Impact of stroke-associated pneumonia on the outcome of acute ischemic stroke in internal carotid artery system
DOI: 10.32364/2587-6821-2020-4-9-539-543
D.T. Chipova1, L.V. Santikova2, A.Ch. Zhemukhov2
1City Clinical Hospital No. 1, Nalchik, Russian Federation
2Kabardino-Balkarian State University named after H.M. Berbekov, Nalchik, Russian Federation
Aim: to study the stroke-associated pneumonia (SAP) effect on the outcome of ischemic stroke (IS) in the internal carotid artery system.
Patients and Methods: 87 patients with IS underwent the follow-up study, of which 75 had no inflammatory bronchopulmonary complications (group 1), and 12 had pneumonia manifestation (group 2). The study was performed on days 1, 5, and 9 after IS, and 6 months and 12 months after discharge from the hospital. Neurological deficit severity (NIHSS, Barthel index) and inflammatory markers (peripheral blood leukocyte composition, C-reactive protein (CRP), ESR) were studied.
Results: it was found that the presence of SAP was associated with increased mortality during the acute IS period (4 (33.1%) patients died in group 1 and 10 (13.3%) — in group 2, p<0.05), greater severity of neurological deficits (63.3±5.3 and 71.5±4.0 points on the NIHSS scale, respectively, p<0.05) and incapacitation (Barthel index — 63.3±5.3 and 71.5±4.0 points, respectively, p<0.05) at the end of the inpatient treatment period. In group 2, signs of an inflammatory response were detected on day 5, and the values of the white blood cell shift index, ESR and CRP significantly (p<0.05) differed from the initial values. During examination at 6 months and 12 months, there were no significant differences in these indicators between the groups. An association was established between the probability of SAP occurrence and the presence of swallowing disorders (r=0.672; p<0.05), the age of patients (r=0.572; p<0.05) and the presence of diabetes mellitus (r=0.522; p<0.05). The studied laboratory inflammatory markers allow us to timely assume the occurrence of pulmonary pathology.
Conclusion: timely diagnosis and prevention of SAP can reduce the risk of fatal outcome, facilitate rehabilitation measures, and improve early IS outcomes.
Keywords: ischemic stroke, cardioembolic stroke, atherothrombotic stroke, complications, acute period, inflammatory markers, stroke-associated pneumonia, long-term outcomes.
For citation: Chipova D.T., Santikova L.V., Zhemukhov A.Ch. Impact of stroke-associated pneumonia on the outcome of acute ischemic stroke in internal carotid artery system. Russian Medical Inquiry. 2020;4(9):539–543. DOI: 10.32364/2587-6821-2020-4-9-539-543.
About the authors:
Dinara T. Chipova — Head of the Department of General Neurology of City Clinical Hospital No. 1: 7, Golovko str., Nalchik, 360000, Russian Federation; ORCID iD 0000-0002-1641-3681.
Liana V. Santikova — post-graduate student of the Department of Neurology, Psychiatry and Narcology, Kabardino-Balkarian State University named after H.M. Berbekov; 173, Chernyshevskogo str., Nalchik, 360004, Russian Federation; ORCID iD 0000-0002-3361-6819.
Aslan Ch. Zhemukhov — post-graduate student of the Department of Neurology, Psychiatry and Narcology, Kabardino-Balkarian State University named after H.M. Berbekov; 173, Chernyshevskogo str., Nalchik, 360004, Russian Federation; ORCID iD 0000-0002-8877-9965.
Contact information: Dinara T. Chipova, e-mail: dinara.chipova@mail.ru. Financial Disclosure: no authors have a financial or property interest in any material or method mentioned. There is no conflict of interests. Received 03.09.2020, revised 17.09.2020, accepted 01.10.2020.
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