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Risk Score to Predict Hospital-Acquired Pneumonia After Spontaneous Intracerebral Hemorrhage

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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; [3]Univ N Carolina, Dept Stat & Operat Res, Chapel Hill, NC USA; [4]Capital Med Univ, Beijing Tiantan Hosp, Tiantan Comprehens Stroke Ctr, 6 Tiantan Xili, Beijing 100050, Peoples R China
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关键词: cerebral hemorrhage forecasting pneumonia

摘要:
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.

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出版当年[2013]版:
大类 | 2 区 医学
小类 | 2 区 临床神经病学 2 区 外周血管病
最新[2023]版:
大类 | 1 区 医学
小类 | 1 区 临床神经病学 1 区 外周血管病
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出版当年[2012]版:
Q1 PERIPHERAL VASCULAR DISEASE Q1 CLINICAL NEUROLOGY
最新[2023]版:
Q1 CLINICAL NEUROLOGY Q1 PERIPHERAL VASCULAR DISEASE

影响因子: 最新[2023版] 最新五年平均 出版当年[2012版] 出版当年五年平均 出版前一年[2011版] 出版后一年[2013版]

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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
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