Risk factors of stroke-associated pneumonia in patients with acute ischemic stroke treated by endovascular thrombectomy

Abstract Background Although there are a variety of risk factors and predictive models for stroke-associated pneumonia (SAP) in patients with acute ischemic stroke (AIS), the risk factors and predictive value for SAP in patients with AIS treated by endovascular thrombectomy (EVT) remain unclear. Thi...

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Main Authors: Kangyue Lin, Xiaoqing Deng, Yumei Xiao, Zhiyong Yang, Zhiyi He, Xiangjun Li, Wenwen Cheng
Format: Article
Language:English
Published: BMC 2025-04-01
Series:BMC Neurology
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Online Access:https://doi.org/10.1186/s12883-025-04182-9
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author Kangyue Lin
Xiaoqing Deng
Yumei Xiao
Zhiyong Yang
Zhiyi He
Xiangjun Li
Wenwen Cheng
author_facet Kangyue Lin
Xiaoqing Deng
Yumei Xiao
Zhiyong Yang
Zhiyi He
Xiangjun Li
Wenwen Cheng
author_sort Kangyue Lin
collection DOAJ
description Abstract Background Although there are a variety of risk factors and predictive models for stroke-associated pneumonia (SAP) in patients with acute ischemic stroke (AIS), the risk factors and predictive value for SAP in patients with AIS treated by endovascular thrombectomy (EVT) remain unclear. This study aimed to investigate the occurrence of SAP in acute ischemic stroke patients treated with EVT and identify independent predictors of SAP. Methods We enrolled patients with acute ischemic stroke who underwent endovascular thrombectomy (EVT) at the stroke center of Maoming People’s Hospital between January 2021 and December 2023. The patients were categorized into the SAP group and Non-SAP group. Univariate analysis was performed to examine the correlation between each potential risk factor and SAP. Multivariate logistic regression analysis and receiver operating characteristic curve (ROC) were applied to identify independent predictors of SAP and evaluate their predictive value, respectively. Results A total of 233 participants were included in this study. Among them, 131 (56.22%) patients were identified with SAP. The univariate analysis showed significant differences in the following variables between groups: admission National Institute of Health Stroke Scale score (NIHSS) (P = 0.005), procedural time (P = 0.000), dysphagia (P = 0.004), white blood cell (WBC) (P = 0.044), neutrophils (P = 0.019), and neutrophil-lymphocyte ratio (NLR) (P = 0.002). The multivariable logistic analysis identified the following independent predictors of SAP: admission NIHSS score [OR = 1.078, 95% CI = 1.020–1.140, P = 0.008], procedural time [OR = 1.023, 95% CI = 1.014–1.032, P = 0.000], NLR [OR = 1.152, 95% CI = 1.005–1.320, P = 0.042], and dysphagia [OR = 0.340, 95% CI = 0.151–0.767, P = 0.009]. Furthermore, the receiver operating characteristic (ROC) curve analysis demonstrated that procedural time had the best predictive performance for SAP in AIS patients undergoing EVT. Conclusion Admission NIHSS score, procedural time, NLR, and dysphagia were associated with SAP in patients with AIS treated with EVT and can be an independent predictor for SAP.
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spelling doaj-art-1e7d3fe40cfd426fbbd0eaf50107f3fd2025-08-20T02:17:57ZengBMCBMC Neurology1471-23772025-04-012511810.1186/s12883-025-04182-9Risk factors of stroke-associated pneumonia in patients with acute ischemic stroke treated by endovascular thrombectomyKangyue Lin0Xiaoqing Deng1Yumei Xiao2Zhiyong Yang3Zhiyi He4Xiangjun Li5Wenwen Cheng6Department of neurocritical care, Maoming People’s HospitalDepartment of clinical nutrition, Maoming People’s HospitalDepartment of neurocritical care, Maoming People’s HospitalDepartment of neurocritical care, Maoming People’s HospitalDepartment of neurocritical care, Maoming People’s HospitalDepartment of neurocritical care, Maoming People’s HospitalDepartment of Neurology, Maoming People’s HospitalAbstract Background Although there are a variety of risk factors and predictive models for stroke-associated pneumonia (SAP) in patients with acute ischemic stroke (AIS), the risk factors and predictive value for SAP in patients with AIS treated by endovascular thrombectomy (EVT) remain unclear. This study aimed to investigate the occurrence of SAP in acute ischemic stroke patients treated with EVT and identify independent predictors of SAP. Methods We enrolled patients with acute ischemic stroke who underwent endovascular thrombectomy (EVT) at the stroke center of Maoming People’s Hospital between January 2021 and December 2023. The patients were categorized into the SAP group and Non-SAP group. Univariate analysis was performed to examine the correlation between each potential risk factor and SAP. Multivariate logistic regression analysis and receiver operating characteristic curve (ROC) were applied to identify independent predictors of SAP and evaluate their predictive value, respectively. Results A total of 233 participants were included in this study. Among them, 131 (56.22%) patients were identified with SAP. The univariate analysis showed significant differences in the following variables between groups: admission National Institute of Health Stroke Scale score (NIHSS) (P = 0.005), procedural time (P = 0.000), dysphagia (P = 0.004), white blood cell (WBC) (P = 0.044), neutrophils (P = 0.019), and neutrophil-lymphocyte ratio (NLR) (P = 0.002). The multivariable logistic analysis identified the following independent predictors of SAP: admission NIHSS score [OR = 1.078, 95% CI = 1.020–1.140, P = 0.008], procedural time [OR = 1.023, 95% CI = 1.014–1.032, P = 0.000], NLR [OR = 1.152, 95% CI = 1.005–1.320, P = 0.042], and dysphagia [OR = 0.340, 95% CI = 0.151–0.767, P = 0.009]. Furthermore, the receiver operating characteristic (ROC) curve analysis demonstrated that procedural time had the best predictive performance for SAP in AIS patients undergoing EVT. Conclusion Admission NIHSS score, procedural time, NLR, and dysphagia were associated with SAP in patients with AIS treated with EVT and can be an independent predictor for SAP.https://doi.org/10.1186/s12883-025-04182-9Stroke-associated pneumoniaAcute ischemic strokeEndovascular thrombectomyRisk factors
spellingShingle Kangyue Lin
Xiaoqing Deng
Yumei Xiao
Zhiyong Yang
Zhiyi He
Xiangjun Li
Wenwen Cheng
Risk factors of stroke-associated pneumonia in patients with acute ischemic stroke treated by endovascular thrombectomy
BMC Neurology
Stroke-associated pneumonia
Acute ischemic stroke
Endovascular thrombectomy
Risk factors
title Risk factors of stroke-associated pneumonia in patients with acute ischemic stroke treated by endovascular thrombectomy
title_full Risk factors of stroke-associated pneumonia in patients with acute ischemic stroke treated by endovascular thrombectomy
title_fullStr Risk factors of stroke-associated pneumonia in patients with acute ischemic stroke treated by endovascular thrombectomy
title_full_unstemmed Risk factors of stroke-associated pneumonia in patients with acute ischemic stroke treated by endovascular thrombectomy
title_short Risk factors of stroke-associated pneumonia in patients with acute ischemic stroke treated by endovascular thrombectomy
title_sort risk factors of stroke associated pneumonia in patients with acute ischemic stroke treated by endovascular thrombectomy
topic Stroke-associated pneumonia
Acute ischemic stroke
Endovascular thrombectomy
Risk factors
url https://doi.org/10.1186/s12883-025-04182-9
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