2020, Number 3
<< Back Next >>
Finlay 2020; 10 (3)
Relationship between indicators of nutritional status and the development of pneumonia associated with ischemic stroke
Suárez QA, Álvarez AA, Pupo JJM, Berdú SJ, Hernández GME
Language: Spanish
References: 26
Page: 231-239
PDF size: 631.11 Kb.
ABSTRACT
Background:
malnutrition is a common problem among hospitalized patients. This disease causes severe consequences in the clinical course, increases the risk of infections, among which pneumonia highlight, mortality and hospital stay.
Objective:
to determine the possible association between the indicators of nutritional status at admission and the development of pneumonia associated with ischemic stroke.
Methods:
361 patients belonging to a prospective cohort study with the diagnosis of acute ischemic stroke, admitted consecutively to the stroke room, internal medicine and clinical intermediate therapy of the Carlos Manuel de Céspedes General University Hospital during the first 7 days were studied from their admission, since September 2016 to December 2018. Independent predictors of pneumonia associated with ischemic stroke were obtained using multivariate logistic regression.
Results:
out of 361 patients, the 21.9% developed stroke-associated pneumonia, atherothrombotic infarction was the most frequent etiological subtype. The 39.1% of the patients presented a certain degree of nutritional risk upon admission, the main factors identified were the global lymphocyte count <2300/mm3, followed by figures on admission of albumin <36 g / l, urea> 7 mmol / l and aspartate- aminotransferase> 25 U/L.
Conclusions:
the initial nutritional status, evaluated using the available nutritional status indicators, has an influence on the development of pneumonia in patients with ischemic stroke.
REFERENCES
Sacco RL, Kasner SE, Broderick JP, Caplan LR, Connors JJ, Culebras A, et al. An Updated Definition of Stroke for the 21st Century. Stroke. 2013;44(7):2064-89.
Katan M, Luft A. Global Burden of Stroke. Semin Neurol. 2018;38(2):208-11.
Kishore AK, Vail A, Chamorro A, Garau J, Hopkins SJ, Di Napoli M, et al. How is pneumonia diagnosed in clinical stroke research? A systematic review and meta-analysis. Stroke. 2015;46(5):1202-9.
Santos C, Pelosi P, Leme P, Macedo PR. Immunomodulation after ischemic stroke: potential mechanisms and implications for therapy. Crit Care. 2016;20(1):391.
González A, Mancha A, Rodríguez FJ, Culebras J, de Ulibarri JI. Confirming the validity of the CONUT system for early detection and monitoring of clinical under nutrition: comparison with two logistic regression models developed using SGA as the gold standard. Nutr Hosp. 2012;27(2):564-71.
Badjatia N, Monahan A, Carpenter A, Zimmerman J, Schmidt JM, Claassen J, et al. Inflammation, negative nitrogen balance, and outcome after aneurysmal subarachnoid hemorrhage. Neurology. 2015;84(7):680-7.
Agra RM, González R, Varela A, Gómez I, Kreidieh O, Conde P, et al. Nutritional status is related to heart failure severity and hospital readmissions in acute heart failure. In J Cardiol. 2017;230(1):108-14.
Sun X, Luo L, Zhao X, Ye P. Controlling Nutritional Status (CONUT) score as a predictor of all-cause mortality in elderly hypertensive patients: a prospective follow-up study. BMJ Open.2017;18(9):e015649.
Qi H, Yang X, Hao C, Zhang F, Pang X, Zhou, et al. Clinical value of controlling nutritional status score in patients with aneurysmal Subarachnoid Hemorrhage. World Neurosurg. 2019;3(1):1352-8.
Kimura Y, Yamada M, Kakehi T, Itagaki A, Tanaka N, Muroh Y. Combination of low body mass index and low serum albumin level leads to poor functional recovery in stroke patients. J Stroke Cerebrovasc Dis. 2017;26(2):448-53.
