índice para predecir neumonía asociada al ictus isquémico agudo

摘要

Foundation : Pneumonia is the most important complication of acute ischemic stroke. It has a serious impact on prognosis, on stay and on patients′ functional recovery. Objective : to prepare an index aimed at predicting pneumonia associated with acute ischemic stroke. Methods : A comparative study was conducted, based on a prospective cohort of patients with clinical diagnosis and confirmed by computed tomography of acute ischemic cerebral infarction (N = 375), treated at the Carlos Manuel de Céspedes University General Hospital, from January 2016 to December 2018. A quantitative index was obtained, based on the regression coefficients corresponding to each independent predictor, which was subdivided into four risk categories. Results : 22.1 % of the patients developed pneumonia associated with acute ischemic stroke. The index presented good discriminative capacity (area under the ROC curve 0.928), with a positive predictive value of 97.60 %, a sensitivity of 92.23 %, specificity of 89.39%, and a positive likelihood ratio of 8,70. The value of the Eta association coefficient was 0.740. Conclusion : the formulated index is composed of reliable parameters, easily available and quick to apply in the first 24-48 hours of acute ischemic cerebral infarction, and allows predicting the development of pneumonia associated with it.