Abstract

ABSTRACT:
BACKGROUND:
The stroke patient is at risk of developing hospital acquired infection, with the lungs being especially vulnerable. Stroke associated pneumonia (SAP) occurring after two days of admission and is the most nosocomial infection seen in the medical wards , pneumonia is the major cause of morbidity and mortality after stroke .The establishment of an accurate diagnosis of stroke associated pneumonia remains problematic and yet there is still no accepted "gold standard" for diagnosis.
OBJECTIVE:
To determine the incidence and risk factors of stroke associated pneumonia.
METHODS:
This is prospective cohort study for 82 stroke patients admitted to medical wards .The study conduct from the 1st July 2009 to the 10th January 2010. Initially stroke diagnosed clinically and by CT scan. Theses cases are assessed after 48 hours after admission, full history, physical examination and investigations were done using clinical criteria (body temperature, WBC count and chest radiography ) for diagnosis of pneumonia.
RESULTS:
11(13.4%) patients developed stroke associated pneumonia from 82 stroke patients admitted to medical wards. Most patients who were developed pneumonia were older than patients who did not developed pneumonia . The incidence is higher in patient with infarction and older age groups than patients with hemorrhagic stroke and younger age groups, and there is no association between the disease and gender .The incidence of late onset is more common than early onset pneumonia. Presence of dysphagia was present in (81.8%) nasogastric tube in (72.7% ),unconsciousness(54.5%),tobacco ,vomiting (36.6%) and fit (27.2%) were found as an important risk factors .The mortality more in hemorrhagic(75%) than thrombotic stroke (14.3%).
CONCLUSION:
stroke associated pneumonia is an important cause of mortality. It is associated with older age, dysphagia , NG intubation ,coma ,vomiting and fit .Simple assessment of these variables could be used to identify patients at high risk of developing pneumonia after stroke.