Makris K, Koniari K, Spanou L, Gialouri E, Evodia E, Lelekis M. Prognostic significance of serum albumin level changes in acute ischemic stroke: the role of biological and analytical variation. Clin Chem Lab Med. 2016;54(1):143-50.
Campos R, Palma S, García N, Plaza B, Bermejo L, Riobó P, et al. Assessment of nutritional status in the health care setting in Spain. Nutr Hosp. 2015;31(Suppl. 3):196-208.
León DO. Medicina Intensiva. Nutrición del paciente crítico. 1ªed. La Habana:ECIMED;2013.
Huynh DK, Selvanderan SP, Harley H, Holloway RH, Nguyen NQ. Nutritional care in hospitalized patients with chronic liver disease. World J Gastroenterol. 2015;21(45): 12835-42.
Kuroda D, Sawayama H, Kurashige J, Iwatsuki M, Eto T, Tokunaga R, et al. Controlling Nutritional Status (CONUT) score is a prognostic marker for gastric cancer patients after curative resection. Gastric Cancer. 2018;21(2):204-12.
Smith CJ, Kishore AK, Vail A, Chamorro A, Garau J, Hopkins SJ, et al. Diagnosis of Stroke-Associated Pneumonia Recommendations From the Pneumonia in Stroke Consensus Group. Stroke. 2015;46(8):2335-40.
Pardo AJ, Bermudo S, Manzano MV. Prevalencia y factores asociados a desnutrición entre pacientes ingresados en un hospital de media-larga estancia. Nutr Hosp. 2011;26(2):369-75.
Luque R. Casos clínicos SAEI de enfermedades infecciosas para residentes. Andalucía:Sociedad Andaluza de Enfermedades Infecciosas;2016[citado 23 Nov 2019]. Disponible en: Disponible en: http://www.saei.org/documentos/biblioteca/pdf-biblioteca-268.pdf .
Shim R, Wong CHY. Ischemia, Immunosuppression and Infection-Tackling the Predicaments of Post-Stroke Complications. Int J Mol Sci. 2016;17(1):64.
Shekhar S, Cunningham MW, Pabbidi MR, Wang S, Booz GW, Fan F. Targeting vascular inflammation in ischemic stroke: Recent development son novel immune modulatory approaches. Eur J Pharmacol. 2018;833(1):531-44.
Cieza JA, Casillas A, Da Fieno AM, Urtecho SB. Asociación del nivel de albúmina sérica y alteraciones de los electrolitos, gases sanguíneos y compuestos nitrogenados en pacientes adultos incidentes del servicio de emergencia de un hospital general. Rev Med Her[Internet]. 2016[citado 3 Sep 2019];27(1):[aprox. 7p.]. Disponible en:http://www.scielo.org.pe/pdf/rmh/v27n4/a05v27n4.pdf.
Hannawi Y, Hannawi B, VenkatasubbaRao CP, Suarez JI, Bershad EM. Stroke-Associated Pneumonia: Major Advances and Obstacles. Cerebrovasc Dis. 2013;35(5):430-43.
Bohl DD, Shen MR, Kayupov E, Della CJ. Hypoalbuminemia Independently Predicts Surgical Site Infection, Pneumonia, Length of Stay, and Readmission After Total Joint Arthroplasty. JArth.2016;31(1):15-21.
de Miguel J, Álvarez JL. Factores pronósticos en la neumonía adquirida en la comunidad. An Med Interna.2007;24(10):465-6.
Akhter S, Warraich UA, Ghazal S, Rizvi N. Assessment and comparison of APACHE II for prediction of inpatient mortality in Acute Exacerbation of Chronic Obstructive Pulmonary Disease. J Pak Med Assoc. 2019;69(2):211-15.
Álvarez H, Pérez E. El paciente con hipertransaminasemia. Rev Fac Med UNAM[Internet]. 2005[citado 24 Sep 2019];48(2):[aprox. 8p.]. Disponible en: https://www.medigraphic.com/pdfs/facmed/un-2005/un052e.pdf.