USU Conference Systems, International Conference on Tropical Medicine and Infectious Diseases (ICTROMI) 2017

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Predictors of pneumonia and Glasgow Coma Scale assessment in acute stroke in an Intensive Care Unit of Adam Malik General Hospital

Last modified: 2017-10-27


Pneumonia is one of the most frequent medical complications of stroke. Despite the well documented association of stroke associated infections with increased mortality and worse long-term outcome, as yet the limited data available on independent predictors of pneumonia in acute stroke patients in an emergency unit. Up to one third of stroke patients suffer from pneumonia. The purpose of study to evaluate the risk factors and comorbid conditions associated with the development of pneumonia in patients in acute stroke. To determine the independents predictors of pneumonia and Glasgow Coma Scale assessment in intensive care units. The cohort retrospective study observed 55 acute stroke patients who stayed in intensive care unit Adam Malik General Hospitals from January until August 2017. We reviewed all medical charts with diagnosis of acute stroke. Patients were excluded if admitted with pneumonia or others of pulmonary infections and were using antibiotics. Patients were followed in acute phase stroke and pneumonia was diagnosed based on Centers of Disease Controls criterias that were adopted by Indonesian Association of Lung Doctors. There were 55 subject acute stroke patients in this study, consist of 60% male and 40% female with mean of age 54,02 years old. The proporsion of pneumonia in Stroke Ischemic of 81,1% and Stroke Haemorrhagic of 18,9%. Pneumonia was more frequent in patients with Ischemic stroke (OR 5,40; 95% CI: 1,28 – 6,40, p=0,003), higher National Institute of Health Stroke Scale (NIHSS) (p= 0,014) and lower Glasgow Coma Scale (p=0,0001). Analysis multivariate logistic regression identified NIHSS as an independent of predictors of pneumonia (95% CI : 1,047 – 1,326, p =0,001).Pneumonia was associated with severity and type of stroke and length of hospital stay. The severity of the deficits evaluated by the NIHSS was shown to be the only independent risk factor for pneumonia in acute stroke patients.

Keywords: Pneumonia, acute stroke, predictors, outcome stroke