Deans' stroke musings: Risk factors for and outcomes of poststroke pneumonia in patients with acute ischemic stroke treated with mechanical thrombectomy

Changing stroke rehab and research worldwide now.Time is Brain! trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 523 posts on hyperacute therapy, enough for researchers to spend decades proving them out. These are my personal ideas and blog on stroke rehabilitation and stroke research. Do not attempt any of these without checking with your medical provider. Unless you join me in agitating, when you need these therapies they won't be there.

What this blog is for:

My blog is not to help survivors recover, it is to have the 10 million yearly stroke survivors light fires underneath their doctors, stroke hospitals and stroke researchers to get stroke solved. 100% recovery. The stroke medical world is completely failing at that goal, they don't even have it as a goal. Shortly after getting out of the hospital and getting NO information on the process or protocols of stroke rehabilitation and recovery I started searching on the internet and found that no other survivor received useful information. This is an attempt to cover all stroke rehabilitation information that should be readily available to survivors so they can talk with informed knowledge to their medical staff. It lays out what needs to be done to get stroke survivors closer to 100% recovery. It's quite disgusting that this information is not available from every stroke association and doctors group.

Thursday, March 9, 2023

Risk factors for and outcomes of poststroke pneumonia in patients with acute ischemic stroke treated with mechanical thrombectomy

Fuck, we don't need predictions of pneumonia you blithering idiots, solve the problem of preventing that pneumonia in the first place. I'd have you all fired.

You've known about this problem for a long time. GET THERE!

Just maybe this vaccine!

Pneumonia Vaccine (3 posts to July 2020)

But we've known for years that pneumonia can occur post stroke, What is the solution to prevent it?

11% Stroke-associated pneumonia (3 posts to October 2020)

The latest here:

Risk factors for and outcomes of poststroke pneumonia in patients with acute ischemic stroke treated with mechanical thrombectomy

Ping Zhang^†,

Lei Chen^†,

Yi Jiang,

Hui Yuan,

Xuan Zhu,

Minmin Zhang,

Tao Wu,

Benqiang Deng,

Pengfei Yang^*,

Yongwei Zhang^* and

Jianmin Liu

Neurovascular Center, Changhai Hospital, Naval Medical University, Shanghai, China

Objective: The purpose of the study was to assess the risk factors for poststroke pneumonia (PSP) and its association with the outcomes in patients with acute ischemic stroke (AIS) due to large artery occlusion treated with mechanical thrombectomy (MT).

Methods: Consecutive patients with AIS who underwent MT from January 2019 to December 2019 in the stroke center of Changhai Hospital were identified retrospectively. All of the patients were evaluated for the occurrence of PSP while in the hospital, and their modified Rankin scale (mRS) scores were assessed 90 days after having a stroke. Logistic regression analysis was conducted to determine the independent predictors of PSP, and the associations between PSP and clinical outcomes were analyzed.

Results: A total of 248 patients were enrolled, of whom 33.47% (83) developed PSP. Logistic regression analysis revealed that body mass index (BMI) [unadjusted odds ratio (OR) 1.200, 95% confidence interval (CI) 1.038–1.387; p = 0.014], systemic immune-inflammation index (SII) (OR 1.001, 95% CI 1.000–1.002; p = 0.003), dysphagia (OR 9.498, 95% CI 3.217–28.041; p < 0.001), and intubation after MT (OR 4.262, 95% CI 1.166–15.581; p = 0.028) were independent risk factors for PSP. PSP was a strong predictor of clinical outcomes: it was associated with functional independence (mRS score ≤ 2) (OR 0.104, 95% CI 0.041–0.260; p < 0.001) and mortality at 90 days (OR 3.010, 95% CI 1.068–8.489; p = 0.037).

Conclusion: More than one in three patients with AIS treated with MT developed PSP. Dysphagia, intubation, higher BMI, and SII were associated with PSP in these patients. Patients with AIS who develop PSP are more likely to experience negative outcomes. The prevention and identification of PSP are necessary to reduce mortality and improve clinical outcomes.

Introduction

Mechanical thrombectomy (MT) has been proven to be effective for patients with acute ischemic stroke (AIS) due to large artery occlusion (1). Although most of these patients achieve complete recanalization after MT, many patients with AIS die of complications (2). The most common complication is pneumonia, which negatively affects clinical outcomes and increases the cost and duration of hospitalization (3). The prediction of poststroke pneumonia (PSP) remains challenging. No single biomarker pattern predicting PSP or outcome has been identified (3). The severity of stroke and dysphagia are considered risk factors for PSP (4). However, there is still no conclusive evidence regarding the risks and effects of PSP after MT (5). Whether thrombolysis before MT or anesthesia adds potential health risks for patients and increases PSP rates is still uncertain (6, 7). Therefore, it is necessary to investigate the risk factors for PSP and its association with outcomes in patients with AIS treated with MT. The goal of this study was to evaluate the predictive factors of PSP in patients with AIS with MT and the association between PSP and clinical outcomes.