Factors associated with stroke associated pneumonia among adult stroke patients admitted to university of Gondar hospital, Northwest Ethiopia
Stroke is the major cause of disability and death in sub-Saharan African countries. The presence and severity of complications play a major role in the outcome of stroke. Stroke associated pneumonia is often noticed post stroke infection that has been linked to an increased risk of hospital mortalit...
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| Vydané v: | Scientific reports Ročník 12; číslo 1; s. 12724 - 8 |
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| Hlavní autori: | , , , , |
| Médium: | Journal Article |
| Jazyk: | English |
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London
Nature Publishing Group UK
26.07.2022
Nature Publishing Group Nature Portfolio |
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| ISSN: | 2045-2322, 2045-2322 |
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| Abstract | Stroke is the major cause of disability and death in sub-Saharan African countries. The presence and severity of complications play a major role in the outcome of stroke. Stroke associated pneumonia is often noticed post stroke infection that has been linked to an increased risk of hospital mortality, a longer hospital stay and higher healthcare expenses. Report on details of stroke-associated pneumonia has never been documented in countries of sub-Saharan Africa. This study aimed to determine the incidence and risk factors of stroke-associated pneumonia among adult stroke patients in hospital settings, Northwest Ethiopia. The study was undertaken at a stroke care unit, University of Gondar hospital between January 1, 2020 and December 31, 2020. A convenience sampling method was used to recruit study subjects. Relevant clinical history was taken, focused physical examination was done, and brain imaging (CT scan or MRI) was performed to settle the diagnosis of stroke. A modified Centre for Disease Control and Prevention (CDC) criteria was used to diagnose stroke-associated pneumonia. All patients with stroke-associated pneumonia were treated according to the 2016 Infectious Diseases Society of America/American Thoracic Society Clinical Practice Guidelines. The Data were cleaned in Epi Info version 4.6.0.2, and analyzed using SPSS version 26. Variables associated with stroke-associated pneumonia were computed using logistic regression analysis. P value < 0.05 was considered to declare statistical significance. The study comprised a total of 325 adult stroke patients. The mean age of study subjects was 65.2 years (SD ± 15.7). The most prevalent type of stroke was ischemic stroke, which accounted for 68% of all cases. Hemiparesis (94%), facial palsy (87%), and swallowing disturbance (51%) were the frequently noticed neurological findings. Stroke-associated pneumonia complicated 116/325 (36%) of stroke patients. Multi-variate regression analysis revealed that patients who were elderly (age > 75 years) (AOR = 3.910, CI 1.181–12.936,
P
= 0.026), had swallowing disturbance (AOR = 4.656, CI 2.356–9.202,
P
-value < 0.001), epileptic seizures (AOR = 2.678, 95% CI 1.253–5.721,
P
-value < 0.001) and moderate to severe stroke (NIHSS score = 16–21) (AOR = 5.994, 95% CI 2.043–17.585,
P
-value < 0.001) were at risk of developing stroke-associated pneumonia. SAP was a substantial medical complication among stroke patients. Early identification and prompt intervention measures for the identified risk factors might address the burden of SAP. |
|---|---|
