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An L-Shaped Relationship Between Serum Iron and Stroke-Associated Pneumonia

Authors Li J, Feng L, Huang Q, Ren W

Received 11 January 2021

Accepted for publication 25 February 2021

Published 22 March 2021 Volume 2021:16 Pages 505—511

DOI https://doi.org/10.2147/CIA.S301480

Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 2

Editor who approved publication: Prof. Dr. Zhi-Ying Wu


Jia Li,1 Liang Feng,1 Qiqi Huang,2 Wenwei Ren1

1Department of Neurology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000, People’s Republic of China; 2Department of Cardiac Care Unit, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000, People’s Republic of China

Correspondence: Wenwei Ren
Department of Neurology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000, Zhejiang Province, People’s Republic of China
Tel/Fax +86 577 555 54543
Email [email protected]
Qiqi Huang
Department of Cardiac Care Unit, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000, Zhejiang Province, People’s Republic of China
Tel/Fax +86 577 555 54543
Email [email protected]

Objective: Pneumonia is a common complication in patients with stroke. There was a close relationship between serum iron and inflammatory response. This study aimed to explore the relationship between serum iron levels and stroke-associated pneumonia (SAP).
Methods: Patients with acute stroke were recruited from the First Affiliated Hospital of Wenzhou Medical University and divided into SAP group and Non-SAP group. The demographic and clinical data of the patients were collected via the medical records, and the blood samples were collected within 24 hours after admission. The predictive value of serum iron to SAP was evaluated by receiver operating characteristic curve (ROC) and binary Logistic regression models. A restricted cubic spline (RCS) was used to furtherly clarify the relationship between serum iron and the risk of SAP.
Results: A total of 906 participants were enrolled, including Non-SAP group (n = 755) and SAP group (n = 151). Serum iron levels in the SAP group were significantly lower than those in the Non-SAP group (9.77± 5.61 vs 14.01± 6.80, P < 0.001). Logistic regression showed that patients with high serum iron levels (≥ 7.8μmol/L) showed a lower risk of SAP (OR=0.43, 95% CI, 0.27– 0.69, P < 0.001). Besides, the RCS model showed that there was an L-shaped relationship between the serum iron and risk of SAP (P for non-linearity: 0.014).
Conclusion: Low serum iron level was a risk factor for SAP, and there was an L-shaped relationship between them. Stroke patients with low serum iron levels should be alert to the risk of SAP.

Keywords: stroke, pneumonia, serum iron

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