title: Total time of operation is a risk factor of stroke-associated pneumonia in acute ischemic stroke patients with intra-arterial treatment.
abstract: OBJECTIVE
  Stroke-associated pneumonia (SAP) is associated with poor functional outcome in patients with acute ischemic stroke (AIS). The objective of this study was to identify predictors of SAP in patients underwent intra-arterial treatment (IAT).
  
  
  METHODS
  Consecutive patients with AIS within 6 h from the symptom onset underwent IAT were enrolled. Independent predictors of in-hospital SAP after AIS were obtained using multivariable logistic regression. Kaplan-Meier survival curves were calculated and compared by the log-rank test.
  
  
  RESULTS
  Of 165 patients with AIS in the study period, 102 (61.8%) underwent IAT. Twenty-two (21.6%; 95% confidence interval [CI], 14.7-29.4) experienced SAP. Patients with SAP were older (69.2 vs 62.9 years, respectively; P = 0.011), more severely affected (National Institutes of Health Stroke Scale score, 18 vs 9, respectively; P = 0.004), more likely to underwent symptom of dysphagia (86.4% vs 15%, respectively; P < 0.001), lower Glasgow Coma Scale score (9 vs 13, respectively; P < 0.001), and longer operation time (149.5 vs 123, respectively; P < 0.001) than those without SAP. Only symptom of dysphagia (adjust odds ratio [OR], 12.051; 95% CI, 3.457-50.610; P < 0.001) and total time of operation (adjust OR, 1.040; 95% CI, 1.009-1.071; P < 0.001) were identified as independent predictors of SAP. Patients with SAP had stable or improved deficits after AIS with IAT (P < 0.001).
  
  
  CONCLUSIONS
  Besides dysphagia, total time of operation is a risk factor of SAP in patients with AIS with IAT.
authors.affiliation: Department of Neurology, Jinling Hospital, The Second Military Medical University Department of Neurology, Jinling Hospital, Southern Medical University, Nanjing, China.
authors.forename: Rui
authors.initials: R
authors.lastname: Liu
authors.forename: Wei
authors.initials: W
authors.lastname: Li
authors.forename: Yaoyang
authors.initials: Y
authors.lastname: Li
authors.forename: Yunfei
authors.initials: Y
authors.lastname: Han
authors.forename: Minmin
authors.initials: M
authors.lastname: Ma
authors.forename: Wusheng
authors.initials: W
authors.lastname: Zhu
authors.forename: Min
authors.initials: M
authors.lastname: Li
authors.forename: Qiliang
authors.initials: Q
authors.lastname: Dai
authors.forename: Yuezhou
authors.initials: Y
authors.lastname: Cao
authors.forename: Gelin
authors.initials: G
authors.lastname: Xu
authors.forename: Xinfeng
authors.initials: X
authors.lastname: Liu
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002545:Brain Ischemia / Q000150:complications* / Q000000981:diagnostic imaging / Q000188:drug therapy*; D003680:Deglutition Disorders / Q000209:etiology; D003952:Diagnostic Imaging; D005260:Female; D006801:Humans; D007261:Infusions, Intra-Arterial; D007269:Injections, Intra-Arterial; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D011014:Pneumonia / Q000209:etiology* / Q000517:prevention & control*; D011446:Prospective Studies; D012307:Risk Factors; D020521:Stroke / Q000150:complications* / Q000000981:diagnostic imaging / Q000188:drug therapy*; D017131:Thrombectomy / Q000379:methods*; D015912:Thrombolytic Therapy / Q000379:methods*; D016896:Treatment Outcome