Background
Pneumonia is one of the most common medical complications after stroke. Incidence
and risk factor analyses of stroke-associated pneumonia (SAP) in stroke care units
(SCUs) are limited. SAP incidence comparisons across countries can identify the most
effective treatment to reduce this incidence.
Methods
This was a retrospective study including consecutive patients with acute stroke in
SCUs in 2 hospitals: 105 patients (mean age 78.2 ± 5.8) from the National Cerebral
and Cardiovascular Center (NCVC) in Osaka, Japan (from July to August 2015), and 105
patients (mean age 60 ± 5.8) from the National Brain Centre (NBC) Hospital in Jakarta,
Indonesia (from May to September 2015). We used descriptive statistics and a logistic
regression model for statistical analysis.
Results
The incidence of SAP in the SCU NBC Hospital was higher than that in the SCU NCVC
(22.9% versus 12.4%, P = .0466). In the SCU NBC Hospital, dysphagia (odds ratio [OR] 15.20, 95% confidence
interval [CI] 1.77-130.73) and severe neurological deficits on admission (OR 5.31,
95% CI 1.60-17.60) were significantly associated with SAP, whereas in the SCU NCVC,
dysphagia (OR 14.42, 95% CI 2.34-88.98) and diabetes mellitus (OR 7.16, 95% CI 1.27-40.18)
were the risk factors. When the patients of both hospitals were analyzed together,
severe neurological deficits on admission (OR 3.36, 95% CI 1.31-8.64) and dysphagia
(OR 12.62, 95% CI 3.75-42.45) were significant determinants for developing SAP.
Conclusions
The incidence of SAP was higher in the Indonesian hospital than in the Japanese one.
Our findings support other epidemiological data of a high incidence of SAP with severe
neurological deficits on admission and dysphagia in an SCU setting.
Key Words
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Article info
Publication history
Published online: October 13, 2016
Accepted:
September 11,
2016
Received in revised form:
August 22,
2016
Received:
July 25,
2016
Footnotes
This study was supported by the Intramural Research Fund of the National Cerebral and Cardiovascular Center (27-1-3).
Identification
DOI: https://doi.org/10.1016/j.jstrokecerebrovasdis.2016.09.018
Copyright
© 2017 National Stroke Association. Published by Elsevier Inc. All rights reserved.
