Department of Neurology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000, People's Republic of China.
Department of Cardiac Care Unit, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000, People's Republic of China.
Clin Interv Aging. 2021 Mar 22;16:505-511. doi: 10.2147/CIA.S301480. eCollection 2021.
Pneumonia is a common complication in patients with stroke. There was a close relationship between serum iron and inflammatory response. This study aimed to explore the relationship between serum iron levels and stroke-associated pneumonia (SAP).
Patients with acute stroke were recruited from the First Affiliated Hospital of Wenzhou Medical University and divided into SAP group and Non-SAP group. The demographic and clinical data of the patients were collected via the medical records, and the blood samples were collected within 24 hours after admission. The predictive value of serum iron to SAP was evaluated by receiver operating characteristic curve (ROC) and binary Logistic regression models. A restricted cubic spline (RCS) was used to furtherly clarify the relationship between serum iron and the risk of SAP.
A total of 906 participants were enrolled, including Non-SAP group (n = 755) and SAP group (n = 151). Serum iron levels in the SAP group were significantly lower than those in the Non-SAP group (9.77±5.61 vs 14.01±6.80, P < 0.001). Logistic regression showed that patients with high serum iron levels (≥7.8μmol/L) showed a lower risk of SAP (OR=0.43, 95% CI, 0.27-0.69, P < 0.001). Besides, the RCS model showed that there was an L-shaped relationship between the serum iron and risk of SAP (P for non-linearity: 0.014).
Low serum iron level was a risk factor for SAP, and there was an L-shaped relationship between them. Stroke patients with low serum iron levels should be alert to the risk of SAP.
肺炎是脑卒中患者的常见并发症。血清铁与炎症反应之间存在密切关系。本研究旨在探讨血清铁水平与卒中相关性肺炎（SAP）的关系。
本研究纳入温州医科大学附属第一医院的急性脑卒中患者，分为 SAP 组和非 SAP 组。通过病历收集患者的人口统计学和临床数据，并在入院后 24 小时内采集血样。通过受试者工作特征曲线（ROC）和二元 Logistic 回归模型评估血清铁对 SAP 的预测价值。采用限制性立方样条（RCS）进一步阐明血清铁与 SAP 风险之间的关系。
共纳入 906 名参与者，包括非 SAP 组（n=755）和 SAP 组（n=151）。SAP 组的血清铁水平明显低于非 SAP 组（9.77±5.61 vs 14.01±6.80，P<0.001）。Logistic 回归显示，血清铁水平较高（≥7.8μmol/L）的患者 SAP 风险较低（OR=0.43，95%CI，0.27-0.69，P<0.001）。此外，RCS 模型显示血清铁与 SAP 风险之间呈 L 形关系（P 非线性：0.014）。
低血清铁水平是 SAP 的危险因素，两者之间存在 L 形关系。血清铁水平较低的脑卒中患者应警惕 SAP 的风险。
