Analysis Of The Risk Factors In Patients With Stroke Associated Pneumonia In The Neurological Intensive Care Unit

Objective: To explore the risk factors、incidence and pathogenesis of stroke-associatedpneumonia(SAP)in acute critical stroke patients admitted to a neurological intensive careunit(NICU). Methods: We retrospectively investigated Clinical data of283patients ofacute stroke treated in the department of Neurology Intensive Care Unit, the People’sHospital of Xinjiang Uygur Autonomous Region between Jan2011and Dec2011.Theywere Divided into SAP and non-SAP. Univariate analysis and multivariate logisticregression analysis were used to analyze the related risk factors for SAP, and thecharacteristics of miroorganism was anlysised as well. Results: The incidence of SAPin283patients of acute stroke was65%.In different types of stroke。the incidence of SAPin cerebral infarct group was57.1％． in cerebral hemorrhage group was65.6％（P<0.05）.In different locations of stroke．the incidence of SAP in anterior circulationgroup was65.6％，in posterior circulation group was74.7％，inanterior+posteriorcirculation group was71.4%(P<0.01)．The mortality of SAP was26.6％, and the mortalityof non-SAP was8.1％, the mortality of SAP was significantly higher thannon-SAP(P<0.01).The risk factors of SAP include age，coronary heart disease, diabetes,locations and types of stroke, history of stroke, nasal feeding, degree of nervous functionaldefects, dysphagia, disturbance of consciousness, dehydrant， inhibitors of protonpump．There were65strains obtained by sputum culture．The percentage of theGram-negative bacteria was65.9%，the major strains was A.baumannii. The percentage ofthe Gram—Postive was8.9%,the major strains was Enterococcus. The percentage of thefungi was25.2%, the major strains was Candida albicans．Conclusions: The incidencerate of SAP is quite high in acute stroke patients admitted to Neurological Intensive CareUnit which was65%. The Gram-negativebacteria is play the most important role, theincidence of the fungi is significantly increased. The incidence rate of SAP iS differentbetween different types and locations．The independent risk factor of SAP in NICU are age≥60岁，NIHSS≥15，diabetes，dysphagia, nasal feeding, disturbance of consciousness,disturbance of consciousness，dehydrant，inhibitors of proton pump.