Predictive value of A2DS2 score combined with serum inflammatory factors for stroke-associated pneumonia and its pathogenic bacteria

WANG Yi-sheng; LI Jing-zhou; LIU Hui; ZHANG Qing-fang; CHEN Pei-li

doi:10.13820/j.cnki.gdyx.20232795

Abstract：Objective To analyze the predictive value of the age,atrial fibrillation,dysphagia,male sex,and National Institutes of Health Stroke Scale(A2DS2)score and serum inflammatory factors in stroke-associated pneumonia(SAP)and its pathogenic bacteria.Methods From July 2022 to September 2023,205 patients with acute stroke were included in the study.Patients with SAP were included in the SAP group(n=57),and the rest were in the non-SAP group(n=148).The A2DS2 scores of the patients were recorded;the serum levels of tumor necrosis factor-α(TNF-α),interleukin-2(IL-2),IL-6,and IL-10 were analyzed by enzyme-related immunosorbent assay;and sputum was detected in SAP patients.Results Patients in SAP group had significantly higher levels of IL-2,IL-6,IL-10,TNF-α and A2DS2 score(P＜0.05).After adjusting for other relevant factors,the scores of IL-2,IL-6,IL-10 and A2DS2 were still independent relevant factors for SAP.The A2DS2 score combined with IL-2,IL-6 and IL-10 predic-ted SAP significantly better than the four predictions alone,with area under receiver operating characteristic curve of 0.891(95％confidence interval:0.847-0.936),sensitivity and specificity of 84.2％and 77.7％,respectively.A to-tal of 61 strains were cultured,and 14 Gram-positive bacteria,44 Gram-negative bacteria and 3 fungi were detected.The IL-6 and IL-10 of SAP patients infected with Gram-negative bacteria were significantly higher(P＜0.05).Conclusion IL-2,IL-6 and IL10 inflammatory factors combined with A2DS2 scores may help to predict SAP in pa-tients with acute stroke,and predict the type of pathogenic bacteria of SAP according to the levels of IL-6 and IL-10.