A STUDY ON STROKE-ASSOCIATED PNEUMONIA IN A TERTIARY CARE CENTER AND EFFECT OF SERUM ALBUMIN ON PATIENT OUTCOMES
DOI:
https://doi.org/10.22159/ajpcr.2022.v15i7.44845Keywords:
Stroke, Pneumonia, Serum albumin, Nosocomial infection, Smoking, Total cholesterolAbstract
Objectives: The objectives of this study were to determine if serum albumin level is an independent predictor of nosocomial pneumonia in stroke patients.
Methods: Relevant medical data of 500 consecutive ischemic stroke patients admitted within 24 h of stroke onset during the study period were analyzed. Serum albumin level was measured within 36 h after stroke onset. Nosocomial pneumonia was foundin 10.5% of stroke patients. SPSS (Version 22.0) was used for analysis.
Results: Patients with pneumonia had significantly lower serum albumin level than those without pneumonia (31.5 ± 7.3 g/l vs. 35.3 ± 6.4 g/l) and serum albumin level was associated with risk of pneumonia on multivariate analysis (OR: 0.95, 95% CI: 0.90–0.97).
Conclusion: Our results show that serum albumin level is an independent predictor of nosocomial pneumonia in stroke patients.
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References
Vincent JL. Nosocomial infections in adult intensive-care units. Lancet 2013;361:2068-77.
Dziedzic T, Slowik A, Szczudlik A. Nosocomial infectionsand immunity: Lesson from brain-injured patients. Crit Care 2014;8: 266-70.
Schneider SM, Veyres P, Pivot X, Soummer AM, Jambou P, Filippi J, et al. Malnutrition is an independent factor associated with nosocomial infections. Br J Nutr 2014;92:105-11.
Lis CG, Grutsch JF, Vashi PG, Lammersfeld CA. Is serum albumin an independent predictor of survival in patients with breast cancer? JPEN J Parenter Enteral Nutr 2003;27:10-5. doi: 10.1177/014860710302700110, PMID 12549592
Hill MD, Martin RH, Palesch YY, Tamariz D, Waldman BD, Ryckborst KJ, et al. The albumin in acute stroke part 1 trial: An exploratory efficacy analysis. Stroke 2015;42:1621-5.
Famakin B, Weiss P, Hertzberg V, McClellan W, Presley R, Krompf K, et al. Hypoalbuminemia predicts acute stroke mortality: Paul coverdell georgia stroke registry. J Stroke Cerebrovasc Dis 2010;19:17-22. doi: 10.1016/j.jstrokecerebrovasdis.2009.01.015, PMID 20123222
Cairella G, Scalfi L, Canani RB, Garbagnati F, Gentile MG, Gianni C, et al. Nutritional management of stroke patients. Riv Ital Nutr Parenterale Enterale 2014;22:205-26.
Gariballa SE, Parker SG, Taub N, Castleden CM. Influence of nutritional status on clinical outcome after acute stroke. Am J Clin Nutr 2009;8:275-81.
Multicenter trial of hemodilution in ischemic stroke--background and study protocol. Scandinavian Stroke Study Group. Stroke 1985;16:885-90. doi: 10.1161/01.str.16.5.885, PMID 3901425
Weimar C, Roth MP, Zillessen G, Glahn J, Wimmer ML, Busse O, et al. Complications following acute ischemic stroke. Eur Neurol 2002;48:133-40. doi: 10.1159/000065512, PMID 12373029
Katzan IL, Cebul RD, Husak SH, Dawson NV, Baker DW. The effect of pneumonia on mortality among patients hospitalized for acute stroke. Neurology 2003;60:620-5. doi: 10.1212/01.wnl.0000046586.38284.60, PMID 12601102
Aslanyan S, Weir CJ, Diener HC, Kaste M, Lees KR, GAIN International Steering Committee and Investigators. Pneumonia and urinary tract infection after acute ischaemic stroke: A tertiary analysis of the GAIN International trial. Eur J Neurol 2004;11:49-53.
Hilker R, Poetter C, Findeisen N, Sobesky J, Jacobs A, Neveling M, et al. Nosocomial pneumonia after acute stroke: Implications for neurological intensive care medicine. Stroke 2003;34:975-81. doi: 10.1161/01.STR.0000063373.70993.CD, PMID 12637700
Dziewas R, Ritter M, Schilling M, Konrad C, Oelenberg S, Nabavi DG, et al. Pneumonia in acute stroke patients fed by nasogastric tube. J Neurol Neurosurg Psychiatry 2017;75:852-6.
Kalita J, Singh RK, Misra UK. Cerebral salt wasting is the most common cause of hyponatremia in stroke. J Stroke Cerebrovasc Dis 2017;26:1026-32. doi: 10.1016/j.jstrokecerebrovasdis.2016.12.011, PMID 28110888
Hannon MJ, Behan LA, O’Brien MM, Tormey W, Ball SG, Javadpour M, et al. Hyponatremia following mild/moderate subarachnoid hemorrhage is due to SIAD and glucocorticoid deficiency and not cerebral salt wasting. J Clin Endocrinol Metab 2014;99:291-8. doi: 10.1210/jc.2013-3032, PMID 24248182
Hoffmann S, Malzahn U, Harms H, Koennecke HC, Berger K, Kalic M, et al. Development of a clinical score (A2DS2) to predict pneumonia in acute ischemic stroke. Stroke 2012;43:2617-23. doi: 10.1161/ STROKEAHA.112.653055, PMID 22798325
Ritarwan K, Batubara CA, Dhanu R. The relationship between pneumonia and Glasgow coma scale assessment on acute stroke patients. IOP Conf Ser Earth Environ Sci 2018;125:012204. doi: 10.1088/1755- 1315/125/1/012204
Batubara CA. The Relationship was Clinical Score A2DS2 for Pneumonia Patients on Acute Stroke. Dissertation; 2015.
Gong S, Zhou Z, Zhou M, Guo J, Chen N, He L. Validation of risk scoring models for predicting stroke-associated pneumonia in patients with ischaemic stroke. Stroke Vasc Neurol 2016;1:122-6.
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