急性缺血性脑卒中患者住院期间吸入性肺炎风险评分构建与验证

Co nstruction and validation of risk score for inhalation pneumonia during hospitalization in patients with acute ischemic stroke

目的 探讨急性缺血性脑卒中(AIS)患者住院期间发生吸入性肺炎的危险因素,并构建AIS患者住院期间发生吸入性肺炎风险的预测模型。方法 收集温州医科大学附属第二医院因AIS入院患者的临床资料。用单因素、多因素Logistic回归分析,筛选出发生吸入性肺炎的相关危险因素,并构建预测模型。结果 高龄、入院时GCS评分低、既往卒中病史、糖尿病史、吞咽障碍及低白蛋白血症是AIS患者住院期间并发吸入性肺炎危险因素。该模型预测吸入性肺炎发生风险的ROC曲线下面积(AUC)为0.831(0.786~0.876),内部验证预测吸入性肺炎发生风险的AUC为0.827(0.782~0.873)。Hosmer-Lemeshow检验:χ^(2)=12.585,P=0.127。结论 本预测模型具有良好的区分度与校准度,有助于临床医师评估AIS中患者住院期间发生吸入性肺炎风险。

Objective To explore the risk factors of aspiration pneumonia in patients with acute ischemic stroke during hospitalization,and to construct a prediction model for the risk of aspiration pneumonia in patients with acute ischemic stroke during hospitalization.Methods The clinical data of patients admitted for acute ischemic stroke in The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University were collected,such as demographic data,laboratory examination,vital signs etc.The risk factors of aspiration pneumonia were screened out by univariate and multivariate Logistic regression analysis,and a predictive model was established.Results Advanced age,low GCS score on admission,history of stroke,history of diabetes,dysphagia and hypoalbuminemia were risk factors for aspiration pneumonia in patients with acute ischemic stroke.The area under the ROC curve(AUC)of the prediction model for the risk of aspiration pneumonia was 0.831(0.786~0.876),and the AUC for internal verification to predict the risk of aspiration pneumonia was 0.827(0.782~0.873).Hosmer-Lemeshow test:χ^(2)=12.585,P=0.127.Conclusion This predictive model is in favor of clinicians to evaluate the risk of aspiration pneumonia during hospitalization in patients with acute ischemic stroke,with good discrimination and calibration.