| Objective:To investigate the predictive value of A2DS2 score combined with neutrophil percentage/albumin ratio (NPAR) and D-dimer for the occurrence of stroke-associated pneumonia (SAP) in Acuteischemicstroke (AIS) patients. Methods:Retrospective analysis of the clinical data of 265 AIS patients admitted to the Southern Theater Command Air Force Hospital from November 2017 to November 2023. AIS patients were divided into SAP group and non-SAP group according to whether occurrence of SAP within one week of onset. Collect clinical data from two groups of patients, calculate A2DS2 score, NPAR, detected the D-dimer levels of two groups. Spearman correlation analysis on the relationship between A2DS2 score and NPAR, D-dimer levels. Multiple factor logistic regression analysis were used to identify independent risk factors. The predictive values were analyzed by receiver operating characteristic (ROC) curve, Constructing a modifed A2DS2 (mA2DS2) score based on the optimal cutoff values of A2DS2 score, NPAR and D-dimer, the predictive values of the mA2DS2 score was analyzed by ROC curve. Results:A total of 265 AIS patients were included in this study, of which 78 patients with AIS developed SAP within one week of onset, and the incidence rate of SAP was 29.43%. There were statistically difference in comparison of age, NIHSS score at admission, swallowing difficulties, atrial fibrillation, history of stroke, A2DS2 score, D-dimer, fibrinogen levels, systemic immune inflammation index (SII), neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), NPAR between SAP group and non-SAP group(P＜0.05). A2DS2 score was positively correlated with NPAR and D-dimer (P<0.05). The results of the multifactor logistic regression model analysis showed that, elevated NPAR, elevated D-dimer and elevated A2DS2 score were risk factors for the occurrence of SAP in AIS patients (P<0.05).The area under curve (AUC) predicted by A2DS2 score for the occurrence of SAP in AIS patients was 0.866, the AUC predicted by NPAR for the occurrence of SAP in AIS patients was 0.815, and the AUC predicted by D-dimer for the occurrence of SAP in AIS patients was 0.705. The ROC curve analysis results show that, the AUC predicted by mA2DS2 score for the occurrence of SAP in AIS patients was 0.898, which was greater than the AUC predicted by A2DS2 score alone. Conclusions:The significant increase in A2DS2 score, NPAR and D-dimer levels is associated with the occurrence of SAP in AIS patients, and the A2DS2 score combined with NPAR and D-dimer detection has a high predictive efficiency for the occurrence of SAP in AIS patients. |
