A Silent Threat: The Aspiration Pneumonia in Hospitalized Stroke Patients
DOI:
https://doi.org/10.47489/szmc.v39i2.574Keywords:
Pneumonia, Acute, Stroke, Dysphagia, Hospitalized PatientsAbstract
Background: Stroke is a common illness globally and is a major cause of disability that results in some serious complications during acute phase including aspiration pneumonia. Stroke patients and caregivers are usually not aware of the difficulty in swallowing and results in aspiration pneumonia.
Objective: To determine the frequency of aspiration pneumonia in acute stroke patients and its’ associated demographic pattern.
Method: A descriptive cross-sectional study was carried out involving 96 patients admitted with stroke at the Department of Neurology, Federal Postgraduate Medical Institute, Shaikh Zayed Hospital Lahore, from January 2023 to December 2023.
Results: There was a total of 96 stroke patients, 18 were with hemorrhagic stroke and 78 patients were with ischemic stroke. Total 24/96 (25%) patients developed aspiration pneumonia, where 17/24 (70.83%) patients were with ischemic and 7/24 (29.16%) were with hemorrhagic stroke.
Conclusion: One fourth of the admitted stroke patients developed post-stroke aspiration pneumonia which shows a high proportion of such a major cause of in-hospital mortality in stroke patients. Aspiration pneumonia is a silent, serious threat in acute stroke patients, which needs quick management plans and intubation of nasogastric tubes to minimize the risk.
References
Sacco RL et al; American Heart Association Stroke Council, Council on ?Cardiovascular Surgery and Anesthesia. Council on Cardiovascular Radiology ?and Intervention. Council on Cardiovascular and Stroke Nursing. Council on ?Epidemiology and Prevention. Council on Peripheral Vascular Disease. Council ?on Nutrition, Physical Activity and Metabolism. An updated definition of stroke ?for the 21st century: a statement for healthcare professionals from the American ?Heart Association/American Stroke Association. Stroke. 2013 Jul;44(7):2064-89.? https://doi.org/10.1161/strokeaha.108.192218
Katan M, Luft A. Global Burden of Stroke. Semin Neurol. 2018 Apr;38(2):208-211. doi: ??10.1055/s-0038-1649503. Epub 2018 May 23. PMID: 29791947.?https://doi.org/10.1055/s-0038-1649503
Girgenti, Sophia et al; Longitudinal outcomes of ischemic versus hemorrhagic stroke: ?Differences may impact future trial design;?Journal of Stroke and Cerebrovascular Diseases, Volume 33, Issue 11, 107952.? https://doi.org/10.1016/j.jstrokecerebrovasdis.2024.107952
Cohen DL, Roffe C, Beavan J, et al. Post-stroke dysphagia: A review and design ?considerations for future trials. International Journal of Stroke. 2016;11(4):399-411.? https://doi.org/10.1177/1747493016639057
Jordi Almirall, ?Ramon Boixeda, Mari C. de la Torre, Antoni Torres. Aspiration ?pneumonia: A ?renewed perspective and practical approach; Respiratory Medicine 185 ??(2021) ??106485.?https://doi.org/10.1016/j.rmed.2021.106485
Sanivarapu RR, Vaqar S, Gibson J. Aspiration Pneumonia. [Updated 2024 Mar ??20].? https://www.ncbi.nlm.nih.gov/books/NBK470459?.?
Finlayson, O., Kapral, M., Hall, R., Asllani, E., Selchen, D., Saposnik, G., et al. ??(2011). Risk factors, inpatient care, and outcomes of pneumonia after ischemic ?stroke. Neurology 77, 1338–1345. doi: 10.1212/WNL.0b013e31823152b1.?https://doi.org/10.1212/wnl.0b013e31823152b1
Sivakumar S, Prabhu A. Physiology, Gag Reflex. [Updated 2023 Mar 12]. In: ?StatPearls [Internet]. https://www.ncbi.nlm.nih.gov/books/NBK554502/?