| AbstractList | Stroke is the major cause of disability and death in sub-Saharan African countries. The presence and severity of complications play a major role in the outcome of stroke. Stroke associated pneumonia is often noticed post stroke infection that has been linked to an increased risk of hospital mortality, a longer hospital stay and higher healthcare expenses. Report on details of stroke-associated pneumonia has never been documented in countries of sub-Saharan Africa. This study aimed to determine the incidence and risk factors of stroke-associated pneumonia among adult stroke patients in hospital settings, Northwest Ethiopia. The study was undertaken at a stroke care unit, University of Gondar hospital between January 1, 2020 and December 31, 2020. A convenience sampling method was used to recruit study subjects. Relevant clinical history was taken, focused physical examination was done, and brain imaging (CT scan or MRI) was performed to settle the diagnosis of stroke. A modified Centre for Disease Control and Prevention (CDC) criteria was used to diagnose stroke-associated pneumonia. All patients with stroke-associated pneumonia were treated according to the 2016 Infectious Diseases Society of America/American Thoracic Society Clinical Practice Guidelines. The Data were cleaned in Epi Info version 4.6.0.2, and analyzed using SPSS version 26. Variables associated with stroke-associated pneumonia were computed using logistic regression analysis. P value < 0.05 was considered to declare statistical significance. The study comprised a total of 325 adult stroke patients. The mean age of study subjects was 65.2 years (SD ± 15.7). The most prevalent type of stroke was ischemic stroke, which accounted for 68% of all cases. Hemiparesis (94%), facial palsy (87%), and swallowing disturbance (51%) were the frequently noticed neurological findings. Stroke-associated pneumonia complicated 116/325 (36%) of stroke patients. Multi-variate regression analysis revealed that patients who were elderly (age > 75 years) (AOR = 3.910, CI 1.181–12.936,
P
= 0.026), had swallowing disturbance (AOR = 4.656, CI 2.356–9.202,
P
-value < 0.001), epileptic seizures (AOR = 2.678, 95% CI 1.253–5.721,
P
-value < 0.001) and moderate to severe stroke (NIHSS score = 16–21) (AOR = 5.994, 95% CI 2.043–17.585,
P
-value < 0.001) were at risk of developing stroke-associated pneumonia. SAP was a substantial medical complication among stroke patients. Early identification and prompt intervention measures for the identified risk factors might address the burden of SAP. Stroke is the major cause of disability and death in sub-Saharan African countries. The presence and severity of complications play a major role in the outcome of stroke. Stroke associated pneumonia is often noticed post stroke infection that has been linked to an increased risk of hospital mortality, a longer hospital stay and higher healthcare expenses. Report on details of stroke-associated pneumonia has never been documented in countries of sub-Saharan Africa. This study aimed to determine the incidence and risk factors of stroke-associated pneumonia among adult stroke patients in hospital settings, Northwest Ethiopia. The study was undertaken at a stroke care unit, University of Gondar hospital between January 1, 2020 and December 31, 2020. A convenience sampling method was used to recruit study subjects. Relevant clinical history was taken, focused physical examination was done, and brain imaging (CT scan or MRI) was performed to settle the diagnosis of stroke. A modified Centre for Disease Control and Prevention (CDC) criteria was used to diagnose stroke-associated pneumonia. All patients with stroke-associated pneumonia were treated according to the 2016 Infectious Diseases Society of America/American Thoracic Society Clinical Practice Guidelines. The Data were cleaned in Epi Info version 4.6.0.2, and analyzed using SPSS version 26. Variables associated with stroke-associated pneumonia were computed using logistic regression analysis. P value < 0.05 was considered to declare statistical significance. The study comprised a total of 325 adult stroke patients. The mean age of study subjects was 65.2 years (SD ± 15.7). The most prevalent type of stroke was ischemic stroke, which accounted for 68% of all cases. Hemiparesis (94%), facial palsy (87%), and swallowing disturbance (51%) were the frequently noticed neurological findings. Stroke-associated pneumonia complicated 116/325 (36%) of stroke patients. Multi-variate regression analysis revealed that patients who were elderly (age > 75 years) (AOR = 3.910, CI 1.181-12.936, P = 0.026), had swallowing disturbance (AOR = 4.656, CI 2.356-9.202, P-value < 0.001), epileptic seizures (AOR = 2.678, 95% CI 1.253-5.721, P-value < 0.001) and moderate to severe stroke (NIHSS score = 16-21) (AOR = 5.994, 95% CI 2.043-17.585, P-value < 0.001) were at risk of developing stroke-associated pneumonia. SAP was a substantial medical complication among stroke patients. Early identification and prompt intervention measures for the identified risk factors might address the burden of SAP.Stroke is the major cause of disability and death in sub-Saharan African countries. The presence and severity of complications play a major role in the outcome of stroke. Stroke associated pneumonia is often noticed post stroke infection that has been linked to an increased risk of hospital mortality, a longer hospital stay and higher healthcare expenses. Report on details of stroke-associated pneumonia has never been documented in countries of sub-Saharan Africa. This study aimed to determine the incidence and risk factors of stroke-associated pneumonia among adult stroke patients in hospital settings, Northwest Ethiopia. The study was undertaken at a stroke care unit, University of Gondar hospital between January 1, 2020 and December 31, 2020. A convenience sampling method was used to recruit study subjects. Relevant clinical history was taken, focused physical examination was done, and brain imaging (CT scan or MRI) was performed to settle the diagnosis of stroke. A modified Centre for Disease Control and Prevention (CDC) criteria was used to diagnose stroke-associated pneumonia. All patients with stroke-associated pneumonia were treated according to the 2016 Infectious Diseases Society of America/American Thoracic Society Clinical Practice Guidelines. The Data were cleaned in Epi Info version 4.6.0.2, and analyzed using SPSS version 26. Variables associated with stroke-associated pneumonia were computed using logistic regression analysis. P value < 0.05 was considered to declare statistical significance. The study comprised a total of 325 adult stroke patients. The mean age of study subjects was 65.2 years (SD ± 15.7). The most prevalent type of stroke was ischemic stroke, which accounted for 68% of all cases. Hemiparesis (94%), facial palsy (87%), and swallowing disturbance (51%) were the frequently noticed neurological findings. Stroke-associated pneumonia complicated 116/325 (36%) of stroke patients. Multi-variate regression analysis revealed that patients who were elderly (age > 75 years) (AOR = 3.910, CI 1.181-12.936, P = 0.026), had swallowing disturbance (AOR = 4.656, CI 2.356-9.202, P-value < 0.001), epileptic seizures (AOR = 2.678, 95% CI 1.253-5.721, P-value < 0.001) and moderate to severe stroke (NIHSS score = 16-21) (AOR = 5.994, 95% CI 2.043-17.585, P-value < 0.001) were at risk of developing stroke-associated pneumonia. SAP was a substantial medical complication among stroke patients. Early identification and prompt intervention measures for the identified risk factors might address the burden of SAP. Stroke is the major cause of disability and death in sub-Saharan African countries. The presence and severity of complications play a major role in the outcome of stroke. Stroke associated pneumonia is often noticed post stroke infection that has been linked to an increased risk of hospital mortality, a longer hospital stay and higher healthcare expenses. Report on details of stroke-associated pneumonia has never been documented in countries of sub-Saharan Africa. This study aimed to determine the incidence and risk factors of stroke-associated pneumonia among adult stroke patients in hospital settings, Northwest Ethiopia. The study was undertaken at a