Thong Tran Huu, Hien Nguyen Thi Thu, Trung Tran Huu, Phan Thang, Lam Tran Huu
Center for Emergency Medicine, Bach Mai Hospital, Hanoi, Vietnam.
Department of Emergency and Critical Care Medicine, Hanoi Medical University, Hanoi, Vietnam.
Dysphagia. 2025 Jul 9. doi: 10.1007/s00455-025-10858-8.
Stroke-associated pneumonia is a common complication in acute ischemic stroke patients, particularly those with dysphagia. Although some studies have addressed stroke-associated pneumonia, research remains limited on this issue among acute ischemic stroke patients with dysphagia, especially in Vietnam. This study used data from a prior cross-sectional study conducted at Bach Mai Hospital in Hanoi, Vietnam. A total of 681 acute ischemic stroke patients with dysphagia were included in the study. The outcome variable was the occurrence of stroke-associated pneumonia within seven days of post-stroke. Univariate and multivariate logistic regression analyses were performed to assess associations with stroke-associated pneumonia. The prevalence of stroke-associated pneumonia among acute ischemic stroke patients with dysphagia was 10.3%. Stroke-associated pneumonia was significantly associated with age > 70 years (AOR: 2.0, 95% CI: 1.1-3.7, P = 0.02), combined or other stroke locations (AOR: 2.6, 95% CI: 1.03-6.3, P = 0.04), National Institute of Health Stroke Scale (NIHSS) score > 14 (AOR: 2.8, 95% CI: 1.4-5.6, P < 0.01), tube feeding (AOR: 3.9, 95% CI: 1.7-8.9, P < 0.01), and hospital stays longer than 14 days (AOR: 3.7, 95% CI: 1.6-8.5, P < 0.01). We found that stroke-associated pneumonia accounts for a significant proportion of stroke patients with dysphagia. The status of stroke-associated pneumonia is associated with older age, specific stroke locations, higher stroke severity, tube feeding, and prolonged hospitalization. We suggest prioritizing respiratory care and physiotherapy, particularly for elderly patients, individuals with severe strokes, those undergoing tube feeding, and those experiencing prolonged hospitalization.
卒中相关性肺炎是急性缺血性卒中患者常见的并发症，尤其是那些存在吞咽困难的患者。尽管一些研究已探讨过卒中相关性肺炎，但针对急性缺血性卒中合并吞咽困难患者的这一问题，研究仍然有限，在越南尤其如此。本研究使用了此前在越南河内巴美医院开展的一项横断面研究的数据。共有681例急性缺血性卒中合并吞咽困难的患者纳入本研究。结局变量为卒中后7天内卒中相关性肺炎的发生情况。进行单因素和多因素逻辑回归分析以评估与卒中相关性肺炎的关联。急性缺血性卒中合并吞咽困难患者中卒中相关性肺炎的患病率为10.3%。卒中相关性肺炎与年龄>70岁（比值比：2.0，95%置信区间：1.1 - 3.7，P = 0.02）、合并或其他卒中部位（比值比：2.6，95%置信区间：1.03 - 6.3，P = 0.04）、美国国立卫生院卒中量表（NIHSS）评分>14（比值比：2.8，95%置信区间：1.4 - 5.6，P < 0.01）、鼻饲（比值比：3.9，95%置信区间：1.7 - 8.9，P < 0.01）以及住院时间超过14天（比值比：3.7，95%置信区间：1.6 - 8.5，P < 0.01）显著相关。我们发现卒中相关性肺炎在急性缺血性卒中合并吞咽困难的患者中占相当大的比例。卒中相关性肺炎的状况与高龄、特定的卒中部位、更高的卒中严重程度、鼻饲以及住院时间延长有关。我们建议优先进行呼吸护理和物理治疗，尤其是针对老年患者、重症卒中患者、接受鼻饲的患者以及住院时间延长的患者。
