Scoring of post stroke pneumonia in uttaradit hospital

Abstract

Background: Stroke is a disease which occurs when the blood supply to the brain is interrupted, depriving brain tissue of oxygen, resulting in cell death. The symptoms of stroke include: numbness, paraplegia, dysarthria, ataxia, etc. The most common complication is infection. The highest death rates among hospitalized stroke patients are from pneumonia. Objective: To develop a score for predicting post-stroke pneumonia infection and identify risk factors for patients with post-stroke pneumonia. Study design: Retrospective case-control. Setting: Uttaradit hospital (the tertiary hospital), Thailand. Method: A retrospective data study was conducted at Uttaradit hospital, Thailand from January 2014 to October 2018 in which all of the subjects were diagnosed with either stroke with pneumonia or without pneumonia by a physician. The selected 324 stroke patients were divided into two groups: 108 patients were stroke with pneumonia and 216 patients were stroke without pneumonia. This study involved data collection and analysis of study characteristics to develop a predictive score for post-stroke pneumonia. Results: This study identified risk factors and developed a score for predicting post-stroke pneumonia infection by using significant covariates (duration of admission; 1–10 days=0 points, 11–20 days=1 point, more than 20 days=2.5 points, Cardiovascular disease=1.5 points, Nasogastric tube=2 points, Urinary tract infection=1 point). This score was interpreted to three groups; low risk (<2 points), moderate risk (2.5–4 points), and high risk (>4 points). Sensitivity was 80.56% and specificity was 93.52%. Conclusion: A simple prediction tool was developed that uses only four clinical variables to predict risk of post-stroke pneumonia with high sensitivity and specificity.