian patients with AIS and the predictors of SAP among patients with HG during AIS.
METHODS: This is a retrospective cross-sectional study that included patients with AIS admitted to Hospital Sultanah Nur Zahirah, Malaysia from 2017 to 2020. SAP was defined as infection with pneumonia during the first seven days after IS. HG was defined as a blood glucose level > 7.8 mmol/L within 72 h after admission. Patients with SAP were divided into two groups according to HG status. Multivariate logistic regression analysis was performed using SPSS software, version 22 (IBM Corp., Armonk, NY) to identify SAP predictors among patients with HG. Kaplan-Meier log-rank test was used to compare the survival rate from unfavourable functional outcomes between hyperglycaemic patients with and without SAP.
RESULTS: Among 412 patients with AIS, 69 (16.74%) had SAP. The prevalence of SAP among patients with HG and normoglycemia during AIS was 20.98%, and 10.65%, respectively. Age above 60 years, leucocytosis, and National Institute of Health Stroke Scale (NIHSS) > 14 on admission were independent predictors of SAP with aOR of 2.08 (95% CI;1.01-4.30), 2.83 (95% CI; 1.41-5.67), and 3.67 (95% CI; 1.53-8.80), respectively. No significant difference in unfavourable functional outcomes survival was found among patients with and without SAP (p = 0.653).
CONCLUSIONS: This study demonstrated the prevalence of SAP was higher among patients with HG compared to normoglycemia during AIS. The patient being old, leucocytosis and severe stroke upon admission predict the occurrence of SAP among patients with HG during AIS.
METHODS: This is a retrospective cross-sectional study that included patients with AIS admitted to Hospital Sultanah Nur Zahirah, Malaysia from 2017 to 2020. SAP was defined as infection with pneumonia during the first seven days after IS. HG was defined as a blood glucose level > 7.8 mmol/L within 72 h after admission. Patients with SAP were divided into two groups according to HG status. Multivariate logistic regression analysis was performed using SPSS software, version 22 (IBM Corp., Armonk, NY) to identify SAP predictors among patients with HG. Kaplan-Meier log-rank test was used to compare the survival rate from unfavourable functional outcomes between hyperglycaemic patients with and without SAP.
RESULTS: Among 412 patients with AIS, 69 (16.74%) had SAP. The prevalence of SAP among patients with HG and normoglycemia during AIS was 20.98%, and 10.65%, respectively. Age above 60 years, leucocytosis, and National Institute of Health Stroke Scale (NIHSS) > 14 on admission were independent predictors of SAP with aOR of 2.08 (95% CI;1.01-4.30), 2.83 (95% CI; 1.41-5.67), and 3.67 (95% CI; 1.53-8.80), respectively. No significant difference in unfavourable functional outcomes survival was found among patients with and without SAP (p = 0.653).
CONCLUSIONS: This study demonstrated the prevalence of SAP was higher among patients with HG compared to normoglycemia during AIS. The patient being old, leucocytosis and severe stroke upon admission predict the occurrence of SAP among patients with HG during AIS.
摘要：
背景：急性缺血性卒中（AIS）期间的高血糖（HG）不仅与不利的功能结局相关，而且与卒中相关性肺炎（SAP）相关。本研究旨在确定马来西亚AIS患者中SAP的患病率以及AIS期间HG患者中SAP的预测因子。
方法：这是一项回顾性横断面研究，包括SultanahNurZahirah医院收治的AIS患者，马来西亚从2017年到2020年。SAP定义为在IS后的前7天感染肺炎。HG定义为入院后72小时内血糖水平>7.8mmol/L。根据HG状态将SAP患者分为两组。采用SPSS软件进行多因素logistic回归分析,第22版(IBM公司,Armonk,NY）以确定HG患者中的SAP预测因子。使用Kaplan-Meier对数秩检验比较有和没有SAP的高血糖患者的不良功能结局的生存率。
结果：在412例AIS患者中，69人（16.74%）患有SAP。在AIS期间，HG和血糖正常的患者中SAP的患病率为20.98％，10.65%，分别。年龄在60岁以上，白细胞增多症,入院时美国国立卫生研究院卒中量表（NIHSS）>14是SAP的独立预测因子，aOR为2.08（95％CI;1.01-4.30），2.83（95%CI；1.41-5.67），和3.67（95%CI；1.53-8.80），分别。在有和没有SAP的患者中，不利的功能结局生存率没有显着差异（p=0.653）。
结论：这项研究表明，与AIS期间血糖正常相比，HG患者中SAP的患病率更高。病人老了，入院时白细胞增多和严重卒中可预测AIS期间HG患者SAP的发生。
方法：这是一项回顾性横断面研究，包括SultanahNurZahirah医院收治的AIS患者，马来西亚从2017年到2020年。SAP定义为在IS后的前7天感染肺炎。HG定义为入院后72小时内血糖水平>7.8mmol/L。根据HG状态将SAP患者分为两组。采用SPSS软件进行多因素logistic回归分析,第22版(IBM公司,Armonk,NY）以确定HG患者中的SAP预测因子。使用Kaplan-Meier对数秩检验比较有和没有SAP的高血糖患者的不良功能结局的生存率。
结果：在412例AIS患者中，69人（16.74%）患有SAP。在AIS期间，HG和血糖正常的患者中SAP的患病率为20.98％，10.65%，分别。年龄在60岁以上，白细胞增多症,入院时美国国立卫生研究院卒中量表（NIHSS）>14是SAP的独立预测因子，aOR为2.08（95％CI;1.01-4.30），2.83（95%CI；1.41-5.67），和3.67（95%CI；1.53-8.80），分别。在有和没有SAP的患者中，不利的功能结局生存率没有显着差异（p=0.653）。
结论：这项研究表明，与AIS期间血糖正常相比，HG患者中SAP的患病率更高。病人老了，入院时白细胞增多和严重卒中可预测AIS期间HG患者SAP的发生。
