Back to Journals » Neuropsychiatric Disease and Treatment » Volume 16

Value of Combination of the A2DS2 Score and IL-6 in Predicting Stroke-Associated Pneumonia

Authors Yang J, Dai Y, Zhang Z, Chen Y

Received 27 June 2020

Accepted for publication 7 September 2020

Published 9 October 2020 Volume 2020:16 Pages 2353—2359

DOI https://doi.org/10.2147/NDT.S268878

Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 4

Editor who approved publication: Dr Yuping Ning


Jun Yang,1 Yonghong Dai,1 Zuowen Zhang,2 Yue Chen3

1Department of Critical Care Medicine, Central Hospital of Jiangjin District, Chongqing 402260, People’s Republic of China; 2Department of Neurology, Central Hospital of Jiangjin District, Chongqing 402260, People’s Republic of China; 3Department of Rehabilitation, Central Hospital of Jiangjin District, Chongqing 402260, People’s Republic of China

Correspondence: Yue Chen
Department of Rehabilitation, Central Hospital of Jiangjin District, Chongqing Dingshan Street, Jiangjin District, Chongqing 402260, People’s Republic of China
Tel +86-15823491696
Email wenlinlin0606@163.com

Purpose: To evaluate the value of the combination of the age, atrial fibrillation, dysphagia, male sex, and National Institutes of Health Stroke Scale (A2DS2) score and serum interleukin 6 (IL-6) concentration in predicting stroke-associated pneumonia (SAP).
Patients and Methods: A total of 398 patients with acute ischemic stroke (AIS) from the medical ward was included in this retrospective study. They were divided into the SAP group and non-SAP group according to the diagnostic criteria of SAP. Multivariate analysis was performed to analyze the association between the A2DS2 score, serum IL-6 concentration, and SAP using a backward stepwise logistic regression model. The receiver operating characteristic (ROC) curve was used to evaluate the value of the A2DS2 score, serum IL-6 concentration and combination of A2DS2 score and IL-6 in predicting SAP.
Results: SAP was diagnosed in 70 patients (17.6%). Multivariate analysis showed that the A2DS2 score (odds ratio [OR]: 2.25, 95% confidence interval [CI]: 1.17– 4.99, P=0.017) and serum IL-6 concentration (OR: 1.76, 95% CI: 1.44– 1.95, P< 0.001) was independently associated with SAP after adjusting for age, smoking, hypertension, hyperlipidemia, and atrial fibrillation. When the A2DS2 score, serum IL-6 concentration and combination of A2DS2 score and IL-6 were employed to predict SAP, the AUC was 0.824 (SE: 0.026, 95% CI: 0.773– 0.875), 0.715 (SE: 0.034, 95% CI: 0.641– 0.788) and 0.917 (SE: 0.015, 95% CI: 0.887– 0.946), respectively. The AUC of combinative prediction was significantly higher than independent prediction (0.917 vs. 0.824, Z=3.098, P< 0.001; 0.917 vs. 0.715, Z=5.436, P< 0.001).
Conclusion: The addition of serum IL-6 to the A2DS2 score could significantly enhance the AUC of predicting SAP in AIS patients from the medical ward.

Keywords: stroke-associated pneumonia; SAP, A2DS2 score, interleukin 6, multivariate analysis, receiver operating characteristic curve; ROC

Creative Commons License This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution - Non Commercial (unported, v3.0) License. By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms.

Download Article [PDF]  View Full Text [HTML][Machine readable]