Background and Purpose-We aimed to develop a risk score (intracerebral hemorrhage-associated pneumonia score, ICH-APS) for predicting hospital-acquired stroke-associated pneumonia (SAP) after ICH. Methods-The ICH-APS was developed based on the China National Stroke Registry (CNSR), in which eligible patients were randomly divided into derivation (60%) and validation (40%) cohorts. Variables routinely collected at presentation were used for predicting SAP after ICH. For testing the added value of hematoma volume measure, we separately developed 2 models with (ICH-APS-B) and without (ICH-APS-A) hematoma volume included. Multivariable logistic regression was performed to identify independent predictors. The area under the receiver operating characteristic curve (AUROC), Hosmer-Lemeshow goodness-of-fit test, and integrated discrimination index were used to assess model discrimination, calibration, and reclassification, respectively. Results-The SAP was 16.4% and 17.7% in the overall derivation (n=2998) and validation (n=2000) cohorts, respectively. A 23-point ICH-APS-A was developed based on a set of predictors and showed good discrimination in the overall derivation (AUROC, 0.75; 95% confidence interval, 0.72-0.77) and validation (AUROC, 0.76; 95% confidence interval, 0.71-0.79) cohorts. The ICH-APS-A was more sensitive for patients with length of stay >48 hours (AUROC, 0.78; 95% confidence interval, 0.75-0.81) than those with length of stay <48 hours (AUROC, 0.64; 95% confidence interval, 0.55-0.73). The ICH-APS-A was well calibrated (Hosmer-Lemeshow test) in the derivation (P=0.20) and validation (P=0.66) cohorts. Similarly, a 26-point ICH-APS-B was established. The ICH-APS-A and ICH-APS-B were not significantly different in discrimination and reclassification for SAP after ICH. Conclusion-The ICH-APSs are valid risk scores for predicting SAP after ICH, especially for patients with length of stay >48 hours.
基金:
Ministry of Science and TechnologyMinistry of Education, Culture, Sports, Science and Technology, Japan (MEXT) [2006BA101A11]; Ministry of Health of the People's Republic of China [2009CB521905]; Nova Program of Beijing Science and Technology Commission [2008B30]
第一作者机构:[1]Capital Med Univ, Tiantan Hosp, Tiantan Comprehens Stroke Ctr, Beijing 100050, Peoples R China;[2]China Natl Clin Res Ctr Neurol Dis, Beijing, Peoples R China;
通讯作者:
通讯机构:[1]Capital Med Univ, Tiantan Hosp, Tiantan Comprehens Stroke Ctr, Beijing 100050, Peoples R China;[2]China Natl Clin Res Ctr Neurol Dis, Beijing, Peoples R China;[4]Capital Med Univ, Beijing Tiantan Hosp, Tiantan Comprehens Stroke Ctr, 6 Tiantan Xili, Beijing 100050, Peoples R China
推荐引用方式(GB/T 7714):
Ji Ruijun,Shen Haipeng,Pan Yuesong,et al.Risk Score to Predict Hospital-Acquired Pneumonia After Spontaneous Intracerebral Hemorrhage[J].STROKE.2014,45(9):2620-+.doi:10.1161/STROKEAHA.114.005023.
APA:
Ji, Ruijun,Shen, Haipeng,Pan, Yuesong,Du, Wanliang,Wang, Penglian...&Wang, Yongjun.(2014).Risk Score to Predict Hospital-Acquired Pneumonia After Spontaneous Intracerebral Hemorrhage.STROKE,45,(9)
MLA:
Ji, Ruijun,et al."Risk Score to Predict Hospital-Acquired Pneumonia After Spontaneous Intracerebral Hemorrhage".STROKE 45..9(2014):2620-+