Risk Factors for Pneumonia in Patients with Acute Ischaemic Stroke- A Retrospective Study

Abstract

Introduction: The most common non-neurological complication of stroke is infection. Stroke, associated with pneumonia is one among them. A few studies have identified prognostic predictors of pneumonia in stroke. Aim: To identify the risk factors of pneumonia in acute ischaemic stroke patients. Materials and Methods: This retrospective cohort study included medical records of 470 adult patients with acute ischaemic stroke between June 2015 to June 2020 (five years) in a Tertiary Care Medical College and Hospital. Among them, 173 had stroke associated with pneumonia. The clinical parameters-age, gender, lesion location, stroke severity (Glasgow Coma Scale (GCS)) , National Institute of Health Stroke Scale (NIHSS), Modified Barthel Activities of Daily Living (ADL) index, water swallow test, vascular risk factors and co-existing conditions (pre-existent Chronic Obstructive Pulmonary Disease (COPD), atrial fibrillation, renal electrolyte dysfunction, hypoproteinaemia) were compared. Chi-square test and logistic regression analysis were used for statistical analysis. Results: In this study, the following factors were associated with increased risk of developing pneumonia-age >70 years, bed ridden status, GCS ≤13, NIHSS ≥5, water swallow test score ≤2. Among them, multivariate analysis identified bed ridden status and water swallow test as independent predictors. Conclusion: Bed ridden status and water swallow test score were significant risk factors of ischaemic stroke associated with pneumonia. Hence, an early identification of these factors and a better knowledge of them may help in better care and prevention of pneumonia in acute ischaemic stroke.