Logistic回归联合ROC曲线对高龄房颤合并脑梗死患者卒中相关性肺炎的预测价值

The value of Logistic regression combined with ROC curve in the prediction of stroke-associated pneumonia in elderly patients with atrial fibrillation and cerebral infarction

目的探讨高龄房颤合并脑梗死患者发生卒中相关性肺炎的危险因素。方法回顾性收集2014-01—2018-01就诊于福建省老年医院的房颤合并脑梗死的高龄患者115例,分为卒中相关性肺炎组和非卒中相关性肺炎组,探讨引起卒中相关性肺炎的危险因素及建立卒中相关性肺炎的评估模型。结果入院NIHSS评分(OR=1.15,P=0.25)、血胆碱酯酶水平(OR=1.09,P=0.047)、吞咽障碍(OR=0.39,P=0.03)是高龄房颤患者脑梗死后发生卒中相关性肺炎的独立危险因素。ROC曲线分析结果提示,综合应用上述3个指标对高龄房颤合并脑梗死患者发生卒中相关性肺炎的预测价值较高(AUC=0.62,P=0.03)。结论血胆碱酯酶、入院NIHSS评分、吞咽困难是高龄房颤合并脑梗死患者卒中相关性肺炎的独立危险因素,综合应用上述3项指标能更好预测高龄房颤合并脑梗死人群发生卒中相关性肺炎的风险。

Objective To investigate the risk factors of stroke-associatedpneumonia in elderly patients with atrial fibrillation and cerebral infarction.Methods From January 2014 to January 2018,115 elderly patients with atrial fibrillation and cerebral infarction were selected retrospectively.They were divided into stroke-associated group and non-stroke-associated group.we explorered the risk factors of stroke-associated pneumonia and established an evaluation model for the stroke-associated pneumonia.Results The NIHSS score（OR=1.15,P=0.25）,blood cholinesterase level（OR=1.09,P=0.047）,and admission NIHSS score（OR=0.39,P=0.03）were the independent risk factors in the elderly patients with atrial fibrillation and cerebral infarction.ROC curve analysis results suggested that comprehensive application of the above three indicators had higher predictive value in the elderly patients with atrial fibrillation and cerebral infarction（AUC =0.62,P =0.03）.Conclusion Blood cholinesterase level,NIHSS score,and dysphagia are the independent risk factors in the elderly patients with atrial fibrillation and cerebral infarction.Comprehensive application of the three indicators can better predict the occurrence of stroke-associated pneumonia in elderly atrial fibrillation patients with cerebral infarction.