Impact of NLR on Stroke-associated Pneumonia with Multidrug Resistant Organisms Infections

REN Pengyu; XIANG Jiamin; JING Zeyu; YU Jiawei; WU Fei; DUAN Han

doi:10.13730/j.issn.2097-2148.2025.11.005

Abstract：Objective To investigate the impact of the neutrophil-to-lymphocyte ratio(NLR)on stroke-associated pneumonia(SAP)complicated with multidrug resistant organisms(MDROs)infections in the neurological intensive care unit(NICU).Methods The clinical data of 65 SAP patients admitted to author's hospital in NICU from January 2021 to June 2024 were retrospectively analyzed,univariate analysis and Logistic regression analysis were used to analyze the risk factors of SAP complicated with MDROs infection,the receiver operating characteristic(ROC)curve was used to analyze the predictive value of NLR and length of NICU stay for MDROs infection.Results Among the 65 SAP patients,spu-tum culture and drug sensitivity tests identified the primary pathogens as Klebsiella pneumoniae,Acinetobacter bauman-nii and Staphylococcus aureus.Univariate analysis revealed that compared with the non-MDROs infection group,the pa-tients in MDROs infection group showed statistically significant differences in the proportion of late SAP onset,moderate to severe national institute of health stroke scale(NIHSS)score,proportion of dysphagia,proportion of nasofeeding tube placement,NICU length of stay and NLR(all P＜0.05).Multivariate Logistic regression analysis showed that increased NLR and long length of NICU stay were independent risk factors for SAP complicated with MDROs infection(all P＜0.05).The ROC curve showed that NLR,NICU length of stay and the area under the curve(AUC)of the combined model were 0.721[95％confidence interval(CI):0.594-0.848],0.843(95％CI:0.739-0.946)and 0.892(95％CI:0.814-0.917),respectively,the AUC of combined prediction was greater than that of NLR or NICU length of stay a-lone.Conclusion Elevated NLR can predict the occurrence of MDROs infection to a certain extent,combined with the length of NICU stay,elevated NLR has a higher predictive value for SAP patients with MDROs infection.