Department of Neurology, Tokai University School of Medicine, Isehara, Japan.
Department of Nursing, Tokai University Hospital, Isehara, Japan.
J Int Med Res. 2021 Nov;49(11):3000605211055829. doi: 10.1177/03000605211055829.
Stroke-associated pneumonia (SAP) is a comorbidity of ischemic stroke related to clinical outcomes. Early enteral nutrition (EEN; within 48 hours) reduces the incidence of infection and length of intensive care unit (ICU)/hospital stay. The relationship between EEN and critical care outcomes, including SAP, in patients with ischemic stroke has been insufficiently studied.
We recruited 499 patients in this retrospective observational study. We evaluated SAP incidence within 14 days from admission. Patients were divided into an EEN group and a late EN group (LEN; start later than EEN). We compared groups regarding background and length of ICU/hospital stay.
EN was started within 48 hours in 236 patients. SAP was diagnosed in 94 patients (18.8%), with most in the LEN group (28.1% vs. 8.5%). Median [interquartile range] lengths of hospitalization (22 [12-30] days vs. 35 [20-45] days) and ICU stay (4 [2-5] days vs. 6 [3-8] days) were longer in the LEN group. EEN reduced the incidence of SAP. By contrast, consciousness disturbance and worsening consciousness level increased the SAP incidence. Increased age and National Institutes of Health Stroke Scale score were associated with start of prolonged EN.
We found that EEN may reduce SAP risk.
卒中相关性肺炎（SAP）是与缺血性脑卒中相关的一种并发症，与临床结局有关。早期肠内营养（EEN；48 小时内）可降低感染发生率和重症监护病房（ICU）/住院时间。EEN 与包括 SAP 在内的危重症结局之间的关系在缺血性脑卒中患者中研究不足。
我们在这项回顾性观察研究中招募了 499 名患者。我们评估了入院后 14 天内 SAP 的发生率。患者分为 EEN 组和晚期肠内营养（LEN；晚于 EEN 开始）组。我们比较了两组的背景和 ICU/住院时间。
236 名患者在 48 小时内开始肠内营养。94 名患者（18.8%）被诊断为 SAP，其中大多数在 LEN 组（28.1%比 8.5%）。LEN 组的住院时间中位数（22 [12-30]天比 35 [20-45]天）和 ICU 住院时间中位数（4 [2-5]天比 6 [3-8]天）更长。EEN 可降低 SAP 的发生率。相比之下，意识障碍和意识水平恶化增加了 SAP 的发生率。年龄增加和美国国立卫生研究院卒中量表评分与延长肠内营养的开始相关。
我们发现 EEN 可能降低 SAP 风险。
