title: Comparison of Characteristics of Stroke-Associated Pneumonia in Stroke Care Units in Indonesia and Japan.
abstract: BACKGROUND
  Pneumonia is one of the most common medical complications after stroke. Incidence and risk factor analyses of stroke-associated pneumonia (SAP) in stroke care units (SCUs) are limited. SAP incidence comparisons across countries can identify the most effective treatment to reduce this incidence.
  
  
  METHODS
  This was a retrospective study including consecutive patients with acute stroke in SCUs in 2 hospitals: 105 patients (mean age 78.2 ± 5.8) from the National Cerebral and Cardiovascular Center (NCVC) in Osaka, Japan (from July to August 2015), and 105 patients (mean age 60 ± 5.8) from the National Brain Centre (NBC) Hospital in Jakarta, Indonesia (from May to September 2015). We used descriptive statistics and a logistic regression model for statistical analysis.
  
  
  RESULTS
  The incidence of SAP in the SCU NBC Hospital was higher than that in the SCU NCVC (22.9% versus 12.4%, P = .0466). In the SCU NBC Hospital, dysphagia (odds ratio [OR] 15.20, 95% confidence interval [CI] 1.77-130.73) and severe neurological deficits on admission (OR 5.31, 95% CI 1.60-17.60) were significantly associated with SAP, whereas in the SCU NCVC, dysphagia (OR 14.42, 95% CI 2.34-88.98) and diabetes mellitus (OR 7.16, 95% CI 1.27-40.18) were the risk factors. When the patients of both hospitals were analyzed together, severe neurological deficits on admission (OR 3.36, 95% CI 1.31-8.64) and dysphagia (OR 12.62, 95% CI 3.75-42.45) were significant determinants for developing SAP.
  
  
  CONCLUSIONS
  The incidence of SAP was higher in the Indonesian hospital than in the Japanese one. Our findings support other epidemiological data of a high incidence of SAP with severe neurological deficits on admission and dysphagia in an SCU setting.
authors.affiliation: National Brain Centre Hospital, Jakarta, Indonesia.
authors.forename: Ita Muharram
authors.initials: IM
authors.lastname: Sari
authors.affiliation: National Brain Centre Hospital, Jakarta, Indonesia.
authors.forename: Lyna
authors.initials: L
authors.lastname: Soertidewi
authors.affiliation: Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Osaka, Japan. Electronic address: cyokota@ncvc.go.jp.
authors.forename: Chiaki
authors.initials: C
authors.lastname: Yokota
authors.affiliation: Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Osaka, Japan.
authors.forename: Muneaki
authors.initials: M
authors.lastname: Kikuno
authors.affiliation: Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Osaka, Japan.
authors.forename: Masatoshi
authors.initials: M
authors.lastname: Koga
authors.affiliation: Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Osaka, Japan.
authors.forename: Kazunori
authors.initials: K
authors.lastname: Toyoda
mesh_terms: D000368:Aged; D002545:Brain Ischemia / Q000150:complications / Q000453:epidemiology; D003680:Deglutition Disorders / Q000150:complications / Q000453:epidemiology; D005260:Female; D006801:Humans; D015994:Incidence; D007214:Indonesia / Q000453:epidemiology; D007564:Japan / Q000453:epidemiology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011014:Pneumonia / Q000453:epidemiology* / Q000209:etiology*; D012189:Retrospective Studies; D012307:Risk Factors; D020521:Stroke / Q000150:complications* / Q000453:epidemiology*
keywords: Indonesia; Japan; Stroke-associated pneumonia; dysphagia