The value of diffusion weighted imaging-alberta stroke program early CT score in predicting stroke-associated pneumonia in patients with acute cerebral infarction: a retrospective study

Abstract

Background In this study, we aimed to investigate the value of Diffusion-Weighted Imaging-Alberta Stroke Program Early CT Score (DWI-ASPECTS) in predicting stroke-associated pneumonia (SAP) in patients with acute ischemic stroke. Methods A total of 291 patients who suffered acute cerebral infarction for the first time were included in this retrospective study. DWI-ASPECTS was assessed and clinical data were collected in order to find the risk factors of SAP, and a logistic regression model was used to investigate the effect of predicting SAP. Furthermore, correlation analysis was used to explore the relationship between DWI-ASPECTS and the immume status of the body. Results Among the 291 patients, 74 (25.4%) subjects were diagnosed with SAP. Compared with non-SAP, the patients with SAP were older and had a higher rate of atrial fibrillation (AF), National Institutes of Health Stroke Scale (NIHSS) scores. The SAP group also had a significantly lower DWI-ASPECTS than did the non-SAP group (P < 0.01). In the multivariable logistic regression analysis, the DWI-ASPECTS (adjusted odds ratio [aOR] = 1.438; 95% CI [1.158–1.787]; P < 0.01) remained significant after adjusting for confounders. What’s more, the predictive ability of DWI-ASPECTS (AUC = 0.743 >0.7, 95% CI [0.678–0.800]) had acceptable discriminatory abilities. By the correlation analysis, DWI-ASPECTS was found to be negatively correlated with the count of white blood cell, neutrophils, monocytes, neutrophil-to-monocyte ratio and neutrophil-to-lymphocyte ratio, and positively correlated with the count of lymphocytes. Conclusions DWI-ASPECTS grades could predict stroke-associated pneumonia for patients with acute ischemic stroke, and combining grade with age, AF, or NIHSS could predict SAP events more accurately.