Background: Hyperglycemia is always seen amongst acute intra-cerebral hemorrhage (ICH) and usually has been reported in literature and studied in relation to mortality and poor recovery. However, literature specific t...Background: Hyperglycemia is always seen amongst acute intra-cerebral hemorrhage (ICH) and usually has been reported in literature and studied in relation to mortality and poor recovery. However, literature specific to stroke-associated pneumonia (SAP) on this topic is very small. Further, how to differentiate the predictive value of hyperglycemia with and without abnormal HbA1C in such patients is still a matter of debate and no universal consensus. We evaluated hyperglycemia as a marker for SAP in patients with ICH to assess its usefulness as a potential predictor. Materials and methods: Clinical characteristics for a sample of 551 patients with acute ICH were collected from the Beijing Tiantan Hospital of Capital Medical University, Beijing, China. Possible associated risk factors of SAP were reviewed. Hyperglycemia and HbA1C on admission were the main hypothetic predictor, SAP occurring within the first 7 days is the primary outcome. Results: The cohort study includes 551 hospitalized patients. The prevalence of hyperglycemia was 52.5% and SAP occurred in 147 (26.7%). The incidence of SAP was higher in the group with hyperglycemia than those without hyperglycemia (37.7% versus 14.5%, p 6.5) (OR, 1.57;95%CI, 0.81 - 3.23) had not been shown to be associated with SAP. Conclusions: In this hospital-based cohort of patients presenting with acute intra-hemorrhage, hyperglycemia on admission was associated significantly with SAP. The association was stronger for hyperglycemia with normal HgbA1C than for hyperglycemia with high HgbA1C. Hyperglycemia with normal HgbA1C might be a more sensitive predictor of early acute complication, such as SAP.展开更多
目的：探讨急性脑出血患者卒中相关性肺炎（ SAP ）发生的危险因素，以便早期干预。方法选择急性脑出血患者196例为研究对象，其中发生SAP 82例为病例组，未发生SAP 114例为对照组。对两组的年龄、性别、心肺疾病史、GCS评分、吞咽困难...目的：探讨急性脑出血患者卒中相关性肺炎（ SAP ）发生的危险因素，以便早期干预。方法选择急性脑出血患者196例为研究对象，其中发生SAP 82例为病例组，未发生SAP 114例为对照组。对两组的年龄、性别、心肺疾病史、GCS评分、吞咽困难、心率、血压、白细胞计数、脑出血量、鼻饲、使用胃黏膜保护剂和手术等共计23项予以比较分析。所得资料在单因素分析的基础上，又作多因素Logistic回归分析。结果急性脑出血SAP的患病率为41．837％。收缩压升高（优势比1．072，95％可信区间1．007～1．141，P＝0．029）、白细胞计数增加（优势比1．331，95％可信区间1．009～1．756，P＝0．043）、脑出血量增多（优势比1．079，95％可信区间1．019～1．142，P＝0．010）、有心肺疾病（优势比12．275，95％可信区间1．210～124．545，P＝0．034）、吞咽困难（优势比12．937，95％可信区间1．918～87．250，P＝0．009）和鼻饲（优势比19．217，95％可信区间1．307～282．651，P＝0．031）均促进发病。而使用胃黏膜保护剂（优势比0．157，95％可信区间0．031～0．790，P＝0．025）和实施手术（优势比0．012，95％可信区间0．000～0．294，P＝0．007）阻止发病。结论收缩压、白细胞计数增加、脑出血量增高、有心肺疾病、吞咽困难和鼻饲是急性脑出血发生SAP的危险因素；而使用胃黏膜保护剂和实施手术为其保护因素。展开更多
文摘Background: Hyperglycemia is always seen amongst acute intra-cerebral hemorrhage (ICH) and usually has been reported in literature and studied in relation to mortality and poor recovery. However, literature specific to stroke-associated pneumonia (SAP) on this topic is very small. Further, how to differentiate the predictive value of hyperglycemia with and without abnormal HbA1C in such patients is still a matter of debate and no universal consensus. We evaluated hyperglycemia as a marker for SAP in patients with ICH to assess its usefulness as a potential predictor. Materials and methods: Clinical characteristics for a sample of 551 patients with acute ICH were collected from the Beijing Tiantan Hospital of Capital Medical University, Beijing, China. Possible associated risk factors of SAP were reviewed. Hyperglycemia and HbA1C on admission were the main hypothetic predictor, SAP occurring within the first 7 days is the primary outcome. Results: The cohort study includes 551 hospitalized patients. The prevalence of hyperglycemia was 52.5% and SAP occurred in 147 (26.7%). The incidence of SAP was higher in the group with hyperglycemia than those without hyperglycemia (37.7% versus 14.5%, p 6.5) (OR, 1.57;95%CI, 0.81 - 3.23) had not been shown to be associated with SAP. Conclusions: In this hospital-based cohort of patients presenting with acute intra-hemorrhage, hyperglycemia on admission was associated significantly with SAP. The association was stronger for hyperglycemia with normal HgbA1C than for hyperglycemia with high HgbA1C. Hyperglycemia with normal HgbA1C might be a more sensitive predictor of early acute complication, such as SAP.
文摘目的：探讨急性脑出血患者卒中相关性肺炎（ SAP ）发生的危险因素，以便早期干预。方法选择急性脑出血患者196例为研究对象，其中发生SAP 82例为病例组，未发生SAP 114例为对照组。对两组的年龄、性别、心肺疾病史、GCS评分、吞咽困难、心率、血压、白细胞计数、脑出血量、鼻饲、使用胃黏膜保护剂和手术等共计23项予以比较分析。所得资料在单因素分析的基础上，又作多因素Logistic回归分析。结果急性脑出血SAP的患病率为41．837％。收缩压升高（优势比1．072，95％可信区间1．007～1．141，P＝0．029）、白细胞计数增加（优势比1．331，95％可信区间1．009～1．756，P＝0．043）、脑出血量增多（优势比1．079，95％可信区间1．019～1．142，P＝0．010）、有心肺疾病（优势比12．275，95％可信区间1．210～124．545，P＝0．034）、吞咽困难（优势比12．937，95％可信区间1．918～87．250，P＝0．009）和鼻饲（优势比19．217，95％可信区间1．307～282．651，P＝0．031）均促进发病。而使用胃黏膜保护剂（优势比0．157，95％可信区间0．031～0．790，P＝0．025）和实施手术（优势比0．012，95％可信区间0．000～0．294，P＝0．007）阻止发病。结论收缩压、白细胞计数增加、脑出血量增高、有心肺疾病、吞咽困难和鼻饲是急性脑出血发生SAP的危险因素；而使用胃黏膜保护剂和实施手术为其保护因素。
