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Predictors of pneumonia in patients with acute spontaneous intracerebral hemorrhage in Algarve, Southern Portugal

2022-10Journal article Restricted access
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dc.contributor.authorSoares, Rita
dc.contributor.authorFernandes, Adriana
dc.contributor.authorTaveira, Isabel
dc.contributor.authorMarreiros, Ana
dc.contributor.authorNzwalo, Hipólito
dc.date.accessioned2023-01-25T15:02:43Z
dc.date.available2023-01-25T15:02:43Z
dc.date.issued2022-10
dc.description.abstractIntroduction: Following the hyperacute phase of spontaneous intracerebral hemorrhage (SICH), the severest form of stroke, pneumonia emerges as the leading cause of morbidity and mortality. Prevention of stroke associated pneumonia (SAP) is fundamental to improve the prognosis of SICH patients. Aim: Identify clinical, sociodemographic and process of care factors associated with occurrence of SAP after SICH in Algarve, southern Portugal. Methods: Observational, retrospective study of community representative consecutive case series of patients with SICH admitted to the sole public hospital in the region. Logistic regression was used to identify predictors of SAP after SICH. Results: A total of 525 patients were included. The mean age was 71 ( +/- 13) years and 64% were men. SAP occurred in 165 (31.5%). Lower Glasgow Coma Scale score (GCS score): <= 8 (OR= 2.087; 95% CI= [1.027;4.424]; p = 0.042) and GCS 9-12 (OR= 1.775; 95% CI= [1.030;3.059]; p = 0.039); prolonged emergency room stay (OR= 8.066; 95%CI=[3.082;21.113]; p < 0.001) and hyperactive delirium (OR=2.860; 95% CI= [1.661;4.925]; p < 0.001) increased the likelihood of SAP. Being younger, = 59 years (OR= 0.391; 95% CI= [0.168; 0.911]; p = 0.029) and 60-71 years (OR= 0.389; 95% CI= [0.185; 0.818]; p = 0.013); and having less severe SICH/intracerebral hemorrhage score (ICH score) <= 2 (OR=0.601; 95% CI= [0.370; 0.975]; p = 0.039), decreased the risk of SAP. Conclusion: After SICH, SAP occurs in approximately a third of patients. Non preventable (admission severity, ageing) and potentially preventable (prolonged emergency room stay, hyperactive delirium) determine the occurrence of SAP. Intensification of preventive intervention in high-risk patients, delirium prevention and improvement of the process of care can potentially reduce the occurrence of SAP after SICH.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.doi10.1016/j.clineuro.2022.107387pt_PT
dc.identifier.eissn1872-6968
dc.identifier.urihttp://hdl.handle.net/10400.1/18930
dc.language.isoporpt_PT
dc.peerreviewedyespt_PT
dc.publisherElsevierpt_PT
dc.subjectPneumoniapt_PT
dc.subjectIntracerebral hemorrhagept_PT
dc.subjectProcess of carept_PT
dc.subjectRisk factorspt_PT
dc.titlePredictors of pneumonia in patients with acute spontaneous intracerebral hemorrhage in Algarve, Southern Portugalpt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.startPage107387pt_PT
oaire.citation.titleClinical Neurology and Neurosurgerypt_PT
oaire.citation.volume221pt_PT
person.familyNameMarreiros
person.familyNameNzwalo
person.givenNameAna
person.givenNameHipólito
person.identifier337064
person.identifier.ciencia-id9A12-9450-7051
person.identifier.ciencia-id2C1F-E4F3-2C79
person.identifier.orcid0000-0001-9410-4772
person.identifier.orcid0000-0002-1502-3534
person.identifier.ridAAG-3931-2020
person.identifier.scopus-author-id57194785077
person.identifier.scopus-author-id36057285600
rcaap.rightsrestrictedAccesspt_PT
rcaap.typearticlept_PT
relation.isAuthorOfPublicationc0a8e5da-26ae-42a8-ab04-fa4df4356375
relation.isAuthorOfPublication287f7d4e-5ad8-4794-b526-c61d32c00446
relation.isAuthorOfPublication.latestForDiscoveryc0a8e5da-26ae-42a8-ab04-fa4df4356375

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