卒中合并医院获得性肺炎的危险因素：队列研究的系统评价和荟萃分析。

Risk factors of stroke complicated with hospital-acquired pneumonia: a systematic review and meta-analysis of cohort studies.

机构信息

Department of Emergency, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China; Department of Emergency, Jiangsu Province Hospital of Chinese Medicine, Nanjing, China.

Department of Respiratory and Critical Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China; Department of Respiratory and Critical Medicine, Jiangsu Province Hospital of Chinese Medicine, Nanjing, China.

出版信息

Ann Palliat Med. 2021 Dec;10(12):12381-12389. doi: 10.21037/apm-21-3278.

DOI:10.21037/apm-21-3278

PMID:35016483

Abstract

BACKGROUND

Hospital-acquired pneumonia (HAP) is a common type of nosocomial infection and a common complication experienced by stroke patients during hospitalization. HAP can aggravate patients' primary disease condition and lead to death. Clinically, a variety of factors may affect the occurrence of HAP in patients. In this study, we conducted a meta-analysis of the literature to investigate the risk factors of stroke with HAP for clinical reference.

METHODS

The PubMed, Medline, Embase and Cochrane Library databases were selected as the sources for the literature search. English-language publications were included. The articles related to stroke with HAP were published from January 2000 to January 2021. The articles were screened and their quality was evaluated using the Newcastle-Ottawa Scale. A meta-analysis was performed of the factors affecting the incidence of HAP using Revman 5.4 software.

RESULTS

Ultimately, 7 articles with a total of 1,172 patients were included in the meta-analysis. Of the 1,172 patients, 352 (30.03%) had an HAP infection. The results of the meta-analysis showed that patient age [mean difference (MD) =4.91, 95% confidence interval (CI): 3.90 to 5.93; P<0.00001], National Institutes of Health Stroke Scale (NIHSS) score (MD =3.84, 95% CI: 3.01 to 4.67; P<0.00001), and patient malnutrition [odds ratio (OR) =1.85, 95% CI: 1.13 to 3.04; P=0.02] were risk factors for the development of HAP, while gender, stroke history, smoking history, and comorbidities (diabetes, hypertension, coronary heart disease, and hyperlipidemia) were not risk factors for the development of HAP.

DISCUSSION

A total of 7 articles were included in this meta-analysis examining the influencing factors of HAP in stroke patients. The results showed that age, NIHSS score, and malnutrition were risk factors of HAP in stroke patients, while gender, stroke history, smoking history, and complications (diabetes, hypertension, coronary heart disease, and hyperlipidemia) were not influencing factors of HAP.

摘要

背景

医院获得性肺炎（HAP）是一种常见的医院感染类型，也是中风患者住院期间常见的并发症。HAP 可使患者的基础疾病恶化，并导致死亡。临床上，多种因素可能会影响患者发生 HAP。本研究通过对文献进行荟萃分析，旨在探讨 HAP 发生的危险因素，为临床提供参考。

方法

检索PubMed、Medline、Embase 和 Cochrane Library 数据库，检索时限均为 2000 年 1 月至 2021 年 1 月，纳入关于中风合并 HAP 的英文文献。采用纽卡斯尔-渥太华量表（Newcastle-Ottawa Scale）对纳入文献进行质量评价，采用 Revman 5.4 软件对影响 HAP 发生率的因素进行荟萃分析。

结果

最终纳入 7 篇文献，共 1172 例患者。1172 例患者中，352 例（30.03%）发生 HAP。荟萃分析结果显示，患者年龄[均数差（MD）=4.91，95%置信区间（CI）：3.90 至 5.93；P<0.00001]、美国国立卫生研究院卒中量表（NIHSS）评分（MD=3.84，95%CI：3.01 至 4.67；P<0.00001）和患者营养不良[比值比（OR）=1.85，95%CI：1.13 至 3.04；P=0.02]是 HAP 发生的危险因素，而性别、卒中史、吸烟史和合并症（糖尿病、高血压、冠心病和高脂血症）不是 HAP 发生的危险因素。