Ding Yunlong, Yan Yazhou, Niu Jiali, Zhang Yanrong, Gu Zhiqun, Tang Ping, Liu Yan
Department of Neurology, Jingjiang People's Hospital, the Seventh Affiliated Hospital of Yangzhou University, No. 28, Zhongzhou Road, Jingjiang, CN 214500, Jiangsu, China.
Department of Neurosurgery, Changhai Hospital affiliated to the Second Military Medical University, Shanghai, China.
BMC Geriatr. 2019 Oct 7;19(1):259. doi: 10.1186/s12877-019-1269-x.
The prevention of pneumonia is critical for patients with acute ischaemic stroke (AIS). The six subscales in the Braden Scale seem to be related to the occurrence of pneumonia. We aimed to evaluate the feasibility of using the Braden Scale to predict the occurrence of pneumonia after AIS.
We studied a series of consecutive patients with AIS who were admitted to the hospital. The cohort was subdivided into pneumonia and no pneumonia groups. The scores on the Braden Scale, demographic characteristics and clinical characteristics were obtained and analysed by statistical comparisons between the two groups. We investigated the predictive validity of the Braden Scale by receiver operating characteristic (ROC) curve analysis.
A total of 414 patients with AIS were included in this study. Of those 414 patients, 57 (13.8%) patients fulfilled the criteria for post-stroke pneumonia. There were significant differences in age and histories of chronic obstructive pulmonary disease (COPD), dysphagia and Glasgow Coma Scale (GCS) score between the two groups, and the National Institutes of Health Stroke Scale (NIHSS) score in the pneumonia group was significantly higher than that in the no pneumonia group (P < 0.01). The mean score on the Braden Scale in the pneumonia group was significantly lower than that in the no pneumonia group (P < 0.01). The six subscale scores on the Braden Scale were all significantly different between the two groups. The area under the curve (AUC) for the Braden Scale for the prediction of pneumonia after AIS was 0.883 (95% CI = 0.828-0.937). With 18 points as the cutoff point, the sensitivity was 83.2%, and the specificity was 84.2%.
The Braden Scale with 18 points as the cutoff point is likely a valid clinical grading scale for predicting pneumonia after AIS at presentation. Further studies on the association of the Braden Scale score with stroke outcomes are needed.
预防肺炎对于急性缺血性卒中（AIS）患者至关重要。Braden量表中的六个子量表似乎与肺炎的发生有关。我们旨在评估使用Braden量表预测AIS后肺炎发生的可行性。
我们研究了一系列连续入院的AIS患者。该队列被分为肺炎组和非肺炎组。获取Braden量表得分、人口统计学特征和临床特征，并通过两组间的统计比较进行分析。我们通过受试者工作特征（ROC）曲线分析研究Braden量表的预测效度。
本研究共纳入414例AIS患者。在这414例患者中，57例（13.8%）符合卒中后肺炎的标准。两组在年龄、慢性阻塞性肺疾病（COPD）病史、吞咽困难和格拉斯哥昏迷量表（GCS）评分方面存在显著差异，肺炎组的美国国立卫生研究院卒中量表（NIHSS）评分显著高于非肺炎组（P<0.01）。肺炎组Braden量表的平均得分显著低于非肺炎组（P<0.01）。Braden量表的六个子量表得分在两组间均有显著差异。AIS后肺炎预测的Braden量表曲线下面积（AUC）为0.883（95%CI=0.828-0.937）。以18分为界值点，敏感性为83.2%，特异性为84.2%。
以18分为界值点的Braden量表可能是预测AIS患者入院时肺炎的有效临床分级量表。需要进一步研究Braden量表得分与卒中结局的关联。