stroke care unit, University of Gondar hospital between January 1, 2020 and December 31, 2020. A convenience sampling method was used to recruit study subjects. Relevant clinical history was taken, focused physical examination was done, and brain imaging (CT scan or MRI) was performed to settle the diagnosis of stroke. A modified Centre for Disease Control and Prevention (CDC) criteria was used to diagnose stroke-associated pneumonia. All patients with stroke-associated pneumonia were treated according to the 2016 Infectious Diseases Society of America/American Thoracic Society Clinical Practice Guidelines. The Data were cleaned in Epi Info version 4.6.0.2, and analyzed using SPSS version 26. Variables associated with stroke-associated pneumonia were computed using logistic regression analysis. P value < 0.05 was considered to declare statistical significance. The study comprised a total of 325 adult stroke patients. The mean age of study subjects was 65.2 years (SD ± 15.7). The most prevalent type of stroke was ischemic stroke, which accounted for 68% of all cases. Hemiparesis (94%), facial palsy (87%), and swallowing disturbance (51%) were the frequently noticed neurological findings. Stroke-associated pneumonia complicated 116/325 (36%) of stroke patients. Multi-variate regression analysis revealed that patients who were elderly (age > 75 years) (AOR = 3.910, CI 1.181–12.936, P = 0.026), had swallowing disturbance (AOR = 4.656, CI 2.356–9.202, P-value < 0.001), epileptic seizures (AOR = 2.678, 95% CI 1.253–5.721, P-value < 0.001) and moderate to severe stroke (NIHSS score = 16–21) (AOR = 5.994, 95% CI 2.043–17.585, P-value < 0.001) were at risk of developing stroke-associated pneumonia. SAP was a substantial medical complication among stroke patients. Early identification and prompt intervention measures for the identified risk factors might address the burden of SAP. Abstract Stroke is the major cause of disability and death in sub-Saharan African countries. The presence and severity of complications play a major role in the outcome of stroke. Stroke associated pneumonia is often noticed post stroke infection that has been linked to an increased risk of hospital mortality, a longer hospital stay and higher healthcare expenses. Report on details of stroke-associated pneumonia has never been documented in countries of sub-Saharan Africa. This study aimed to determine the incidence and risk factors of stroke-associated pneumonia among adult stroke patients in hospital settings, Northwest Ethiopia. The study was undertaken at a stroke care unit, University of Gondar hospital between January 1, 2020 and December 31, 2020. A convenience sampling method was used to recruit study subjects. Relevant clinical history was taken, focused physical examination was done, and brain imaging (CT scan or MRI) was performed to settle the diagnosis of stroke. A modified Centre for Disease Control and Prevention (CDC) criteria was used to diagnose stroke-associated pneumonia. All patients with stroke-associated pneumonia were treated according to the 2016 Infectious Diseases Society of America/American Thoracic Society Clinical Practice Guidelines. The Data were cleaned in Epi Info version 4.6.0.2, and analyzed using SPSS version 26. Variables associated with stroke-associated pneumonia were computed using logistic regression analysis. P value < 0.05 was considered to declare statistical significance. The study comprised a total of 325 adult stroke patients. The mean age of study subjects was 65.2 years (SD ± 15.7). The most prevalent type of stroke was ischemic stroke, which accounted for 68% of all cases. Hemiparesis (94%), facial palsy (87%), and swallowing disturbance (51%) were the frequently noticed neurological findings. Stroke-associated pneumonia complicated 116/325 (36%) of stroke patients. Multi-variate regression analysis revealed that patients who were elderly (age > 75 years) (AOR = 3.910, CI 1.181–12.936, P = 0.026), had