A 2 DS 2 Score to Predict the Risk of Stroke-Associated Pneumonia in Acute Stroke: An Indian Perspective

Abstract

Background âfStroke-associated pneumonia (SAP) is an important cause of poststroke morbidity and mortality. Several clinical risk scores predict the risk of SAP. In this study, we used the A 2 DS 2 score (age, atrial fibrillation, dysphagia, sex, and stroke severity) to assess the risk of SAP in patients admitted with acute stroke. Methods âfA high (5-10) and a low (0-4) A 2 DS 2 score was assigned to patients with acute stroke admitted to the neurology ward. Univariate binary logistic regression analysis was performed to find the strength of association of SAP and A 2 DS 2 score. Results âfThere were 250 patients with acute stroke of which 46 developed SAP. Forty-four patients developed SAP in high score as against 2 in low-score group (odds ratio [OR] = 0.03, 95% confidence interval [CI] = 0.01-0.15, p = 0.0001). A 2 DS 2 score >5 had sensitivity of 82.6% and specificity of 65.1% to predict SAP. The mean A 2 DS 2 score in patients with pneumonia was 7.02 ± 1.40 compared to 4.75 ± 1.92 in patients without pneumonia (p = 0.0001). Conclusions âfA 2 DS 2 score has a high sensitivity of 82% in predicting the risk of SAP and is a useful tool to monitor patients after acute stroke. A 2 DS 2 score can help in timely detection and prevention of SAP and reduction in caregiver's burden.