The impact of post-stroke pneumonia on survival and functional outcomes: A systematic review and meta-analysis

TL;DR

This study finds that pneumonia after a stroke significantly increases the risk of death and poor recovery outcomes in patients.

Contribution

The study provides a comprehensive meta-analysis of the long-term effects of post-stroke pneumonia on mortality and functional outcomes.

Findings

SAP increases in-hospital mortality risk by 2.67 times compared to stroke patients without SAP.

Mortality risk remains elevated for up to three months after stroke when SAP is present.

SAP is associated with a 4.82 times higher risk of poor functional recovery in stroke patients.

Abstract

To evaluate the impact of stroke-associated pneumonia (SAP) on mortality risk and poor functional outcomes.

PubMed, Embase and Scopus databases were searched to identify studies with adult stroke patients (≥40 years) who were diagnosed with SAP. Risk of mortality and poor functional outcome were of primary interest. Results were reported as pooled odds ratios (OR) or hazard ratios (HR) with 95% confidence intervals (CI).

A total of 22 studies were included. SAP was associated with the increased risk of in-hospital mortality (OR 2.67, 95% CI: 1.82, 3.93) and mortality at one (OR 2.11, 95% CI: 1.17, 3.79), two (OR 6.97, 95% CI: 4.63, 10.5) and three months (OR 4.26, 95% CI: 2.44, 7.44) of follow up compared to stroke patients without SAP. Risk of mortality at ≥1 year of follow up was also higher in patients with SAP (HR 2.44, 95% CI: 1.33, 4.48). SAP also correlated with the increased risk of poor functional outcome (OR 4.82, 95% CI: 3.47, 6.69)

SAP is associated with significant adverse impact on survival and functional outcomes of stroke patients and further strengthen the need for a comprehensive approach to stroke management.

Registration No: PROSPERO [CRD420251020683].

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