swallowing disturbance (AOR = 4.656, CI 2.356–9.202, P-value < 0.001), epileptic seizures (AOR = 2.678, 95% CI 1.253–5.721, P-value < 0.001) and moderate to severe stroke (NIHSS score = 16–21) (AOR = 5.994, 95% CI 2.043–17.585, P-value < 0.001) were at risk of developing stroke-associated pneumonia. SAP was a substantial medical complication among stroke patients. Early identification and prompt intervention measures for the identified risk factors might address the burden of SAP. Stroke is the major cause of disability and death in sub-Saharan African countries. The presence and severity of complications play a major role in the outcome of stroke. Stroke associated pneumonia is often noticed post stroke infection that has been linked to an increased risk of hospital mortality, a longer hospital stay and higher healthcare expenses. Report on details of stroke-associated pneumonia has never been documented in countries of sub-Saharan Africa. This study aimed to determine the incidence and risk factors of stroke-associated pneumonia among adult stroke patients in hospital settings, Northwest Ethiopia. The study was undertaken at a stroke care unit, University of Gondar hospital between January 1, 2020 and December 31, 2020. A convenience sampling method was used to recruit study subjects. Relevant clinical history was taken, focused physical examination was done, and brain imaging (CT scan or MRI) was performed to settle the diagnosis of stroke. A modified Centre for Disease Control and Prevention (CDC) criteria was used to diagnose stroke-associated pneumonia. All patients with stroke-associated pneumonia were treated according to the 2016 Infectious Diseases Society of America/American Thoracic Society Clinical Practice Guidelines. The Data were cleaned in Epi Info version 4.6.0.2, and analyzed using SPSS version 26. Variables associated with stroke-associated pneumonia were computed using logistic regression analysis. P value < 0.05 was considered to declare statistical significance. The study comprised a total of 325 adult stroke patients. The mean age of study subjects was 65.2 years (SD ± 15.7). The most prevalent type of stroke was ischemic stroke, which accounted for 68% of all cases. Hemiparesis (94%), facial palsy (87%), and swallowing disturbance (51%) were the frequently noticed neurological findings. Stroke-associated pneumonia complicated 116/325 (36%) of stroke patients. Multi-variate regression analysis revealed that patients who were elderly (age > 75 years) (AOR = 3.910, CI 1.181–12.936, P = 0.026), had swallowing disturbance (AOR = 4.656, CI 2.356–9.202, P-value < 0.001), epileptic seizures (AOR = 2.678, 95% CI 1.253–5.721, P-value < 0.001) and moderate to severe stroke (NIHSS score = 16–21) (AOR = 5.994, 95% CI 2.043–17.585, P-value < 0.001) were at risk of developing stroke-associated pneumonia. SAP was a substantial medical complication among stroke patients. Early identification and prompt intervention measures for the identified risk factors might address the burden of SAP. |
| ArticleNumber | 12724 |
| Author | Assefa, Messay Yimer, Mekonnen Tadesse, Melaku Tadesse, Abilo Adane, Aynishet |
| Author_xml | – sequence: 1 givenname: Messay surname: Assefa fullname: Assefa, Messay organization: Department of Internal Medicine, School of Medicine, College of Medicine and Health Sciences, University of Gondar – sequence: 2 givenname: Abilo surname: Tadesse fullname: Tadesse, Abilo email: abilotad@gmail.com organization: Department of Internal Medicine, School of Medicine, College of Medicine and Health Sciences, University of Gondar – sequence: 3 givenname: Aynishet surname: Adane fullname: Adane, Aynishet organization: Department of Internal Medicine, School of Medicine, College of Medicine and Health Sciences, University of Gondar – sequence: 4 givenname: Mekonnen surname: Yimer fullname: Yimer, Mekonnen organization: Department of Internal Medicine, School of Medicine, College of Medicine and Health Sciences, University of Gondar – sequence: 5 givenname: Melaku surname: Tadesse fullname: Tadesse, Melaku organization: Department of Internal Medicine, School of Medicine, College of Medicine and Health Sciences, University of Gondar |
