Objective To evaluate the quality of acute ischemic stroke-associated pneumonia (AISAP) related
guidelines, and provide a reference for developing the clinical guidelines for AISAP scientifically
and systematically in China.
Methods According to the inclusion and exclusion criteria, the domestic and international AISAP
related guidelines searched in the database and websites were included in this study. All the
guidelines were evaluated for the quality according to the Appraisal of Guidelines for Research and
Evaluation Ⅱ (AGREE Ⅱ), and the similarities and differences among the recommendations of the
guidelines were analyzed.
Results A total of 8 guidelines were included, with 3 Chinese and 5 international ones. The total
scores of the six dimensions (scope and purpose, participants in the development of guidelines, rigor,
clarity and readability, applicability, and editorial independence) for all the guidelines were 100%,
39.58%, 60.18%, 36.46%, 41.67%, 56.25%, respectively. The Kappa values of the two evaluators
for the 8 guidelines were both equal to 0.75 (both P <0.05), with excellent consistency. The class of
recommendations of two guidelines was class A — Guidelines for the early management of patients
with acute ischemic stroke and Management of patients with stroke: identification and management of dysphagia , with the best quality; the class of five guidelines was class B, and the class of one Chinese
guideline was class C, with the worst quality. None of the included guidelines specially developed the
best practice recommendations for AISAP management.
Conclusions The overall quality of the foreign guidelines was relatively high, and the domestic
guidelines were inferior to the foreign ones in many aspects such as the rigor and editorial
independence. The biggest problem for the 8 guidelines was that they all did not consider the
wishes of the patients. The current domestic and international guidelines mainly focused on stroke
or swallowing, with no guideline specially for AISAP.
