The A(2)DS(2) Score as a Predictor of Pneumonia and In-Hospital Death after Acute Ischemic Stroke in Chinese Populations

BACKGROUND AND PURPOSE: Stroke-associated pneumonia (SAP) is a common complication and an important cause of death during hospitalization. The A(2)DS(2) (Age, Atrial fibrillation, Dysphagia, Sex, Stroke Severity) score was developed from the Berlin Stroke Registry and showed good predictive value for predicting SAP. We sought to identify the association between the A(2)DS(2) score and SAP, and, furthermore, to identify whether the A(2)DS(2) score was a predictor for in-hospital death after acute ischemic stroke in a Chinese population. METHODS: This was a retrospective study. 1239 acute ischemic stroke patients were classified to low A(2)DS(2) group (0–4) and high A(2)DS(2) score (5–10) group. Primary outcome was in-hospital SAP. Logistic regression analyses were performed to identify the association between the A(2)DS(2) score and SAP, and also the association between the A(2)DS(2) score and in-hospital death. RESULTS: The overall incidence rates of SAP and in-hospital mortality after acute ischemic stroke were 7.3% and 2.4%, respectively. The incidence rate of SAP in low and high A(2)DS(2) score groups was separately 3.3% and 24.7% (P<0.001). During hospitalization, 1.2% patients in low score group and 7.8% patients in high score group died (P<0.001). Multivariate regression demonstrated that patients in high score group had a higher risk of SAP (OR = 8.888, 95%CI: 5.552–14.229) and mortality (OR = 7.833, 95%CI: 3.580–17.137) than patients in low score group. CONCLUSIONS: The A(2)DS(2) score was a strong predictor for SAP and in-hospital death of Chinese acute ischemic stroke patients. The A(2)DS(2) score might be a useful tool for the identification of patients with a high risk of SAP and death during hospitalization.