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Objective To investigate the relationship between high-sensitivity C-reactive protein-albumin ratio(HCAR), acute ischemic stroke(AIS) associated pneumonia(SAP) and early clinical outcomes. Methods A total of 495 AIS who received treatment in the hospital from February 2021 to December 2022 patients with AIS were enrolled. All patients were divided into the SAP group and the non-SAP group according to whether SAP occurred during hospitalization. The patients were divided into four groups according to the quartile of HCAR level at admission[Q1 group(≤1. 3), Q2 group(1. 3-3. 7), Q3 group(3. 9-9. 2), Q4 group (≥9. 3)]. Baseline data at admission, data at discharge and 3-month follow-up data of all patients were collected. Univariate and multivariate logistic regression analysis were used to investigate the relationship between HCAR quartiles and SAP risk, 3-month adverse outcomes and 3-month all-cause mortality. Receiver-operating characteristic(ROC) curve was used to evaluate the predictive value of HCAR and other related indicators for SAP. Results SIP was diagnosed in 68(18. 6%) AIS patients during hospitalization, and the HCAR in the SAP group was significantly higher than that in the non-SAP group, the differences wase statistically significant( P <0. 001). In the unadjusted model, the incidence of SAP in Q2 group, Q3 group and Q4 group was significantly higher than that in the Q1 group(P <0. 05, Ptrend <0. 001). In the adjusted model, the incidence of SAP in Q2 group, Q3 group and Q4 group was also higher than that in Q1 group, and the incidence of SAP in Q3 group and Q4 group was significantly higher than that in Q1 group(P <0. 05, Ptrend <0. 001). ROC curve analysis showed that the AUC of HCAR was the largest, and the AUC of HCAR was significantly different from that of high-sensitivity C-reactive protein(hs-CRP) or albumin(Alb)(P <0. 05). There was no significant difference in AUC between HCAR and A2DS2 score(P >0. 05), but HCAR(sensitivity and specificity were 77. 17% and 73. 44%, respectively) had a more balanced sensitivity and specificity than A2DS2 score(sensitivity and specificity were 58. 72% and 83. 19%, respectively). HCAR at the Q4 level was significantly associated with adverse clinical outcomes(adjusted OR:Q4 vs. Q1 was 1. 98, Ptrend=0. 013). Patients with HCAR above Q3 had a higher risk of death within three months(adjusted OR:Q3 vs. Q1 was 2. 63, Q4 vs. Q1 was 3. 75, Ptrend=0. 001). Conclusion AIS patients with high HCAR levels at admission are more likely to develop SAP during hospitalization, and their early clinical outcomes are relatively worse. The incidence of adverse outcome and mortality rate at three months are higher. [ABSTRACT FROM AUTHOR]

Objective To study the risk factors and pathogens of stroke-associated pneumonia (SAP) multi-drug resistant bacteria (MDR) infection, so as to identify SAP as soon as possible and take preventive measures. Methods From June 2016 to December 2018, 680 elderly stroke patients in the neurological disease center of the hospital were selected, of which 156 were SAP patients. The clinical data of patients were retrospectively analyzed, single-factor and multi-factor analysis of risk factors for MDR infection were conducted, and pathogenic bacteria were analyzed. Results Among 156 SAP patients, 69 had MDR infection, and the infection rate was 44.2%. MDR infection was related to age, stroke type, level of consciousness, coronary heart disease, history of chronic lung disease,dysphagia,indwelling gastric tube, tracheal intubation,and preventive use of antibiotics (P <0.05). MDR infection was not related to gender, smoking history, diabetes, hypertension, intravenous thrombolysis (P>0.05). A total of 47 pathogens were isolated from patients with MDR infection, including 27 Gram-negative bacteria (57.4%) and 15 Gram-positive bacteria (31.9%). Conclusion Age, stroke type, level of consciousness, coronary heart disease, history of chronic lung disease, combined dysphagia, indwelling gastric tube, tracheal intubation, and preventive use of antibiotics are risk factors for MDR infection in elderly SAP patients.The pathogenic bacteria are mainly Gram-negative bacteria. [ABSTRACT FROM AUTHOR]