不同卒中相关性肺炎预测量表预测缺血性脑卒中患者发生医院获得性肺炎的效果

目的探讨不同卒中相关性肺炎量表在预测缺血性脑卒中患者医院获得性肺炎中的应用效果。方法收集某二级综合医院2015—2018年入住神经内科的缺血性脑卒中患者病历资料,采用受试者工作特征曲线(ROC)对6个卒中相关性肺炎预测量表在缺血性脑卒中患者医院获得性肺炎中的应用进行分析,评估各预测量表的性能。结果共收集628例患者资料。发生医院获得性肺炎44例(发生率为7.01%),发生卒中相关性肺炎46例(发生率为7.32%)。Kwon等评分量表、Chumbler等评分量表、A2 DS2量表、PANTHERIS量表、ASI-APS量表、ISAN量表的c统计量分别为0.731、0.764、0.729、0.728、0.66、0.778,除ASI-APS量表外,其他5个量表差异均有统计学意义(均P0.05),但各量表曲线下面积差异无统计学意义(均P0.05)。各量表医院获得性肺炎预测性能与报道卒中相关性肺炎预测性能对比,Chumbler等评分量表和ISAN量表在预测HAP和SAP中的性能差异较小。结论除ASI-APS量表,其他卒中相关性肺炎预测量表可应用于预测缺血性脑卒中患者医院获得性肺炎。

Effect of different predictive scales of stroke-associated pneumonia on predicting hospital-acquired pneumonia in patients with ischemic stroke

Objective To explore the application effect of different scales of stroke-associated pneumonia (SAP) on predicting hospital-acquired pneumonia (HAP) in patients with ischemic stroke. Methods Data of patients with ischemic stroke admitted to department of neurology in a secondary general hospital from 2015 to 2018 were collected, the application of 6 SAP predictive scales in predicting HAP in patients with ischemic stroke was analyzed by recei-ver operating characteristic(ROC) curve, and performance of each predictive scale was evaluated. Results Data of 628 patients were collected, there were 44 cases of HAP (7.01%) and 46 cases of SAP (7.32%). C statistics of Kwon, Chumbler,A²DS²,PANTHERIS,ASI-APS,and ISAN were 0.731, 0.764, 0.729, 0.728, 0.66, and 0.778 respectively, except for ASI-APS sale, there were significant differences among the other 5 scales (all P<0.05), but there was no significant difference in the area under the curve of each score (all P>0.05). Comparison of predictive performance of HAP and reported SAP showed that Chumbler and ISAN had little difference in predicting HAP and SAP. Conclusion Except ASI-APS, other SAP predictive scales can be used to predict HAP in patients with ischemic stroke.