High fibrinogen-prealbumin ratio (FPR) predicts stroke-associated pneumonia

Abstract

AbstractBackgroundStroke-associated pneumonia (SAP) is a common complication in acute ischemic stroke patients. Although both single markers of fibrinogen and prealbumin are found to be associated with stroke and pneumonia, fibrinogen-prealbumin ratio (FPR) is a novel and comprehensive indicator that has not been explored in acute ischemic stroke patients. Besides, no study has explored the relationship between SAP and FPR. This study aims to explore whether FPR is higher in acute ischemic stroke patients and whether FPR is associated with SAP.MethodsA total of 902 acute ischemic stroke patients participated in this study. Meanwhile, 146 healthy controls were also recruited. Fibrinogen and prealbumin were measured within 24 hours on admission. FPR was calculated after dividing fibrinogen (g/L) by prealbumin (mg/L)× 1000. SAP was defined according to the modified Centers for Disease Control criteria.ResultsIn this study, 121 patients were diagnosed with SAP. FPR was significantly higher in both non-SAP patients and SAP patients than in healthy controls. In binary logistic regression analysis, we found that FPR was significantly higher in SAP group than non-SAP group (15.97[11.72-24.34] vs. 11.81[9.27-15.64]; P < 0.001) after adjusting for confounders. Besides, FPR (>18.22) was independently associated with SAP (OR3.028; 95% CI:1.607-5.706; P = 0.001). Moreover, diabetes mellitus, NIHSS score, dysphagia, leukocyte count and hs-CRP were independently correlated with SAP.ConclusionHigher FPR was observed in acute ischemic stroke patients compared to healthy controls and high FPR significantly increased the risk of SAP. Patients with high FPR should be paid more attention by physicians.