Deans' stroke musings: Novel Predictors of Stroke-Associated Pneumonia: A Single Center Analysis

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, April 14, 2022

Novel Predictors of Stroke-Associated Pneumonia: A Single Center Analysis

Well then, should the pneumonia vaccine be a protocol to prevent that problem? Provide solutions instead of just lazily just describing a problem. Does no one in stroke have any functioning brain cells at all?

Pneumonia Vaccine: Should I Get It? - WebMD

The latest here:

Novel Predictors of Stroke-Associated Pneumonia: A Single Center Analysis

Ya-ming Li,

Li Zhao,

Yue-guang Liu,

Yang Lu,

Jing-zhu Yao,

Chun-ju Li,

Wei Lu and

Jian-hua Xu^*

Department of Neurology, Jiading District Central Hospital Affiliated Shanghai University of Medicine & Health Sciences, Shanghai, China

Stroke-associated pneumonia (SAP) is a common cause of disability or death. Although the researches on SAP have been relatively mature, the method that can predict SAP with great accuracy has not yet been determined. It is necessary to discover new predictors to construct a more accurate predictive model for SAP. We continuously collected 2,366 patients with acute ischemic stroke, and then divided them into the SAP group and non-SAP group. Data were recorded at admission. Through univariate analyses and multivariate regression analyses of the data, the new predictive factors and the predictive model of SAP were determined. The receiver operating characteristic (ROC) curve and the corresponding area under the curve (AUC) were used to measure their predictive accuracy. Of the 2,366 patients, 459 were diagnosed with SAP. International normalized ratio (INR) (odds ratio = 37.981; 95% confidence interval, 7.487–192.665; P < 0.001), age and dysphagia were independent risk factors of SAP. However, walking ability within 48 h of admission (WA) (odds ratio = 0.395; 95% confidence interval, 0.287–0.543; P < 0.001) was a protective factor of SAP. Different predictors and the predictive model all could predict SAP (P < 0.001). The predictive power of the model (AUC: 0.851) which included age, homocysteine, INR, history of chronic obstructive pulmonary disease (COPD), dysphagia, and WA was greater than that of age (AUC: 0.738) and INR (AUC: 0.685). Finally, we found that a higher INR and no WA could predict SAP in patients with acute ischemic stroke. In addition, we designed a simple and practical predictive model for SAP, which showed relatively good accuracy. These findings might help identify high-risk patients with SAP and provide a reference for the timely use of preventive antibiotics.(Why not just prevent the problem with vaccines?)

Introduction

Stroke-associated pneumonia (newly developed pneumonia following stroke onset) is a common complication after stroke, with a reported incidence of 2.4% to 47% (1–3). Stroke-associated pneumonia (SAP) can worsen stroke outcomes, increase the occurrence of severe disabilities, and even cause death (4–8). There have been many studies on predicting SAP before. By summarizing a large number of studies, the predictors of SAP include age, sex, smoking, pre-stroke modified Rankin Scale (mRS), National Institutes of Health Stroke Scale (NIHSS), dysphagia, history of various diseases (e.g., atrial fibrillation, cardiac valve disease, chronic obstructive pulmonary disease, congestive heart failure, diabetes, etc.), and predictors in the blood (e.g., interleukin-6, interleukin-10, procalcitonin, C-reactive protein, leukocyte count, lymphocyte count, neutrophil-to-lymphocyte ratio, fibrinogen, etc.) (9–17). Although the researches on SAP have been relatively mature, the method that can predict SAP with great accuracy has not yet been determined. Moreover, for patients with acute ischemic stroke, routine examinations at admission have much more indicators than these predictive indicators. Therefore, it is necessary to discover new predictors in the routine examinations of stroke patients, and then combine these new factors with known predictors to form an accurate SAP prediction method.

In this study, we attempted to collect undiscovered blood indicators that may be related to SAP in patients with acute ischemic stroke. Then, we analyzed the indicators to determine whether there were new predictors. Furthermore, we tried to use these new predictors, combined with the patient's demographic characteristics, disease history, and stroke-related scores to design a simple and practical method for predicting SAP.