Ji et al developed a score for predicting stroke-associated pneumonia (SAP) after acute ischemic stroke (AIS). This can help to identify a patient who should be monitored more closely for this complication. The authors are from the China National Stroke Registry.
Patient selection: acute ischemic stroke
Outcome: stroke-associated pneumonia (SAP)
Parameters:
(1) age in years
(2) atrial fibrillation
(3) congestive heart failure (CHF)
(4) COPD
(5) current smoking
(6) prestroke disability (modified Rankin scale >= 3)
(7) admission NIHSS
(8) admission Glasgow coma score (GCS)
(9) symptoms of dysphagia
(10) Oxfordshire Community Stroke Project (OCSP) stroke subtype
(11) admission glucose in mmol/L
|
Paraemeter |
Finding |
Points |
|
age in years |
<= 59 years |
0 |
|
|
60 to 69 years |
2 |
|
|
70 t0 79 years |
5 |
|
|
>= 80 years |
7 |
|
atrial fibrillation |
absent |
0 |
|
|
present |
1 |
|
congestive heart failure |
absent |
0 |
|
|
present |
3 |
|
COPD |
absent |
0 |
|
|
present |
3 |
|
current smoking |
absent |
0 |
|
|
present |
1 |
|
prestroke disability |
absent |
0 |
|
|
present |
2 |
|
admission NIHSS |
0 to 4 |
0 |
|
|
5 to 9 |
2 |
|
|
10 to 14 |
5 |
|
|
>= 15 |
8 |
|
admission GCS |
9 to 15 |
0 |
|
|
3 to 8 |
3 |
|
dysphagia |
absent |
0 |
|
|
present |
3 |
|
OCSP stroke subtype |
lacunar circulation infarct (LACI) |
0 |
|
|
partial anterior circulation infarct (PACI) |
0 |
|
|
total anterior circulation infarct (TACI) |
2 |
|
|
posterior circulation infarct (POCI) |
2 |
|
admission glucose |
<= 11 mmol/L |
0 |
|
|
> 11 mmol/L |
2 |
total score =
= SUM(points for all of the parameters)
Interpretation:
• minimum score: 0
• maximum score: 35
• The higher the score the greater the risk for stroke-associated pneumonia.
|
Total Score |
Risk Group |
Percent with SAP |
|
0 to 6 |
very low |
< 5% |
|
7 to 13 |
low |
10-15% |
|
14 to 20 |
intermediate |
40% |
|
21 to 27 |
high |
50-60% |
|
28 to 35 |
very high |
70-80% |
Performance:
• The area under the ROC curve was 0.79.
Specialty: Infectious Diseases, Neurology, Pulmonology
