摘要
目的探讨急性脑卒中患者肺炎发生的危险因素,评价A2DS2评分对卒中后肺炎预测的准确程度。方法收集418例急性脑卒中患者资料分别应用单因素及多因素Logistic回归分析卒中后肺炎发生的危险因素。应用受试者工作特征(receiver operating characteristic,ROC)曲线评价A2DS2评分对卒中后肺炎诊断的准确性。结果卒中后肺炎发生率为23.92%。其中高龄、男性、吸烟史、吞咽困难、肺部基础疾病史、应用质子泵抑制剂或H2受体阻断剂、NIHSS评分中5～15分及≥16分以上、房颤、留置胃管是卒中后肺炎发生的独立危险因素(均有P<0.05)。ROC曲线结果分析,曲线下面积为0.888,在评分为5分时其正确指数最高。结论高龄、男性、吸烟史、吞咽困难、NIHSS评分中≥5及以上、留置胃管等是卒中后肺炎发生的独立危险因素。A2DS2评分可很好用于卒中后肺炎发生的预测,对于指导卒中后肺炎防治有重要意义。
Objective To investigate the risk factors for post-stroke pneumonia,and to assess the value of A2DS2 scoring in predicting pneumonia in acute stroke patients. Methods The clinical data of acute stroke patients were retrospectively collected in Anhui provincial hospital from January,2013 to December,2013. A2DS2 score was then assigned using the clinical information from the medical record. The ability of the score to diagnose patients with post-stroke pneumonia was quantified using receiver operating characteristic( ROC) analysis. Results A total of 418 acute stroke patients were enrolled in this study,among them the incidence of post-stroke pneumonia was 23. 92%. Age,male,smoking,dysphagia,the underlying lung disease,gastro protective agents,atrial fibrillation,NIHSS score,and gastric tube were independent risk factors for pneumonia among acute stroke patient. The ROC area was 0. 888 and the score was 5 when the index was the highest. Conclusions The A2DS2 scoring was well calibrated to predict pneumonia in acute stroke patients by the ROC analysis.
出处
《中华疾病控制杂志》
CAS
北大核心
2014年第9期855-858,共4页
Chinese Journal of Disease Control & Prevention
基金
安徽省教育厅课题(KJ2009B001Z)
关键词
卒中
肺炎
危险因素
Stroke
Pneumonia
Risk factors