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| References | Sacco, Kasner, Broderick, Caplan, Connors, Culebras (CR1) 2013; 44 Matz, Seyfang, Dachenhausen, Teuschl, Tuomilehto, Brainin (CR8) 2016; 16 Johnson, Onuma, Owolabi, Sachdev (CR3) 2016; 94 Smith, Kishore, Vail, Chamorro, Garau, Hopkins (CR13) 2015; 46 CR15 Ramsey, Smithard, Kalra (CR26) 2003; 34 Kishore, Vail, Chamorro, Garau, Hopkins, Di Napoli (CR14) 2015; 46 Fekadu, Chelkeba, Kebede (CR27) 2019; 19 Owolabi, Olowoyo, Popoola, Lackland, Jenkins, Arulogun (CR5) 2018; 20 Hannawi, Hannawi, Rao, Suarez, Bershad (CR18) 2013; 35 Feigin, Norrving, Mensah (CR2) 2017; 120 Owolabi, Arulogun, Melikam, Adeoye, Akarolo-Anthony, Akinyemi (CR4) 2015; 26 Kalil, Metersky, Klompas, Muscedere, Sweeney, Palmer (CR25) 2016; 63 Ji, Shen, Pan, Wang, Liu, Wang (CR22) 2013; 44 Adeloye (CR6) 2014; 9 Mohammed, Degu, Woldekidan, Adem, Edessa (CR16) 2021; 9 Russell, Charles, Conteh, Lisk (CR17) 2020; 60 Hoffmann, Malzahn, Harms, Koennecke, Berger, Kalic (CR21) 2012; 43 Alene, Assemie, Yismaw, Ketema (CR29) 2020; 20 Yuan, Li, Zhang, Zhang, Zou, Qin (CR23) 2021; 100 Li, Zhang, Ma, Niu, Chang (CR10) 2019; 19 Westendorp, Nederkoorn, Vermeij, Dijkgraaf, de Beek (CR7) 2011; 11 CR24 Vyas, Kulshreshtha, Maurya, Singh, Qavi, Thacker (CR11) 2019; 10 Martino, Foley, Bhogal, Diamant, Speechley, Teasell (CR20) 2005; 36 Baye, Hintze, Gordon-Murer, Mariscal, Belay, Gebremariam (CR28) 2020; 11 Dziewas, Ritter, Schilling, Konrad, Oelenberg, Nabavi (CR12) 2004; 75 Sellars, Bowie, Bagg, Sweeney, Miller, Tilston (CR9) 2007; 38 Finlayson, Kapral, Hall, Asllani, Selchen, Saposnik (CR19) 2011; 77 R Dziewas (14656_CR12) 2004; 75 14656_CR15 DJ Ramsey (14656_CR26) 2003; 34 M Alene (14656_CR29) 2020; 20 AS Mohammed (14656_CR16) 2021; 9 JB Russell (14656_CR17) 2020; 60 VL Feigin (14656_CR2) 2017; 120 R Ji (14656_CR22) 2013; 44 M Yuan (14656_CR23) 2021; 100 O Finlayson (14656_CR19) 2011; 77 Y Hannawi (14656_CR18) 2013; 35 RL Sacco (14656_CR1) 2013; 44 M Owolabi (14656_CR5) 2018; 20 G Fekadu (14656_CR27) 2019; 19 M Baye (14656_CR28) 2020; 11 D Adeloye (14656_CR6) 2014; 9 AK Kishore (14656_CR14) 2015; 46 14656_CR24 MO Owolabi (14656_CR4) 2015; 26 CJ Smith (14656_CR13) 2015; 46 K Matz (14656_CR8) 2016; 16 C Sellars (14656_CR9) 2007; 38 R Martino (14656_CR20) 2005; 36 AC Kalil (14656_CR25) 2016; 63 W Johnson (14656_CR3) 2016; 94 L Vyas (14656_CR11) 2019; 10 S Hoffmann (14656_CR21) 2012; 43 Y Li (14656_CR10) 2019; 19 WF Westendorp (14656_CR7) 2011; 11 |
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Res. doi: 10.1161/CIRCRESAHA.116.308413 – volume: 9 issue: 6 year: 2014 ident: 14656_CR6 publication-title: PLoS ONE doi: 10.1371/journal.pone.0100724 – volume: 44 start-page: 1303 issue: 5 year: 2013 ident: 14656_CR22 publication-title: Stroke doi: 10.1161/STROKEAHA.111.000598 – ident: 14656_CR24 – volume: 26 start-page: S27 issue: 2 year: 2015 ident: 14656_CR4 publication-title: Cardiovasc. J. Afr. doi: 10.5830/CVJA-2015-038 – volume: 60 start-page: 293 year: 2020 ident: 14656_CR17 publication-title: Ann. Med. Surg. doi: 10.1016/j.amsu.2020.10.060 – volume: 38 start-page: 2284 issue: 8 year: 2007 ident: 14656_CR9 publication-title: Stroke doi: 10.1161/STROKEAHA.106.478156 – volume: 36 start-page: 2756 issue: 12 year: 2005 ident: 14656_CR20 publication-title: Stroke doi: 10.1161/01.STR.0000190056.76543.eb – volume: 35 start-page: 430 issue: 5 year: 2013 ident: 14656_CR18 publication-title: Cerebrovasc. 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| Title | Factors associated with stroke associated pneumonia among adult stroke patients admitted to university of Gondar hospital, Northwest Ethiopia |
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