J Korean Neurol Assoc > Volume 21(5); 2003 > Article
Journal of the Korean Neurological Association 2003;21(5): 455-460.
급성 뇌졸중 후 발생하는 폐렴에 관한 예측인자
권형민 , 정상욱 홍근식 한문구 주 건 윤병우
서울대학교 의과대학 신경과학교실, 인제대학교 의과대학 신경과학교실 일산 백병원
Predicting Factors in the Development of Pneumonia after Acute Stroke
Hyung-Min Kwon
"Department of Neurology, Seoul National University College of Medicine, Inje University Collge of Medicine, Ilsan Paik Hospital"
Abstract
"Background: Pneumonia is a common medical complication after acute stroke, and makes a considerable influence on the prognosis. It is potentially preventable or treatable if early recognized. Thus, the identification of which patients are at risk for the development of pneumonia is clinically significant.
Methods: A total of 240 patients with an acute stroke who were consecutively admitted to a Seoul National University Hospital were studied. The following prognostic factors were accounted for in the statistical analyses: age, sex, hypertension, diabetes, cardiac disease, smoking, recurrent stroke, NIHSS, modified Rankin scale (mRS), the presence of dysphagia, blood pressure, body temperature, white blood cell count, blood sugar, fibrinogen, Levin tube insertion, Foley catheter insertion, and subtype of stroke.
Results: Pneumonia was diagnosed in 36 (17.0%) patients during the acute stage of stroke, particularly within 2 weeks. Average admission stay of patients with pneumonia was 38.7 days, whereas it was 19.3 days for those without pneumonia. By multivariate analysis, Levin tube insertion, body temperature, recurrent stroke, and mRS were significant predictor of pneumonia development. Forty percent of patients with four or five points of mRS developed pneumonia, compared to 6% in less than four points.
Conclusions: Our results show that the patients who have Levin tube, high mRS, or recurrent stroke tend to develop pneumonia after acute stroke. It is important for early detection and prevention of pneumonia in patients with high mRS.Key Words: Pneumonia, Acute stroke, Complications"
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