Chest computed tomography and multi-criteria decision analysis-guided interventions for stroke-associated pneumonia in acute ischemic stroke

TL;DR

Using chest CT scans and a decision-making approach helps reduce pneumonia in stroke patients, improving recovery and shortening hospital stays.

Contribution

A multi-criteria decision analysis-guided intervention combined with chest CT improves outcomes for stroke-associated pneumonia.

Findings

Intervention group had lower pneumonia incidence (12.8% vs. 31.6%) and shorter hospital stays (14.1 vs. 16.8 days).

Barthel Index and Glasgow Coma Scale scores improved more in the intervention group.

Age, Glasgow Coma Scale score, and smoking history were independent risk factors for stroke-associated pneumonia.

Abstract

Stroke-associated pneumonia is a common complication of acute cerebral infarction, worsening prognosis and prolonging hospitalization. Early detection and timely intervention are critical to improving outcomes. The aim of this study was to evaluate the effectiveness of a multi-criteria decision analysis-based intervention in preventing stroke-associated pneumonia and examine the role of chest computed tomography in guiding early interventions.

A total of 77 patients with acute cerebral infarction were divided into a control group (n=38) receiving standard care and an intervention group (n=39) receiving an multi-criteria decision analysis-guided bundled intervention. Chest computed tomography identified early pulmonary infections, and interventions such as anti-infective and respiratory support were adjusted accordingly. Stroke-associated pneumonia incidence, hospital stay, and functional recovery were compared, and multivariate logistic regression analysis identified independent stroke-associated pneumonia risk factors.

The intervention group showed a statistically significantly lower stroke-associated pneumonia incidence (12.8 vs. 31.6%, p=0.034), shorter hospital stays (14.1 vs. 16.8 days, p=0.027), and better improvements in Barthel Index for Activities of Daily Living (50.3 vs. 35.7, p=0.005) and Glasgow Coma Scale scores (14.1 vs. 12.7, p=0.041). Independent stroke-associated pneumonia risk factors included age (OR 1.03, 95%CI 1.01–1.06, p=0.029), Glasgow Coma Scale score (OR 0.83, 95%CI 0.73–0.94, p=0.014), and smoking history (OR 2.11, 95%CI 1.08–4.02, p=0.031). The intervention statistically significantly reduced stroke-associated pneumonia risk (OR 0.39, 95%CI 0.17–0.92, p=0.032).

Multi-criteria decision analysis-guided interventions, supported by chest computed tomography for early detection, significantly reduce stroke-associated pneumonia incidence, improve recovery, and shorten hospital stays in acute cerebral infarction patients. Chest computed tomography is crucial for optimizing early interventions and treatment strategies.

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