Cohen DL, Roffe C, Beavan J, et al. Post-stroke dysphagia: A review and ?design considerations for future trials. International Journal of Stroke. ??2016;11(4):399-411. doi:10.1177/1747493016639057?. https://doi.org/10.1177/1747493016639057
Westendorp W, Nederkoorn P, Vermeij J, Dijkgraaf M, van de Beek D. Post-stroke infection: a systematic review and meta-analysis. BMC Neurol 2011; 11: 110.) https://doi.org/10.1186/1471-2377-11-110
Muhammad Khalid, Iftikhar Ali Kakar, Haris Khan, Muhammad Haroon Shahid, Hazrat Abbas, Muhammad Salman, Prevalence of aspiration Pneumonia in Stroke Patients at Tertiary Care Hospital, Vol. 16 No. 10 (2022): Pakistan Journal of Medical and Health Sciences.https://doi.org/10.53350/pjmhs221610569
Chen Y, Yang H, Wei H, et al. Stroke-associated pneumonia: a bibliometric analysis of worldwide trends from 2003 to 2020. Medicine (Baltimore). 2021;100(38):e27321. https://doi.org/10.1097/md.0000000000027321
Verma R. Stroke-associated pneumonia: management issues. J Neurosci Rural Pract. 2019;10(3):472-473. doi:10.1055/s-0039-1696743. https://doi.org/10.1055/s-0039-1696743
Sellars C, Bowie L, Bagg J, et al. Risk factors for chest infection in acute stroke: A prospective cohort study. Stroke. 2007;38(8):2284–2291. https://doi.org/10.1161/strokeaha.106.478156
Jeroen C. de Jonge, MD https://orcid.org/0000-0002-0025-8760 [email protected], Diederik van de Beek, MD, PhD, Patrick Lyden, MD https://orcid.org/0000-0001-6170-4042, Marian C. Brady, PhD, Philip M. Bath, DSc, FMedSci; Temporal Profile of Pneumonia After Stroke, Stroke,Volume 53, Number 1 https://doi.org/10.1161/STROKEAHA.120.032787
Takayoshi Akimoto *ORCID,Makoto Hara,Masaki Ishihara,Katsuhiko Ogawa andHideto Nakajima, Post-Stroke Pneumonia in Real-World Practice: Background, Microbiological Examination, and Treatment, Neurol. Int. 2023, 15(1), 69-77 https://doi.org/10.3390/neurolint15010006
Hoffmann S, Malzahn U, Harms H, et al. Development of a clinical score (A2DS2) to predict pneumonia in acute ischemic stroke. Stroke 2012; 43: 2617–2623.) https://doi.org/10.1161/strokeaha.112.653055
MUHAMMAD IMRAN, ABDUL WARIS KHAN, MUHAMMAD UMAR et al; Frequency of Aspiration Pneumonia in Patients with Stroke; P J M H S Vol. 16, No.01, JAN 2022. http://dx.doi.org/10.53350/pjmhs221611062
HUSNAIN HASHIM, LARAIB SHAHID, DANIAL BAJWA; Prevalence of Stroke Associated Pneumonia in Stroke Patients; P J M H S Vol. 16, No. 10, October, 2022. https://doi.org/10.53350/pjmhs221610590
Moulaei N. A et al Aspiration pneumonia after cerebrovascular stroke: a comparison between patients with and without dysphagia; Anest. intenziv. Med.2022;33(3-4):148-152.https://doi.org/10.36290/aim.2022.023
Wakabayashi T, Hamaguchi S, Morimoto K; Adult Pneumonia Study Group – Japan. Clinically defined aspiration pneumonia is an independent risk factor associated with long-term hospital stay: a prospective cohort study. BMC Pulm Med. 2023 Sep 18;23(1):351. doi: 10.1186/s12890-023-02641-y. PMID: 37718411; PMCID: PMC10506309. https://doi.org/10.1186/s12890-023-02641-y

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