title: Elderly age, bilateral lesions, and severe neurological deficit are correlated with stroke-associated pneumonia.
abstract: Causative factors for pneumonia and their impact on prognosis were investigated in patients with acute ischemic stroke. Patient characteristics, swallowing function, lesions, and the presence or absence of intervention by dysphagia rehabilitation were assessed in 292 patients with acute cerebral infarction to determine the association of these factors with pneumonia. As a result, 52 patients (17.8%) experienced pneumonia. Of these, 14 developed pneumonia within 3 days of hospital admission and 38 developed the disease after 4 days or later. Pneumonia was frequently seen among elderly patients, those with severe neurological symptoms or cognitive disorders and those with bilateral multiple lesions, and was associated with prolonged length of stay and decline in activities of daily living at hospital discharge. In conclusion, elderly age, bilateral lesions, and severe neurological deficit were significantly associated with pneumonia. Pneumonia in turn strongly predicted inability to take food orally and be discharged from hospital to home.
authors.affiliation: Department of Rehabilitation Medicine II, School of Medicine, Fujita Health University, Mie, Japan. Electronic address: maeshima@fujita-hu.ac.jp.
authors.forename: Shinichiro
authors.initials: S
authors.lastname: Maeshima
authors.affiliation: Department of Rehabilitation Medicine, National Center for Geriatrics and Gerontology, Aichi, Japan.
authors.forename: Aiko
authors.initials: A
authors.lastname: Osawa
authors.affiliation: Department of Neurology, Saitama Medical University International Medical Center, Hidaka, Saitama, Japan.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Hayashi
authors.affiliation: Department of Neurology, Saitama Medical University International Medical Center, Hidaka, Saitama, Japan.
authors.forename: Norio
authors.initials: N
authors.lastname: Tanahashi
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D003679:Deglutition; D003680:Deglutition Disorders / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D003952:Diagnostic Imaging; D004435:Eating; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009460:Neurologic Examination; D010343:Patient Admission; D010351:Patient Discharge; D011015:Pneumonia, Aspiration / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D011237:Predictive Value of Tests; D011379:Prognosis; D020127:Recovery of Function; D018570:Risk Assessment; D012307:Risk Factors; D012720:Severity of Illness Index; D020521:Stroke / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology; D013997:Time Factors
keywords: Dysphagia; acute stroke; outcome; pneumonia; rehabilitation