title: The A2DS2 Score as a Predictor of Pneumonia and In-Hospital Death after Acute Ischemic Stroke in Chinese Populations.
abstract: OBJECTIVE
  Stroke-associated pneumonia (SAP) is a common complication and an important cause of death during hospitalization. The A2DS2 (Age, Atrial fibrillation, Dysphagia, Sex, Stroke Severity) score was developed from the Berlin Stroke Registry and showed good predictive value for predicting SAP. We sought to identify the association between the A2DS2 score and SAP, and, furthermore, to identify whether the A2DS2 score was a predictor for in-hospital death after acute ischemic stroke in a Chinese population.
  
  
  METHODS
  This was a retrospective study. 1239 acute ischemic stroke patients were classified to low A2DS2 group (0-4) and high A2DS2 score (5-10) group. Primary outcome was in-hospital SAP. Logistic regression analyses were performed to identify the association between the A2DS2 score and SAP, and also the association between the A2DS2 score and in-hospital death.
  
  
  RESULTS
  The overall incidence rates of SAP and in-hospital mortality after acute ischemic stroke were 7.3% and 2.4%, respectively. The incidence rate of SAP in low and high A2DS2 score groups was separately 3.3% and 24.7% (P<0.001). During hospitalization, 1.2% patients in low score group and 7.8% patients in high score group died (P<0.001). Multivariate regression demonstrated that patients in high score group had a higher risk of SAP (OR = 8.888, 95%CI: 5.552-14.229) and mortality (OR = 7.833, 95%CI: 3.580-17.137) than patients in low score group.
  
  
  CONCLUSIONS
  The A2DS2 score was a strong predictor for SAP and in-hospital death of Chinese acute ischemic stroke patients. The A2DS2 score might be a useful tool for the identification of patients with a high risk of SAP and death during hospitalization.
authors.affiliation: Department of Neurology, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, Guangdong, China.
authors.forename: Xiaopei
authors.initials: X
authors.lastname: Zhang
authors.affiliation: Department of Neurology, JiangmenWuyi Traditional Chinese Medicine Hospital, Jiangmen, Guangdong, China.
authors.forename: Shangzhen
authors.initials: S
authors.lastname: Yu
authors.affiliation: Department of Neurology, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, Guangdong, China.
authors.forename: Lin
authors.initials: L
authors.lastname: Wei
authors.affiliation: Department of Neurology, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, Guangdong, China.
authors.forename: Richun
authors.initials: R
authors.lastname: Ye
authors.affiliation: Department of Neurology, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, Guangdong, China.
authors.forename: Meizhen
authors.initials: M
authors.lastname: Lin
authors.affiliation: Department of Neurology, JiangmenWuyi Traditional Chinese Medicine Hospital, Jiangmen, Guangdong, China.
authors.forename: Xiaomin
authors.initials: X
authors.lastname: Li
authors.affiliation: Department of Neurology, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, Guangdong, China.
authors.forename: Guoming
authors.initials: G
authors.lastname: Li
authors.affiliation: Department of Neurology, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, Guangdong, China.
authors.forename: Yefeng
authors.initials: Y
authors.lastname: Cai
authors.affiliation: Department of Neurology, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, Guangdong, China.|National Clinical Research Center for Kidney Disease, State Key Laboratory for Organ Failure Research, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China.
authors.forename: Min
authors.initials: M
authors.lastname: Zhao
mesh_terms: D000367:Age Factors; D000368:Aged; D001281:Atrial Fibrillation / Q000150:complications*; D002545:Brain Ischemia / Q000150:complications*; D003680:Deglutition Disorders / Q000150:complications*; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D011014:Pneumonia / Q000150:complications* / Q000175:diagnosis*; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D012737:Sex Factors; D020521:Stroke / Q000150:complications / Q000401:mortality*