Risk factors of acute stroke associated pneumonia and predictive value of serum amyloid A combined with neutrophil-to-lymphocyte ratio

Abstract

Objectives: This study aimed to explore the risk factors for stroke-associated pneumonia (SAP) and assess the predictive value of Serum Amyloid A (SAA) combined with neutrophil-to-lymphocyte ratio (NLR) on SAP.

Methods: The study included acute ischemic stroke (AIS) patients from January 2021 to June 2022 in our hospital. The patients’ history of chronic diseases, the clinical characteristics, and the laboratory testing data were recorded. SPSS 22 was used for statistical analysis. Receiver operating characteristics (ROC) curves and logistic regression analysis were used to identify independent predictors.

Results: We studied 356 patients with AIS, of which 19.4% (n = 69) developed SAP. In the SAP group, the patients with higher the proportion of hypertension, coronary heart disease and higher the NIHSS score were older, the blood glucose, neutrophil count, NLR and SAA of the SAP group were significantly higher than the Non-SAP group. Multiple logistic regression analysis for SAP showed that age , NIHSS,SAA and NLR were independent risk factors for SAP. For SAA alone, the area under the curve (AUC) in the ROC curve was 0.765, For NLR alone, the AUC was 0.840. When SAA combined with NLR, the AUC increased to 0.853. we created a 4-item prediction model, the AUC increased to 0.881.

Conclusion: Age, NIHSS, SAA and NLR were independent risk factors for SAP. When SAA combined with NLR, its predictive value for SAP was higher than its alone, the value of prediction for SAP appeared to be much stronger when SAA and NLR incorporated in a prediction model including age, and NIHSS.