Zhang Xiaopei, Yu Shangzhen, Wei Lin, Ye Richun, Lin Meizhen, Li Xiaomin, Li Guoming, Cai Yefeng, Zhao Min
Department of Neurology, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, Guangdong, China.
Department of Neurology, JiangmenWuyi Traditional Chinese Medicine Hospital, Jiangmen, Guangdong, China.
PLoS One. 2016 Mar 7;11(3):e0150298. doi: 10.1371/journal.pone.0150298. eCollection 2016.
Stroke-associated pneumonia (SAP) is a common complication and an important cause of death during hospitalization. The A2DS2 (Age, Atrial fibrillation, Dysphagia, Sex, Stroke Severity) score was developed from the Berlin Stroke Registry and showed good predictive value for predicting SAP. We sought to identify the association between the A2DS2 score and SAP, and, furthermore, to identify whether the A2DS2 score was a predictor for in-hospital death after acute ischemic stroke in a Chinese population.
This was a retrospective study. 1239 acute ischemic stroke patients were classified to low A2DS2 group (0-4) and high A2DS2 score (5-10) group. Primary outcome was in-hospital SAP. Logistic regression analyses were performed to identify the association between the A2DS2 score and SAP, and also the association between the A2DS2 score and in-hospital death.
The overall incidence rates of SAP and in-hospital mortality after acute ischemic stroke were 7.3% and 2.4%, respectively. The incidence rate of SAP in low and high A2DS2 score groups was separately 3.3% and 24.7% (P<0.001). During hospitalization, 1.2% patients in low score group and 7.8% patients in high score group died (P<0.001). Multivariate regression demonstrated that patients in high score group had a higher risk of SAP (OR = 8.888, 95%CI: 5.552-14.229) and mortality (OR = 7.833, 95%CI: 3.580-17.137) than patients in low score group.
The A2DS2 score was a strong predictor for SAP and in-hospital death of Chinese acute ischemic stroke patients. The A2DS2 score might be a useful tool for the identification of patients with a high risk of SAP and death during hospitalization.
卒中相关性肺炎（SAP）是一种常见并发症，也是住院期间死亡的重要原因。A2DS2（年龄、房颤、吞咽困难、性别、卒中严重程度）评分由柏林卒中登记处制定，对预测SAP具有良好的预测价值。我们试图确定A2DS2评分与SAP之间的关联，此外，确定A2DS2评分是否为中国人群急性缺血性卒中后院内死亡的预测指标。
这是一项回顾性研究。1239例急性缺血性卒中患者被分为低A2DS2组（0 - 4分）和高A2DS2评分组（5 - 10分）。主要结局为院内SAP。进行逻辑回归分析以确定A2DS2评分与SAP之间的关联，以及A2DS2评分与院内死亡之间的关联。
急性缺血性卒中后SAP的总体发生率和院内死亡率分别为7.3%和2.4%。低A2DS2评分组和高A2DS2评分组的SAP发生率分别为3.3%和24.7%（P<0.001）。住院期间，低评分组1.2%的患者和高评分组7.8%的患者死亡（P<0.001）。多因素回归显示，高评分组患者发生SAP的风险（OR = 8.888，95%CI：5.552 - 14.229）和死亡风险（OR = 7.833，95%CI：3.580 - 17.137）高于低评分组患者。
A2DS2评分是中国急性缺血性卒中患者发生SAP和院内死亡的有力预测指标。A2DS2评分可能是识别住院期间发生SAP和死亡高风险患者有用的工具。
