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Predictive value of the Oxford Acute Severity of Illness Score in acute stroke patients with stroke-associated pneumonia

BACKGROUND: Stroke-associated pneumonia (SAP) is associated with a poor prognosis and a high mortality rate in stroke patients. However, the accuracy of early prediction of SAP is insufficient, and there is a lack of effective prognostic evaluation methods. Therefore, in this study, we investigated...

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Autores principales: Wang, Ximei, Xia, Jianhua, Shan, Yanhua, Yang, Yang, Li, Yun, Sun, Haiyan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10507346/
https://www.ncbi.nlm.nih.gov/pubmed/37731859
http://dx.doi.org/10.3389/fneur.2023.1251944
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author Wang, Ximei
Xia, Jianhua
Shan, Yanhua
Yang, Yang
Li, Yun
Sun, Haiyan
author_facet Wang, Ximei
Xia, Jianhua
Shan, Yanhua
Yang, Yang
Li, Yun
Sun, Haiyan
author_sort Wang, Ximei
collection PubMed
description BACKGROUND: Stroke-associated pneumonia (SAP) is associated with a poor prognosis and a high mortality rate in stroke patients. However, the accuracy of early prediction of SAP is insufficient, and there is a lack of effective prognostic evaluation methods. Therefore, in this study, we investigated the predictive value of the Oxford Acute Severity of Illness Score (OASIS) in SAP to provide a potential reference index for the incidence and prognosis of SAP. METHODS: We recruited a total of 280 patients with acute ischemic stroke who had been diagnosed and treated in the Zhumadian Central Hospital between January 2021 and January 2023. These patients were divided into an SAP group (86 cases) and a non-SAP group (194 cases) according to SAP diagnostic criteria by expert consensus on the diagnosis and treatment of SAP. We collated general and clinical data from all patients, including the survival of SAP patients during the follow-up period. Multivariate logistic regression was used to analyze the risk factors for SAP. Kaplan–Meier and multivariate COX regression analyses were used to investigate the relationship between OASIS and the prognosis of SAP, and a receiver operating characteristic (ROC) curve was drawn to analyze the predictive value of OASIS for SAP. RESULTS: Our analyses identified body temperature, C-reactive protein, procalcitonin, OASIS, and a prolonged length of intensive care unit (ICU) stay as the main risk factors for SAP (all Ps < 0.05). Advanced age and an elevated OASIS were identified as the main risk factors for death in SAP patients (all Ps < 0.05). The risk of death in patients with OASIS of 31–42 points was significantly higher than that in patients with OASIS of 12–20 points (HR = 5.588, 95% CI = 1.531–20.401, P = 0.009). ROC curve analysis further showed that OASIS had a high predictive value for morbidity and the incidence of death in SAP patients. CONCLUSION: OASIS can effectively predict the onset and death of SAP patients and provides a potential reference index for early diagnosis and the prediction of prognosis in patients with SAP. Our findings should be considered in clinical practice.
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spelling pubmed-105073462023-09-20 Predictive value of the Oxford Acute Severity of Illness Score in acute stroke patients with stroke-associated pneumonia Wang, Ximei Xia, Jianhua Shan, Yanhua Yang, Yang Li, Yun Sun, Haiyan Front Neurol Neurology BACKGROUND: Stroke-associated pneumonia (SAP) is associated with a poor prognosis and a high mortality rate in stroke patients. However, the accuracy of early prediction of SAP is insufficient, and there is a lack of effective prognostic evaluation methods. Therefore, in this study, we investigated the predictive value of the Oxford Acute Severity of Illness Score (OASIS) in SAP to provide a potential reference index for the incidence and prognosis of SAP. METHODS: We recruited a total of 280 patients with acute ischemic stroke who had been diagnosed and treated in the Zhumadian Central Hospital between January 2021 and January 2023. These patients were divided into an SAP group (86 cases) and a non-SAP group (194 cases) according to SAP diagnostic criteria by expert consensus on the diagnosis and treatment of SAP. We collated general and clinical data from all patients, including the survival of SAP patients during the follow-up period. Multivariate logistic regression was used to analyze the risk factors for SAP. Kaplan–Meier and multivariate COX regression analyses were used to investigate the relationship between OASIS and the prognosis of SAP, and a receiver operating characteristic (ROC) curve was drawn to analyze the predictive value of OASIS for SAP. RESULTS: Our analyses identified body temperature, C-reactive protein, procalcitonin, OASIS, and a prolonged length of intensive care unit (ICU) stay as the main risk factors for SAP (all Ps < 0.05). Advanced age and an elevated OASIS were identified as the main risk factors for death in SAP patients (all Ps < 0.05). The risk of death in patients with OASIS of 31–42 points was significantly higher than that in patients with OASIS of 12–20 points (HR = 5.588, 95% CI = 1.531–20.401, P = 0.009). ROC curve analysis further showed that OASIS had a high predictive value for morbidity and the incidence of death in SAP patients. CONCLUSION: OASIS can effectively predict the onset and death of SAP patients and provides a potential reference index for early diagnosis and the prediction of prognosis in patients with SAP. Our findings should be considered in clinical practice. Frontiers Media S.A. 2023-09-04 /pmc/articles/PMC10507346/ /pubmed/37731859 http://dx.doi.org/10.3389/fneur.2023.1251944 Text en Copyright © 2023 Wang, Xia, Shan, Yang, Li and Sun. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Neurology
Wang, Ximei
Xia, Jianhua
Shan, Yanhua
Yang, Yang
Li, Yun
Sun, Haiyan
Predictive value of the Oxford Acute Severity of Illness Score in acute stroke patients with stroke-associated pneumonia
title Predictive value of the Oxford Acute Severity of Illness Score in acute stroke patients with stroke-associated pneumonia
title_full Predictive value of the Oxford Acute Severity of Illness Score in acute stroke patients with stroke-associated pneumonia
title_fullStr Predictive value of the Oxford Acute Severity of Illness Score in acute stroke patients with stroke-associated pneumonia
title_full_unstemmed Predictive value of the Oxford Acute Severity of Illness Score in acute stroke patients with stroke-associated pneumonia
title_short Predictive value of the Oxford Acute Severity of Illness Score in acute stroke patients with stroke-associated pneumonia
title_sort predictive value of the oxford acute severity of illness score in acute stroke patients with stroke-associated pneumonia
topic Neurology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10507346/
https://www.ncbi.nlm.nih.gov/pubmed/37731859
http://dx.doi.org/10.3389/fneur.2023.1251944
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