Abstract:

Objective To explore the value of the preadmission comorbidities, level of consciousness, age, and focal neurologic deficit (PLAN) score in predicting the risk of stroke-associated pneumonia after ischemic stroke in China. Methods Patients who were eligible for inclusion criteria from China National Stroke Registry (CNSR) were screened. Their clinical data were collected and assessed by PLAN score. The predictive ability of the PLAN score on ischemic stroke-related pneumonia was analyzed. The receiver operating characteristic curve (ROC) and the area under curve (AUC) were applied to evaluate the identification capacity of PLAN. The calibration of the score was analyzed by using Hosmer-Lemeshow goodness-of-fit test. Results A total of 8909 patients (mean age, 65.4±12.3 years; female: 3410, 38.3%) from CNSR were included into the study. The proportion of patients with post-stroke pneumonia was 12% (1069/8909). The risk of post-stroke pneumonia increased with the increasing of PLAN score. The area under the ROC curve was 0.78 [95% confidence interval (CI) 0.79-0.83], and the P value of Hosmer-Lemeshow χ 2 test was 0.001. The area under the ROC curve was 0.79 (95%CI 0.77-0.81) in male, 0.77 (95%CI 0.75-0.80) in female, 0.77 (95%CI 0.75-0.80)in patients under 70 years old, and 0.73 (95%CI 0.71-0.75) in patients older than 70 years, respectively. Conclusion The PLAN score is a reliable tool to predict the risk of post-stroke pneumonia in Chinese ischemic stroke patients.

Key words: China National Stroke Registry; Ischemic stroke; Pneumonia; PLAN score

摘要：

目的 探讨院前合并症、意识水平、年龄、神经功能缺损（preadmission c omorbidities，l evel o f consciousness，age，and focal neurologic deficit，PLAN）评分对中国缺血性卒中相关性肺炎发生风险的 预测能力。 方法 从中国国家卒中登记研究（China National Stroke Registry，CNSR）中筛选符合入组条件的缺血 性卒中患者，采集临床信息并应用PLAN评分法对其评分，分析PLAN评分对缺血性卒中相关性肺炎的 预测能力。应用受试者工作特征曲线（receiver operating characteristic curve，ROC）及曲线下面积（area under curve，AUC）评价PLAN评分的辨别能力，应用Hosmer-Lemeshow法评价其校准能力。 结果 共纳入8909例缺血性卒中患者，平均年龄（65.4±12.3）岁，女性3410例（38.3%），合并肺炎 患者共1069例（12.0%）。随着PLAN评分增高，卒中相关性肺炎的发生风险也逐渐增高。PLAN评分预 测缺血性卒中相关性肺炎的ROC曲线下面积为0.78[95%可信区间（confidence interval，CI）0.77～0.80]， Hosmer-Lemeshow检验显示预测卒中后肺炎的显著性水平为0.001（P =0.001）。在男性中，ROC曲线下面 积为0.79（95%CI 0.77～0.81），在女性中，ROC曲线下面积为0.77（95%CI 0.75～0.80）；在70岁以下缺 血性卒中患者中，ROC曲线下面积为0.77（95%CI 0.75～0.80），在70岁及以上患者中，ROC曲线下面积为 0.73（95%CI 0.71～0.75）。

结论 PLAN评分法在中国缺血性卒中患者中能够较好地预测卒中相关性肺炎发生风险。

关键词: 中国国家卒中登记研究; 缺血性卒中; 肺炎; PLAN评分