Advanced Search
CHEN Yun, XU Min, ZHANG Li-ren, et al. A2DS2 combined with neutrophil-to-lymphocyte ratio in the prediction of acute ischemic stroke-associated pneumonia[J]. Chin J Clin Med, 2020, 27(5): 806-810. DOI: 10.12025/j.issn.1008-6358.2020.20200020
Citation: CHEN Yun, XU Min, ZHANG Li-ren, et al. A2DS2 combined with neutrophil-to-lymphocyte ratio in the prediction of acute ischemic stroke-associated pneumonia[J]. Chin J Clin Med, 2020, 27(5): 806-810. DOI: 10.12025/j.issn.1008-6358.2020.20200020

A2DS2 combined with neutrophil-to-lymphocyte ratio in the prediction of acute ischemic stroke-associated pneumonia

More Information
  • Received Date: January 02, 2020
  • Accepted Date: May 06, 2020
  • Objective 

    To explore predictive effect of the A2DS2 scoring system combined with neutrophil-to-lymphocyte ratio (NLR) on stroke-associated pneumonia (SAP).

    Methods 

    Data of 468 patients with acute ischemic stroke admitted to the Sixth People's Hospital, Shanghai Jiao Tong University from January 2018 to August 2018 were retrospectively collected, patients were divided into SAP group (n=61) and non-SAP group (n=407). A2DS2 score and NLR value were calculated for all patients. The receiver operating characteristic curve (ROC) was used to evaluate the predictive value of A2DS2-NLR score to SAP.

    Results 

    The area under curve (AUC) of A2DS2 score was 0.868 (95% CI 0.815-0.921), the sensitivity was 0.787, the specificity was 0.803, and the optimal cut-off value was 3.5. The AUC of A2DS2-NLR model 1 score (NLR>3.73, +1) was 0.888 (95% CI 0.844-0.932), the sensitivity was 0.803, the specificity was 0.789, and the optimal cut-off value was 3.5. The AUC of A2DS2-NLR model 2 score (NLR>3.73, +2) was 0.892 (95% CI 0.850-0.935), the sensitivity was 0.852, the specificity was 0.754, and the optimal cut-off value was 3.5.

    Conclusions 

    Compared to the A2DS2 score, the A2DS2-NLR model 1 score has higher value in predicting the risk of SAP.

