Clinical Research
Serum hypersensitive C-reactive protein predicts stroke-associated pneumonia in patients treated with intravenous thrombolysis
Meng Wang, Pengyu Gong, Ting Huang, Yukai Liu, Yingdong Zhang, Junshan Zhou, Min Lu
Published 2020-01-28
Cite as Int J Cerebrovasc Dis, 2020, 28(1): 44-49. DOI: 10.3760/cma.j.issn.1673-4165.2020.01.002
Abstract
ObjectiveTo investigate the predictive value of serum hypersensitive C-reactive protein (hs-CRP) for stroke-associated pneumonia (SAP) in patients with acute ischemic stroke (AIS) who received intravenous thrombolysis.
MethodsFrom May 2015 to April 2017, the clinical data of the patients with AIS treated with intravenous thrombolysis in Nanjing First Hospital were collected retrospectively. Multivariate logistic regression analysis was used to determine the independent risk factors for SAP in patients with AIS after intravenous thrombolysis. Receiver operating characteristic (ROC) curve and nomogram-based methods were used to analyze the predictive value of hs-CRP for SAP.
ResultsA total of 243 patients with AIS who received intravenous thrombolysis were included, and 63 (34.6%) of them had SAP. There were significant differences in age (P=0.006), leukocyte count (P=0.044), fasting blood glucose level (P=0.003), serum hs-CRP level (P=0.001), hs-CRP classification (P=0.001) and dysphagia rate (P=0.035) between the SAP group and non-SAP group. Multivariate logistic regression analysis showed that after adjusting for the confounding factors, taking the first quartile of serum hs-CRP level as a reference, the third quantile (odds ratio [OR] 18.790, 95% confidence interval [CI] 4.771-74.007; P=0.001) and the fourth quantile (OR 54.054, 95% CI 12.248-324.088; P=0.001) of hs-CRP were the independent predictors of SAP. The area under the ROC curve of the baseline serum hs-CRP level for predicting SAP was 0.805 (95% CI 0.742-0.868; P<0.001). When the optimal cut-off value of hs-CRP was 5.54 mg/L, the sensitivity and specificity of predicting SAP were 76.11% and 76.19%, respectively. The analysis of nomogram also showed that hs-CRP was an independent predictor of SAP (consistency index 0.862, 95% CI 0.738-0.986; P<0.001).
ConclusionsThe increased serum hs-CRP was an independent predictor of SAP in patients with AIS receiving intravenous thrombolysis, and had a higher predictive value.
Key words:
Stroke; Brain ischemia; Thrombolytic therapy; Pneumonia; C-reactive protein; Biomarkers
Contributor Information
Meng Wang
Department of Neurology, Nanjing First Hospital, Nanjing Medical University, Nanjing 210006, China
Pengyu Gong
Department of Neurology, Nanjing First Hospital, Nanjing Medical University, Nanjing 210006, China
Ting Huang
Department of Neurology, Nanjing First Hospital, Nanjing Medical University, Nanjing 210006, China
Yukai Liu
Department of Neurology, Nanjing First Hospital, Nanjing Medical University, Nanjing 210006, China
Yingdong Zhang
Department of Neurology, Nanjing First Hospital, Nanjing Medical University, Nanjing 210006, China
Junshan Zhou
Department of Neurology, Nanjing First Hospital, Nanjing Medical University, Nanjing 210006, China
Min Lu
Department of Neurology, Nanjing First Hospital, Nanjing Medical University, Nanjing 210006, China
