Hassan A, Khealani B A, Shafqat S, Aslam M, Salahuddin N, Syed N A, Baig S M, Wasay M
Department of Neurology, Shifa International Hospital, Islamabad, Pakistan.
Singapore Med J. 2006 Mar;47(3):204-7.
Pneumonia is a common complication after acute stroke. It affects the outcome adversely. However, data regarding microbiology of stroke-associated pneumonia and its effect on outcome is scarce.
Stroke-associated pneumonia was identified through chart review of all ICD-9 identified adult stroke patients admitted to our hospital over a period of four years (1998-2001). The demographical, laboratory, radiological, microbiological data and outcome of patients with stroke-associated pneumonia were recorded and analysed.
443 patients with stroke were admitted over the four-year period and 102 (23 percent) had stroke-associated pneumonia. Their ages range from 28 to 100 (mean 64+/-14) years. 69 (68 percent) were men. Median length of stay was nine days compared to four days for all stroke patients. 68 (67 percent) patients manifested pneumonia within 48 hours and 34 (33 percent) after 48 hours of admission. Yield of tracheal aspirate cultures was 38 percent and that of chest radiographs was 25 percent. Pseudomonas aeruginosa and Staphylococcus aureus were the most common organisms (12 percent each) followed by Streptococcus pneumoniae and Klebsiella pneumoniae (4 percent each). Patients with infiltrates on chest radiographs were more likely to have positive tracheal aspirate cultures (p-value is 0.003). 35 patients (34 percent) expired during hospital stay. Positive chest radiographs and tracheal aspirates were independent predictors of prolonged hospital stay (p-value is less than 0.005).
Pneumonia is a common medical complication of stroke. It is associated with a high mortality and prolongs the hospital stay. The yield of chest radiographs and tracheal aspirates is low. However, these are independent predictors of prolonged hospital stay. Pseudomonas aeruginosa and Staphylococcus aureus are most common organisms in stroke-associated pneumonia.
肺炎是急性中风后的常见并发症。它对预后有不利影响。然而，关于中风相关性肺炎的微生物学及其对预后影响的数据却很匮乏。
通过回顾我院在四年期间（1998 - 2001年）收治的所有国际疾病分类第九版（ICD - 9）确诊的成年中风患者病历，确定中风相关性肺炎。记录并分析中风相关性肺炎患者的人口统计学、实验室、放射学、微生物学数据及预后情况。
四年期间共收治443例中风患者，其中102例（23%）患有中风相关性肺炎。他们的年龄在28岁至100岁之间（平均64±14岁）。69例（68%）为男性。中风相关性肺炎患者的中位住院时间为9天，而所有中风患者的中位住院时间为4天。68例（67%）患者在入院48小时内出现肺炎，34例（33%）在入院48小时后出现肺炎。气管吸出物培养的阳性率为38%，胸部X光片的阳性率为25%。铜绿假单胞菌和金黄色葡萄球菌是最常见的病原体（各占12%），其次是肺炎链球菌和肺炎克雷伯菌（各占4%）。胸部X光片有浸润影的患者气管吸出物培养更可能呈阳性（p值为0.003）。35例患者（34%）在住院期间死亡。胸部X光片和气管吸出物阳性是住院时间延长的独立预测因素（p值小于0.005）。
肺炎是中风常见的医学并发症。它与高死亡率相关，并延长住院时间。胸部X光片和气管吸出物的阳性率较低。然而，这些是住院时间延长的独立预测因素。铜绿假单胞菌和金黄色葡萄球菌是中风相关性肺炎最常见的病原体。