  • [1]
    KATZAN I L, CEBUL R D, HUSAK S H, et al. The effect of pneumonia on mortality among patients hospitalized for acute stroke[J].Neurology, 2003, 60(4):620-625. DOI: 10.1212/01.WNL.0000046586.38284.60
    [2]
    NAM K W, KIM T J, LEE J S, et al. High neutrophil-to-lymphocyte ratio predicts stroke-associated pneumonia[J].Stroke, 2018, 49(8):1886-1892. DOI: 10.1161/STROKEAHA.118.021228
    [3]
    NAM K W, KWON H M, LIM J S, et al. Leukoaraiosis is associated with pneumonia after acute ischemic stroke[J].BMC Neurol, 2017, 17(1):51. http://www.wanfangdata.com.cn/details/detail.do?_type=perio&id=hnsysjjbzz201803018
    [4]
    KWON H M, JEONG S W, LEE S H, et al. The pneumonia score:a simple grading scale for prediction of pneumonia after acute stroke[J].Am J Infect Control, 2006, 34(2):64-68. DOI: 10.1016/j.ajic.2005.06.011
    [5]
    HOFFMANN S, MALZAHN U, HARMS H, et al. Development of a clinical score (A2DS2) to predict pneumonia in acute ischemic stroke[J].Stroke, 2012, 43(10):2617-2623. DOI: 10.1161/STROKEAHA.112.653055
    [6]
    JI R, SHEN H, PAN Y, et al. Novel risk score to predict pneumonia after acute ischemic stroke[J].Stroke, 2013, 44(5):1303-1309. DOI: 10.1161/STROKEAHA.111.000598
    [7]
    HARMS H, GRITTNER U, DRÖGE H, et al. Predicting post-stroke pneumonia:the PANTHERIS score[J].Acta Neurol Scand, 2013, 128(3):178-184. DOI: 10.1111/ane.12095
    [8]
    PAPAVASILEIOU V, MILIONIS H, SMITH C J, et al. External validation of the prestroke independence, sex, age, national institutes of health stroke scale (isan) score for predicting stroke-associated pneumonia in the athens stroke registry[J].J Stroke Cerebrovasc Dis, 2015, 24(11):2619-2624. DOI: 10.1016/j.jstrokecerebrovasdis.2015.07.017
    [9]
    CUGY E, SIBON I. Stroke-associated pneumonia risk score:validity in a French stroke unit[J]. J Stroke Cerebrovasc Dis, 2017, 26(1):225-229. DOI: 10.1016/j.jstrokecerebrovasdis.2016.09.015
    [10]
    SMITH C J, BRAY B D, HOFFMAN A, et al. Can a novel clinical risk score improve pneumonia prediction in acute stroke care? A UK multicenter cohort study[J]. J Am Heart Assoc, 2015, 4(1):e001307. DOI: 10.1161/jaha.114.001307
    [11]
    NAM K, KIM T J, LEE J S, et al. High neutrophil-to-lymphocyte ratio predicts stroke-associated pneumonia[J].Stroke, 2018, 49(8):1886-1892. DOI: 10.1161/STROKEAHA.118.021228
    [12]
    中华医学会神经病学分会, 中华医学会神经病学分会脑血管病学组.中国急性缺血性脑卒中诊治指南2014[J].中华神经科杂志, 2015, 48(4):246-257. http://www.wanfangdata.com.cn/details/detail.do?_type=perio&id=zhsjk201504002
    [13]
    SMITH C J, KISHORE A K, VAIL A, et al. Diagnosis of stroke-associated pneumonia:recommendations from the pneumonia in Stroke Consensus Group[J].Stroke, 2015, 46(8):2335-2340. DOI: 10.1161/STROKEAHA.115.009617
    [14]
    HANNAWI Y, HANNAWI B, RAO C P, et al. Stroke-associated pneumonia:major advances and obstacles[J].Cerebrovasc Dis, 2013, 35(5):430-443. DOI: 10.1159/000350199
    [15]
    GONG S, ZHOU Z, ZHOU M, et al. Validation of risk scoring models for predicting stroke-associated pneumonia in patients with ischaemic stroke[J].Stroke Vasc Neurol, 2016, 1(3):122-126. DOI: 10.1136/svn-2016-000025
    [16]
    SHEKHAR S, CUNNINGHAM M W, PABBIDI M R, et al. Targeting vascular inflammation in ischemic stroke:recent developments on novel immunomodulatory approaches[J]. Eur J Pharmacol, 2018, 833:531-544. DOI: 10.1016/j.ejphar.2018.06.028
    [17]
    SONG S Y, ZHAO X X, RAJAH G, et al. Clinical significance of baseline neutrophil-to-lymphocyte ratio in patients with ischemic stroke or hemorrhagic stroke:an updated meta-analysis[J]. Front Neurol, 2019, 10:1032. DOI: 10.3389/fneur.2019.01032
    [18]
    MERALI Z, HUANG K, MIKULIS D, et al. Evolution of blood-brain-barrier permeability after acute ischemic stroke[J]. PLoS One, 2017, 12(2):e0171558. DOI: 10.1371/journal.pone.0171558
    [19]
    MEISEL C, SCHWAB J M, PRASS K, et al. Central nervous system injury-induced immune deficiency syndrome[J].Nat Rev Neurosci, 2005, 6(10):775-786. http://www.ncbi.nlm.nih.gov/pubmed/16163382
    [20]
    SANTOS SAMARY C, PELOSI P, LEME SILVA P, et al. Immunomodulation after ischemic stroke:potential mechanisms and implications for therapy[J].Crit Care, 2016, 20(1):391. DOI: 10.1186/s13054-016-1573-1

Catalog

    Article views (1331) PDF downloads (523) Cited by()

    /

    DownLoad:  Full-Size Img  PowerPoint
    Return
    Return