Development and validation of a predictive model for stroke associated pneumonia in patients after thrombectomy for acute ischemic stroke

作者：Jingying Wang, Chao Yang, Ruihai Zhang, Wei Hu, Peng Yang, Yiqing Jiang, Yiqing Jiang, Weijun Hong, Renfei Shan, Yongpo Jiang, Yongpo Jiang · 发表于：Frontiers in Medicine · 年份：2024 · DOI：10.3389/fmed.2024.1370986 · 被引用次数：6 · 研究领域：Acute Ischemic Stroke Management、Dysphagia Assessment and Management、Intracerebral and Subarachnoid Hemorrhage Research

Objective: This study aims to identify the risk factors associated with stroke-associated pneumonia (SAP) in patients who have undergone thrombectomy for acute ischemic stroke and to develop a nomogram chart model for predicting the occurrence of pneumonia. Methods: Consecutive patients who underwent thrombectomy for acute ischemic stroke were enrolled from three hospitals at Taizhou Enze Medical Center. They were randomly divided into a training group and a validation group in a 7:3 ratio. The training group data was used to screen for effective predictive factors using LASSO regression. Multiple logistic regression was then conducted to determine the predictive factors and construct a nomogram chart. The model was evaluated using the validation group, analyzing its discrimination, calibration, and clinical decision curve. Finally, the newly constructed model was compared with the AIS-APS, A2DS2, ISAN, and PANTHERIS scores for acute ischemic stroke-associated pneumonia. Results: Out of 913 patients who underwent thrombectomy, 762 were included for analysis, consisting of 473 males and 289 females. The incidence rate of SAP was 45.8%. The new predictive model was constructed based on three main influencing factors: NIHSS ≥16, postoperative LMR, and difficulty swallowing. The model demonstrated good discrimination and calibration. When applying the nomogram chart to threshold probabilities between 7 and 90%, net returns were increased. Furthermore, the AUC was higher compared ...