急性蛛网膜下腔出血患者卒中相关性肺炎的相关因素分析

Risk factors for stroke-associated pneumonia in acute subarachnoid hemorrhage patients

回顾性分析2014年5月至2016年5月首都医科大学附属北京天坛医院神经病学中心普通病房收治的328例急性蛛网膜下腔出血(SAH)患者的临床资料,其中住院期间发生卒中相关性肺炎(SAP)者55例(16.8%),SAH发病至SAP确诊的中位时间为5(3,7)d。多因素Cox回归模型分析显示,入院时白细胞计数[11.4(9.4,13.8)×10^(9)/L比9.6(7.9,11.5)×10^(9)/L,OR=1.11,95%CI:1.04~1.20]、Hunt-Hess评分[2(1,3)比1(1,1)分,OR=2.39,95%CI:1.42~4.04]、世界神经外科联盟(WFNS)分级1(1,2)比[1(1,1)级,OR=1.11,95%CI:1.03~2.00]和年龄[(59.0±11.5)比(53.3±12.2)岁,OR=1.03,95%CI:1.01~1.05]是SAH后SAP的独立相关因素。提示SAH患者入院时高白细胞计数、高Hunt-Hess评分、高WFNS分级和高龄是SAH后SAP发生的相关因素。

The clinical data of 328 patients with subarachnoid hemorrhage(SAH)admitted in the Neurology Center of Beijing Tiantan Hospital affiliated to Capital Medical University from May 2014 to May 2016 were retrospectively analyzed,of whom 55 cases(16.8%)developed stroke-associated pneumonia(SAP)during hospitalization.The median time from onset of SAH to diagnosis of pneumonia was 5(3,7)d.Multivariate Cox regression analysis showed that white blood cell count[11.4(9.4,13.8)×10^(9)/L vs.9.7(7.9,11.5)×10^(9)/L,OR=1.11,95%CI:1.04-1.20],Hunt-Hess score[2(1,3)vs.1(1,1),OR=2.39,95%CI:1.42-4.04],World Federation of Neurosurgical Societies(WFNS)grade[1(1,2)vs.1(1,1),OR=1.11,95%CI:1.03-2.00]and age[(59.0±11.5)vs.(53.3±12.2)years,OR=1.03,95%CI:1.01-1.05]were independent risk factors for SAP after SAH.The study indicates that high white blood cell count,high Hunt-Hess score,high WFNS grade and advanced age at admission are closely related to the occurrence of SAP in patients with SAH during hospitalization.