Yang Jun, Dai Yonghong, Zhang Zuowen, Chen Yue
Department of Critical Care Medicine, Central Hospital of Jiangjin District, Chongqing 402260, People's Republic of China.
Department of Neurology, Central Hospital of Jiangjin District, Chongqing 402260, People's Republic of China.
Neuropsychiatr Dis Treat. 2020 Oct 9;16:2353-2359. doi: 10.2147/NDT.S268878. eCollection 2020.
To evaluate the value of the combination of the age, atrial fibrillation, dysphagia, male sex, and National Institutes of Health Stroke Scale (ADS) score and serum interleukin 6 (IL-6) concentration in predicting stroke-associated pneumonia (SAP).
A total of 398 patients with acute ischemic stroke (AIS) from the medical ward was included in this retrospective study. They were divided into the SAP group and non-SAP group according to the diagnostic criteria of SAP. Multivariate analysis was performed to analyze the association between the ADS score, serum IL-6 concentration, and SAP using a backward stepwise logistic regression model. The receiver operating characteristic (ROC) curve was used to evaluate the value of the ADS score, serum IL-6 concentration and combination of ADS score and IL-6 in predicting SAP.
SAP was diagnosed in 70 patients (17.6%). Multivariate analysis showed that the ADS score (odds ratio ]: 2.25, 95% confidence interval ]: 1.17-4.99, =0.017) and serum IL-6 concentration (: 1.76, 95% : 1.44-1.95, <0.001) was independently associated with SAP after adjusting for age, smoking, hypertension, hyperlipidemia, and atrial fibrillation. When the ADS score, serum IL-6 concentration and combination of ADS score and IL-6 were employed to predict SAP, the AUC was 0.824 (: 0.026, 95% : 0.773-0.875), 0.715 (: 0.034, 95% : 0.641-0.788) and 0.917 (: 0.015, 95% : 0.887-0.946), respectively. The AUC of combinative prediction was significantly higher than independent prediction (0.917 vs. 0.824, =3.098, <0.001; 0.917 vs. 0.715, =5.436, <0.001).
The addition of serum IL-6 to the ADS score could significantly enhance the AUC of predicting SAP in AIS patients from the medical ward.
评估年龄、心房颤动、吞咽困难、男性以及美国国立卫生研究院卒中量表（ADS）评分与血清白细胞介素6（IL-6）浓度相结合在预测卒中相关性肺炎（SAP）方面的价值。
本回顾性研究纳入了来自内科病房的398例急性缺血性卒中（AIS）患者。根据SAP的诊断标准将他们分为SAP组和非SAP组。采用向后逐步逻辑回归模型进行多因素分析，以分析ADS评分、血清IL-6浓度与SAP之间的关联。采用受试者工作特征（ROC）曲线评估ADS评分、血清IL-6浓度以及ADS评分与IL-6联合应用在预测SAP方面的价值。
70例患者（17.6%）被诊断为SAP。多因素分析显示，在对年龄、吸烟、高血压、高脂血症和心房颤动进行校正后，ADS评分（比值比：2.25；95%置信区间：1.17 - 4.99，P = 0.017）和血清IL-6浓度（比值比：1.76；95%置信区间：1.44 - 1.95，P < 0.001）与SAP独立相关。当采用ADS评分、血清IL-6浓度以及ADS评分与IL-6联合应用来预测SAP时，曲线下面积（AUC）分别为0.824（标准误：0.026；95%置信区间：0.773 - 0.875）、0.715（标准误：0.034；95%置信区间：0.641 - 0.788）和0.917（标准误：0.015；95%置信区间：0.887 - 0.946）。联合预测的AUC显著高于单独预测（0.917对0.824，Z = 3.098，P < 0.001；0.917对0.715，Z = 5.436，P < 0.001）。
在ADS评分中加入血清IL-6可显著提高内科病房AIS患者预测SAP的AUC。
