To investigate the epidemiological characteristics of pulmonary infection secondary to intracerebral hemorrhage, to determine the risk factors and to analyze the prognosis.

The clinical data of 265 patients with cerebral hemorrhage in 5 general intensive care units (ICU) of three hospitals in Changshu, Jiangsu Province from January 2016 to December 2018 were collected, including general situation, neurological function related score, surgical intervention measures, mechanical ventilation, and indwelling time of various pipelines. Telephone follow-up was conducted to evaluate the outcome of neurological function 3 months after discharge, and statistical analysis was conducted.

Of the 265 patients, 180 (67.9%) patients had pulmonary infection during hospitalization, including 118 patients diagnosed with stroke-associated pneumonia (SAP). And 51 (19.2%) of 265 patients had sepsis during hospitalization. Compared with SAP patients, the duration of mechanical ventilation, central venous catheter indwelling time, and total hospital stay were longer in patients with non-SAP pulmonary infection, and the incidence of sepsis was higher, 50.0% (31/62) vs. 16.9% (20/118). The case fatality rate during hospitalization and the incidence of poor neurological outcomes at 3 months of patients with sepsis were 31.4%% (16/51) and 52.9% (27/51), respectively, higher than the 14.0% (30/214) and 36.9% (79/214) of patients without sepsis (P<0.05). The in-hospital case fatality rate of all patients in the study was 17.0% (45/265). The risk factors associated with case fatality rate were higher acute physiology and chronic health evaluation (APACHE Ⅱ) score at admission, lower Glasgow coma scale (GCS) score, non-SAP pulmonary infection, and sepsis (allP<0.05). The risk factors associated with poor neurological outcome at 3 months were higher APACHE Ⅱ at admission, lower GCS score at admission, and sepsis during hospitalization (allP<0.05).

The incidence of pulmonary infection after intracerebral hemorrhage in comprehensive ICU is high. High APACHE Ⅱ score, low GCS score, and being complicated by sepsis are main risk factors. And the long-term prognosis of neurological function is relatively poor.

Sepsis; Cerebral hemorrhage; Stroke-associated pneumonia; Prognosis