摘要
目的探讨院前合并症、意识水平、年龄、神经功能缺损(preadmission comorbidities,level of 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。
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.
作者
田蕊
王宇
张润华
房继明
郑华光
王蓬莲
王伊龙
王拥军
刘改芬
TIAN Rui1,2,3, WANG Yu1,2,3, ZHANG Run-Hua1,2,3, FANG Ji-Ming4, ZHENG Huan-Guang1,2,3, WANG Peng-Lian1,2,3, WANG Yi-Long1,2,3, WANG Yong-Jun1,2,3, LIU Gai-Fen1,2,3(1Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing 100050, China; 2China National Clinical Research Center for Neurological Diseases （NCRC-ND）, Beijing 100050, China; SCenter of Stroke, Beijing Institute for Brain Disorders, Beijing 100050, China; 4Institute for Clinical Evaluative Sciences, Toronto, Canada)
出处
《中国卒中杂志》
2018年第1期29-34,共6页
Chinese Journal of Stroke
基金
首都卫生发展科研专项项目(首发2016-1-2041)
北京市科技计划重大项目(D131100002313002)
重大慢性非传染性疾病防控研究(2017YFC1307702)
