Risk factors for post-stroke pneumonia in patients with acute ischemic stroke and construction of a nomogram model

XI Moyang; DING Weimin; MA Xiaorui; DONG Xia; GUO Jianying; BIAN Xuqing; LU Meicui

doi:10.3639/j.issn.1671-2897.2025.04.019

Abstract：Objective To explore the risk factors for post-stroke pneumonia in patients with acute ischemic stroke(AIS)and construct a nomogram model.Methods A total of 120 AIS cases from January 2021 to December 2024 were selected and divided into the pneumonia group(n=34)and the non-pneumonia group(n=86)based on the development of post-stroke pneumonia.The influencing factors of post-stroke pneumonia in AIS patients were explored by multivariate Logistic stepwise regression analysis and a nomogram model was constructed and its predictive value for post-stroke pneumonia in AIS patients was evaluated.Results The proportions of patients aged≥60 years,with a history of diabetes,consciousness disorder,dysphagia,and mechanical ventilation in the pneumonia group were all higher than those in the non-pneumonia group,while the proportion of patients receiving prophylactic antibiotics was lower.The National Institutes of Health Stroke Scale(NIHSS)score and white blood cell count at admission were higher in the pneumonia group,and their albumin level was lower(P<0.05).Multivariate analysis showed that age≥60 years(OR=2.085,95%CI:1.457～2.985),high NIHSS score at admission(OR=2.846,95%CI:1.846～4.389),mechanical ventilation(OR=2.604,95%CI:1.719～3.945),high white blood cell count(OR=2.385,95%CI:1.618～3.515),and low albumin level(OR=0.444,95%CI:0.305～0.646)were risk factors for post-stroke pneumonia in AIS patients(P<0.05).The consistency index(C-index)of the nomogram model was 0.891(95%CI:0.839～0.943).Internal validation analysis showed that the nomogram model had a good fitting effect(χ2=0.764,P=0.518),and the original curve was close to the ideal curve.The area under the curve(AUC)(95%CI)of the nomogram model for predicting post-stroke pneumonia in AIS patients was 0.883(0.831～0.935),with a specificity of 68.41%and a sensitivity of 92.67%.Conclusion The nomogram model based on age,NIHSS score at admission,mechanical ventilation,white blood cell count,and albumin has a high predictive value for post-stroke pneumonia in AIS patients.