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

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.